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International Journal of Nutrology
Articles
DOI: 10.1055/s-0040-1705257
Submitted: 02-06-2022
Published: 02-06-2022

Liraglutideas Adjunct Therapy in the Management of Obesity

Associate Professor of Medicine, Clinical Research Director Texas Diabetes Institute
Professor of Nutrology Padre Albino School of Medicine/FAMECA/SP / Director of Brazilian Association of Nutrology Obesity Department/ABRAN / Titular Member of the Nutrology Technical Chamber Medicine Council/CREMESP-SP
Obesity GLP-1 RA Liraglutide Pre-Diabetes

Abstract

The obesity epidemic has reached a new level with some impressive numbers recently published in the United States of America. Even more alarming is the rapid increase in childhood obesity, which has been universally documented over the past few decades. The reasons underlying the problem of obesity can be simplified into three categories: i) routine consumption of bigger portion size meals; ii) confusing messages from food industry to consumers; and iii) physical inactivity is the “new normal”. Considering that the medical consequences of obesity are serious and directly affect morbidity and mortality, it has become necessary to act concomitantly to prevent and treat the increase in body weight and fat excess accumulation. The prevention of obesity is a formidable task that can only be accomplished with a concerted effort put together by several governmental agencies, especially those interested in agriculture, health and education, the food industry and health care providers, including physicians and nutrition specialists. Treatment of obesity with behavioral management, nutritional manipulations (“diets”) and, even bariatric surgery has had some success, but these strategies are accompanied by limited benefits and only to a select group of individuals. More importantly, the overall impact of these on the growing obesity pandemic is disappointing, at best. Some dietary recommendations with caloric restriction and adjustments in nutrient intake combined to pharmacotherapy have expanded our ability to manage obese patients.The recent approval by the U.S. Food and Drug Administration (FDA) agency of the Glucagon-Like-Peptide-1 (GLP-1) receptor analog liraglutide, at the dose of 3.0 mg once daily, has provided us with an additional tool to combat the disease and minimize its complications. In this particular study, a significant reduction in the conversion ratesfrom pre-diabetes to diabetes was also shown and represents an important findingof the trial. Despite the fact that nausea, vomiting and diarrhea were frequently reported during the 1-year period of observation, tolerance was acceptable and most subjects completed the study.These data clearly indicate that combination drug therapy with dietary adjustments can be successful in promoting weight reduction and further support routine utilization of adjuvant pharmacotherapy in the management of obesity.

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References

  1. Obesity in America. www.publichealth.org/public-awareness, consulted in August 2015.
  2. Ogden CL, Caroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014; 311 (8): 806-14.
  3. Razak F, Arnad SS, Shannon H, et al. Defining obesity cut points in a multiethnic population. Circulation 2007; 115:2111-8.
  4. National Health and Nutrition Examination Survey. Obesity and Socioeconomic Status in Adults; United States, 2005-2008. NHCS Data Brief No 50, December 2010.
  5. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox and impact of weight loss. J Am Coll Cardiol. May 2009; 26: 53 (21): 1925-32.
  6. Mathew B, Francis L, Kayalar A, Cone J. Obesity: effects on cardiovascular disease and its diagnosis. J Am Board Fam Med. 2008; 21(6):462-8.
  7. Ludka O, Konecny T, Somers V, Massumi A. Sleep Apnea, Cardiac Arrhythmias and Sudden Death. Tex Heart Inst. J. 2011; 38(4):34-43.
  8. Marchesini G, Natale S, Tiraferri F, Tartaglia A, Moscatiello S, Marchesini RL, Villanova N. Forlani G, Melchionda N. The burden of obesity on everyday life: a role for osteoarticular and respiratory diseases. Diabetes Nutr Metab. 2003; 16(5-6):284-90.
  9. Vaidya V. Psychosocial aspects of obesity. Ad. Psychosom. Med. 2006; 27:73-85.
  10. Jiang J, Ahn J, Huang WY, Hayes RB. Association of obesity with cardiovascular disease mortality in the PLCO trial. Prev Med. Jul 2013; 57 (1):60-4.
  11. Golan M. Parents as agents of change in childhood obesity –from research to practice. International J. Ped Obesity 2006; 1(2): 66-76.
  12. Tate DF, Jackvony EH, Wing RR. Effect of internet behavioral counseling on weight loss in adults a risk for type 2 diabetes: a randomized trial. JAMA 2003; 289: 1833-36.
  13. Shai I, Schwartzfuchs D, Henkin Y, et al. Dietary Intervention Randomized Controlled Trial (DIRECT) Group. Weight loss with a low-carbohydrate, Mediterranean or low-fat diet. N Engl J Med. 2008; 359: 229-41.
  14. Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight loss diets with different compositions of fat, protein and carbohydrates. N Engl J Med. 2009; 360: 859-73
  15. Golay A, Eigenheer C, Morel Y, Kujawski P, Lehman T, de Tonnac MN. Weight loss with low or high carbohydrate diet? Int J Obes Relat Metab Disord. 1996; 20: 1067-72.
  16. De Fronzo RA, Triplitt C, Abdul-Ghani M, Cersosimo E. Novel Agents for the Treatment of Type 2 Diabetes. Diabetes Spectrum, May 2014; (2):100-12.
  17. MacLean PS, Higgins JA, Wyatt HR, et al. Regular exercises attenuates the metabolic drive to regain weight after long-term weight loss. Am J Physiol Regula Integr. Comp Physiol. 2009; 297:R793-R802.
  18. Sjostrom L, Narbro K, Sjostrom CD. Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007; 357:741-52.
  19. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366:156-76.
  20. Sjostrom L, Peltonen M, Jacobson P, et al. Bariatric Surgery and long-term cardivascular events. JAMA 2012; 307: 56-65.
  21. Rosenbaum M, Goldsmith R, Bloomfield D, et al. Low-dose leptin reverses skeletal muscle, autonomic and neuroendocrine adaptations to maintenance of reduced weight. J Clin Invest2005; 115:357-86.
  22. Wadden TA, Berkowitz RI, Womble LG, et al. Randomized trial of lifestyle modifications and pharmacotherapy for obesity. New Engl J Med 2005; 353: 2111-20.
  23. Smith SR, Aronne LJ, Burns CM, Kesty NC, Halseth Ae, Weyer C. Sustained weight loss following 12-month pramlintide treatment as an adjunct to lifestyle intervention in obesity. Diabetes Care 2008; 31:1816-23.
  24. Kim GW, Lin JE, Blomainn ES, Waldman SA. Anti-obesity pharmacotherapy; new drugs and emerging targets. Clin Pharmacol Ther. 2014; 95:53-66.
  25. Pi-Sunyer X, Astrup A, Fujioka K, et.al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med 2015; 373:11-22.
  26. Cersosimo E, Gastaldelli A, Cervera A, et al. Effect of exenatide on splanchnic and peripheral glucose metabolism in type 2 diabetic subjects. J Clin Endo Metab. 2011; 96:1763-70.
  27. Daniele G, Iozzo P, Molina-Carrion M, et al. Exentaide increases brain glucose metabolism except inhypothalamus. Diabetes 2015; June 26, pi: db 141718 [Epub ahead of print].
  28. Knowler WC, Barrett-Connor E, Fowler SE, et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346:393-403.
  29. Chiasson JL, Josse RG, Gomis R, et al. STOP-NIDDM Trial Research Group. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomized trial. Lancet 2002; 359:2072-77.
  30. Buchanan TA, Xiang AH, Peters RK, et al. Preservation of beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk Hispanic women. Diabetes 2002; 51:2796-2803.
  31. DeFronzo RA, Tripathy D, Dawn C, et al. Pioglitazone for diabetes prevention in impaired glucose tolerance. N Engl J Med 2011; 364:1104-15.
  32. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-Analyses: surgical treatment of obesity. Ann Intern Med 2005; 142: 547-59.

How to Cite

Cersosimo, E., & Ribas Filho, D. (2022). Liraglutideas Adjunct Therapy in the Management of Obesity. International Journal of Nutrology, 8(4), 78–84. https://doi.org/10.1055/s-0040-1705257