Pharmacy Magazine recently hosted a webinar in partnership with Novo Nordisk on Understanding obesity management with Saxenda which provided pharmacists with comprehensive insights into the management and treatment of obesity. This is a summary of the key points covered.
RECOGNISING OBESITY AS A CHRONIC DISEASE
Obesity is acknowledged as a chronic, relapsing, and progressive disease that necessitates immediate action for effective prevention and control. It is associated with multiple health complications, including diabetes, cardiovascular diseases, and certain cancers.
THE ROLE OF THE BRAIN IN APPETITE REGULATION
The brain's unique three-layer appetite system regulates eating behaviour through homeostatic (hunger-driven) and hedonic (pleasure-driven) eating, influenced by endocrine signals and the brain's reward system.
OBESITY MANAGEMENT GUIDELINES
The webinar provided guidelines on managing obesity, classifying it based on BMI and waist circumference. Pharmacotherapy options like Saxenda (liraglutide), Naltrexone/bupropion, and Orlistat were discussed for their efficacy and safety.
GLOBAL TRENDS AND SCREENING
Global trends indicate increasing obesity prevalence. The importance of waist circumference and other measurements like DEXA, CT, and MRI in assessing health risks was emphasised.
BEHAVIORAL INTERVENTIONS
Behavioural interventions, including cognitive behavioural therapy and counselling, were highlighted as effective for sustainable weight management. Surgical and endoscopic interventions also offer significant weight loss.
STRUCTURED APPROACH TO OBESITY MANAGEMENT
A structured approach involves asking for permission to discuss weight, assessing patient history, agreeing on treatment plans and goals, advising on treatment options, and assisting with long-term management.
CANADIAN CLINICAL PRACTICE GUIDELINES
The guidelines recommend an empathetic approach in discussing weight, assessing patient stories, advising on management options, and agreeing on realistic goals.
COMPREHENSIVE HISTORY AND SCREENING
A detailed history to identify root causes of weight gain, blood pressure measurement, fasting glucose or HbA1c levels, lipid profile, and screening for non-alcoholic fatty liver disease (NAFLD) were recommended.
EDMONTON OBESITY STAGING SYSTEM (EOSS)
EOSS helps determine obesity severity and guide clinical decision-making. The American Association of Clinical Endocrinologists (AACE) guidelines recommend lifestyle therapy, pharmacotherapy, and bariatric surgery based on BMI and complications.
GLP-1 AND SAXENDA
GLP-1 and its receptor agonists (GLP-1RAs) were discussed for appetite regulation. Saxenda (liraglutide), a GLP-1 analogue, showed significant weight loss in clinical trials and improved health outcomes.
TRIALS AND FINDINGS
The webinar reviewed clinical trials showing Saxenda's effectiveness in achieving weight loss. The ACTION IO study indicated that sustained long-term weight loss is challenging due to adaptive biological responses.
COMPREHENSIVE CARE APPROACH
Pharmacotherapy, combined with lifestyle interventions, can effectively manage obesity. Proper obesity care in clinical settings helps achieve sustained weight loss and improves quality of life.
The summary reflects critical takeaways for pharmacists managing obesity, emphasising the integration of behavioural, pharmacological, and clinical strategies for effective patient care.
Be sure to watch the webinar replay to learn about pharmacotherapy intervention and the role of Saxenda in managing obesity as a chronic disease.