Obesity: Difference between revisions
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* [[Semaglutide]] (Ozempic) |
* [[Semaglutide]] (Ozempic) |
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**GLP-1 analogue, so essentially sends a satiety signal |
**GLP-1 analogue, so essentially sends a satiety signal |
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**''Not'' the oral version; the subcut version is required for it to cross the blood-brain barrier and have the desired effect |
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**Target dose |
**Target dose is 2.4 mg/week (higher than for diabetes) |
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** In STEP 4 trial, lost 8% of body weight, with decreased waist circumference and blood pressure, up to 48 weeks |
** In STEP 4 trial, lost 8% of body weight, with decreased waist circumference and blood pressure, up to 48 weeks |
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** GI side effects are common |
** GI side effects are common |
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Latest revision as of 19:49, 14 October 2021
Background
- Obesity is a chronic relapsing condition
Management
Pharmacotherapy
- Semaglutide (Ozempic)
- GLP-1 analogue, so essentially sends a satiety signal
- Not the oral version; the subcut version is required for it to cross the blood-brain barrier and have the desired effect
- Target dose is 2.4 mg/week (higher than for diabetes)
- In STEP 4 trial, lost 8% of body weight, with decreased waist circumference and blood pressure, up to 48 weeks
- GI side effects are common
- In the future, look out for combination treatment with GIP analogues
- Bupropion/Naltrexone (Contrave)
- Bupropion stimuates POMC cells, suppressing appetits, and naltrexone blocks β-endorphin negative feedback loop which would otherwise prevent bupropion from having its intended effect
- About 30% of patients lost 10% body weight
- Orlistat
- Poorly tolerated due to diarrhea
- Bariatric surgery
