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Obesity Epidemic: A Case Study

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Unfortunately, obesity’s prevalence is showing an exponentially increasing trend. In the United States, two out of three adults are overweight or obese; likewise, one out of three children are considered overweight or obese.1 The obesity epidemic is a cause of great concern for the nation’s overall health because it is the foundation for secondary diseases such as hypertension, high cholesterol, type two diabetes, and osteoarthritis. As obesity continues throughout a patient’s life, the secondary diseases are expected to increase in prevalence and severity. Many of the secondary diseases can be reversed with weight loss.
It is important to distinguish the difference between patients who are obese and those who are overweight. Overweight …show more content…
Success is only seen in patients who are able to change bad eating habits while increasing physical activity.1Those who seek pharmacologic therapy will often regain the weight if no lifestyle changes were established before starting therapy. All pharmacological therapies should be used when lifestyle changes are not sufficient and at least one comorbid condition is present. Long-term drugs include Orlistat, Locaserin, and Phentermine-Topiramate extended release. Orlistat works by inhibiting lipase, causing a decrease in absorbable fats. Patients taking Orlistat’s over-the-counter (60-mg) option or prescription strength (120-mg) taken three times a day following meals have seen modest weight loss. Lorcaserin is a selective serotonin agonist targeting the 5-HT2C receptor. Stimulation of this receptor causes appetite suppression; however, stimulation of the 5-HT2B has been reported. Therefore, patients with heart failure should avoid this drug. Finally, phentermine-topiramate works by increasing norepinephrine and dopamine, which helps control the patient’s appetite. With all seizure medications, a titration and tapering dose is required to protect the patient. This medication is also contraindicated in patients who have glaucoma, hyperthyroidism, or are pregnant. This medication can also affect heart rate and electrolyte levels, and both should be monitored throughout therapy. With all …show more content…
When analyzing body weight, 92% of patients taking liraglutide saw a reduction in weight. In the control group, 65% saw a decrease in body weight. With such a significant number of the patients seeing a reduction in weight within the placebo, it is possible that the lifestyle intervention could have had a greater impact on weight loss than expected. However, sensitivity analyses did confirm liraglutide was more effective at reducing weight compared to the placebo. A decrease of 8 kg in the treatment group compared to 2.6 kg in the placebo was found. Approximately 63.2% and 33.1% of the treatment group saw a 5% and 10% loss of body weight, respectively, and 27.1% and 10% of the placebo group saw the same results, respectively. One note of importance was the decrease in efficacy with liraglutide in aiding with weight loss in patients displaying a BMI of 40 or greater. However, a statistically significant decrease in BMI and WC was still seen, a decrease of 3 kg/m2 and 8.2 cm (P-value < 0.001),

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