Background Obesity is a chronic relapsing condition Management Pharmacotherapy Semaglutide (Ozempic)
GLP-1 analogue, so essentially sends a satiety signal
Target dose of 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
