Section 3.2 When to Initiate Pharmacotherapy

Key Points

  • Weight-loss medications should be considered when obesity-related complications can be ameliorated by weight loss.
  • Pharmacotherapy should always be combined with lifestyle therapy, never used alone.

AACE/ACE Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity Recommendation1

  • R76. Pharmacotherapy for overweight and obesity should be used only as an adjunct to lifestyle therapy and not alone.
  • R77. The addition of pharmacotherapy produces greater weight loss and weight-loss maintenance compared with lifestyle therapy alone.
  • R78. The concurrent initiation of lifestyle therapy and pharmacotherapy should be considered in patients with weight-related complications that can be ameliorated by weight loss.
  • R79. Pharmacotherapy should be offered to patients with obesity, when potential benefits outweigh the risks, for the chronic treatment of the disease. Short-term treatment (3 to 6 months) using weight-loss medications has not been demonstrated to produce longer-term health benefits and cannot be generally recommended based on scientific evidence.

Reference

  1. Garvey WT, Mechanick JL, Brett EM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients With Obesity. Endocr Pract. 2016;22(suppl 3);1-205.