New Guidelines Recommend GLP-1 Medications for Targeted Obesity Complications
Recent guidelines are shaping how obesity and its related health issues are treated, with a focus on utilizing medications like semaglutide and tirzepatide – drugs belonging to the GLP-1 agonist class – in a more targeted manner. Dr.Andreea ciudin of Vall d’Hebron University Hospital in Barcelona, a co-author of the guidelines, emphasized that while these recommendations are valuable, they shouldn’t replace a doctor’s comprehensive clinical judgment.
The guidelines, developed after analyzing clinical trial data on weight loss, safety, and effectiveness in the presence of specific complications, suggest specific drugs as first-line treatments for particular conditions. For patients suffering from obstructive sleep apnea due to excess adipose tissue, tirzepatide is recommended. Semaglutide is suggested for those experiencing knee osteoarthritis.
Beyond addressing the physical consequences of obesity, the guidelines also offer recommendations for conditions linked to metabolic and immune dysfunction. Semaglutide is favored for individuals with a history of heart disease or stroke. Tirzepatide is recommended for those with non-alcoholic fatty liver disease, while either tirzepatide or semaglutide can be used for patients with prediabetes or type 2 diabetes. It’s crucial to note that these drugs were originally developed to manage type 2 diabetes.
The authors acknowledge the high cost of these medications and stress that the long-term costs of not treating obesity – allowing it to progress and cause organ damage – should be equally considered in healthcare decisions.
The guidelines also highlight that obesity management should extend beyond weight loss and complication treatment, encompassing improvements in mental well-being, physical fitness, social functioning, and overall quality of life. While many newer medications haven’t been specifically tested for individual complications, the observed weight loss has consistently correlated with improvements in various health issues. Researchers believe these drugs may positively impact conditions like chronic kidney disease, neurodegenerative diseases, polycystic ovary syndrome, certain cancers, and mental health conditions.
Professor Volkan Yumuk, President of the European Association for the Study of Obesity (EASO), stated the institution plans to regularly update the treatment algorithm to reflect the rapidly evolving research in obesity medications.
However, other organizations caution that medication alone isn’t enough. The American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The obesity Society jointly advised in June that GLP-1 treatment must be combined with nutritional and lifestyle interventions. They point to potential challenges with GLP-1s, including gastrointestinal side effects, nutrient deficiencies, muscle and bone loss, high costs, discontinuation, and weight regain, highlighting the need for a holistic approach.
