3. UNINTENTIONAL WEIGHT GAIN - RED FLAG
SYMPTOMS
• The patient may be unaware of weight gain so
previous weight data can frame the consultation
and your concerns.
14. MOST COMMON MEDICATIONS USED IN
TREATING OBESITY
• Currently there is a list of medications used for pharmacological treatment , however, there is
no enough evidence regarding the efficacy of different drugs, the benefit of combination
therapy, weight regain after withdrawal of medications or the benefits of continuing treatment
beyond 1 year.
However, the following are recommended
Consider adding pharmacologic agent with lifestyle interventions on an individual case basis after assessment of
risks and benefits:
- In obese adults (BMI ≥30 kg/m2) who failed to achieve or maintain weight loss with lifestyle modification program.
- In obese or overweight individuals (BMI ≥28 kg/m2 with co-morbidities) to assist in reducing obesity-related co-
morbidities, like type 2 diabetes, impaired glucose tolerance or the risk factors for type 2 diabetes .
- In pre-pubertal obese children Pharmacological therapy is generally not recommended, however, it can be
considered only (treatment with Orlistat) under supervision of specialized team, if severe co-morbidities are
present, e.g. orthopedic problems, sleep apnea, severe psychological disease or within the context of a supervised
clinical trial
15. PHARMACOLOGICAL TREATMENT:
• • Discuss with the patient the potential benefits, limitations, drug’s side effects, and the
temporary nature of the weight loss achieved with medications before initiating therapy
• • Discontinue use if the drug is ineffective, or if there are serious adverse effects
17. 1. saxenda (liraglutide ) in FHx of thyroid
cancer or multiple endocrine neoplasia
2. Xenical (orlistat) in cholestasis and chronic
malabsorption syndrome
3. belviq (lorcaserin)
https://www.aafp.org
18. BARIATRIC SURGERY
• Consider Bariatric surgery as part of an overall clinical pathway for adult weight management.
• Consider bariatric surgery on an individual case basis after assessing the risks and benefits .
• • Consider bariatric surgery:
• - In adults with clinically severe obesity (BMI > 40 kg/m2 ). It is the most effective treatment for
morbid obesity, it leads to durable weight loss and improvement of co-morbidities
• - In adults with BMI > 35 kg/m2 and severe co-morbidities .
http://www.sages.org/publications/guidelines/guidelines-for-clinical-application-of-laparoscopic-bariatric-surgery/
Canadian clinical practice guidelines on the management and prevention of obesity in adults and children. CMAJ April 10, 2007 vol. 176 no. 8 doi: 10.1503/ cmaj.061409
Scottish Intercollegiate Guidelines Network (SIGN). Management of obesity: A national clinical guideline. Edinburgh: SIGN; 2010. http://www.sign.ac.uk/pdf/sign115.pdf.
19. BARIATRIC SURGERY
• • Consider bariatric surgery:
• - In adults with BMI > 30 kg/m2 who have poorly controlled type 2 diabetes and are at increased
cardiovascular risk .
• - In post pubertal adolescents with very severe to extreme obesity and severe co-morbidities .
Scottish Intercollegiate Guidelines Network (SIGN). Management of obesity: A national clinical guideline. Edinburgh: SIGN; 2010. http://www.sign.ac.uk/pdf/sign115.pdf.
Australian Government: Department of Health and Aging. Clinical Practice Guidelines for the Management of overweight and obesity in adults, adolescents and children in Australia
http://www.healthyactive.gov.au/internet/main/publishing.nsf/Content/obesityguidelines-guidelines-adults.htm .
20. COMMON TYPES OF BARIATRIC
SURGERY
Sleeve Gastrectomy
Laparoscopic adjustable
gastric banding
بالمنظار للتعديل قابل المعدة ربط
المعدة تكميم
Gastric bypass
المعدة تجاوز
https://www.moh.gov.sa/OCP
23. REFERENCE :
• https://www.moh.gov.sa/OCP
• https://www.aafp.org
• Scottish Intercollegiate Guidelines Network (SIGN).
Management of obesity: A national clinical guideline.
• Australian Government: Department of Health and
Aging. Clinical Practice Guidelines for the Management
of overweight and obesity in adults, adolescents and
children in Australia
• sages - guidelines-for-clinical-application-of-
laparoscopic-bariatric-surgery
• Canadian clinical practice guidelines on the
management and prevention of obesity in adults and
children.