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- May 17, 2008 |
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Welcome to the #1 online source of information for Diabetes Specialists! An international online community of more than 10,000 Diabetes Specialists.
CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
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"Pharmacotherapy for Obesity"Dr. David Lau (biography)
English - 2006-05-26 - 82 minutes
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 | (40 slides) |
 | (55 slides) |
Summary :
According to data from Statistics Canada the majority of adults in Canada are overweight or obese, and not only that but as a study reported in the Canadian Medical Association Journal in 2000 indicated, the childhood obesity rates have been climbing as well (1).
Obesity is known to be associated with a number of medical complications, and with respect to the metabolic co-morbidities, three-quarters of people with a BMI of 30 or more already have one or more of them, according to findings from NHANES III. The time to intervene is not when the person is obese but when the person is overweight says Dr. Lau. Visceral fat in particular is considered to be the "ugly" fat as the processes occurring in this depot lead to changes that result in increased cardiometabolic risk (2).
Lifestyle intervention is the cornerstone of obesity management however there is a role for pharmacotherapy as an adjunct. Dr. Lau talks about optimal weight loss goals and pharmacological therapy for obesity to inhibit absorption, enhance satiety and reduce appetite.
In closing Dr. Lau reviews some recommendations from the evidence-based clinical practice guidelines on the management and prevention of obesity that are expected to be released later in the year.
Copyright © 2006 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation, participants will be able to discuss:
- The emerging dual epidemics of obesity and type 2 diabetes
- The role of abdominal adiposity in metabolic co-morbidities
- Current and future pharmacotherapy for obesity
- Implications of CPGs in the treatment and prevention of obesity
Bibliographic references :
1. Mark S. Tremblay and J. Douglas Willms Secular trends in the body mass index of Canadian children CMAJ. 2000 Nov 28;163(11):1429-33
2. Lau DC, Yan H, Dhillon B. Metabolic syndrome: A marker of patients at high cardiovascular risk Can J Cardiol. 2006 Feb;22 Suppl B:85B-90B.
Further reading:
Alison E. Field, ScD; Eugenie H. Coakley; Aviva Must, PhD; Jennifer L. Spadano, MA; Nan Laird, PhD; William H. Dietz, MD, PhD; Eric Rimm, ScD; Graham A. Colditz, MD, DrPH Impact of Overweight on the Risk of Developing Common Chronic Diseases During a 10-Year Period Arch Intern Med. 2001;161:1581-1586
Yong-Woo Park, MD, PhD; Shankuan Zhu, MD, PhD; Latha Palaniappan, MD; Stanley Heshka, PhD; Mercedes R. Carnethon, PhD; Steven B. Heymsfield, MD The Metabolic Syndrome: Prevalence and Associated Risk Factor Findings in the US Population From the Third National Health and Nutrition Examination Survey, 1988-1994 Arch Intern Med. 2003;163:427-436
Vincent J. Carey, Ellen E. Walters, Graham A. Colditz, Caren G. Solomon, Walter C. Willet, Bernard A. Rosner, Frank E. Speizer and JoAnn E. Manson Body Fat Distribution and Risk of Non-Insulin-dependent Diabetes Mellitus in Women: The Nurses' Health Study American Journal of Epidemiology Vol. 145, No. 7: 614-619
Lau DC, Dhillon B, Yan H, Szmitko PE, Verma S. Adipokines: molecular links between obesity and atheroslcerosis Am J Physiol Heart Circ Physiol 288: H2031-H2041, 2005
Jean-Pierre Després, professor, Isabelle Lemieux, PhD student, Denis Prud'homme, professor Treatment of obesity: need to focus on high risk abdominally obese patients BMJ 2001;322:716-720
Sjostrom L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients Lancet. 1998 Jul 18;352(9123):167-72
Hollander PA, Elbein SC, Hirsch IB, Kelley D, McGill J, Taylor T, Weiss SR, Crockett SE, Kaplan RA, Comstock J, Lucas CP, Lodewick PA, Canovatchel W, Chung J, Hauptman J. Role of orlistat in the treatment of obese patients with type 2 diabetes. A 1-year randomized double-blind study Diabetes Care. 1998 Aug;21(8):1288-94
James WP, Astrup A, Finer N, Hilsted J, Kopelman P, Rossner S, Saris WH, Van Gaal LF. Effect of sibutramine on weight maintenance after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance Lancet. 2000 Dec 23-30;356(9248):2119-25
Thomas A. Wadden, Ph.D., Robert I. Berkowitz, M.D., Leslie G. Womble, Ph.D., David B. Sarwer, Ph.D., Suzanne Phelan, Ph.D., Robert K. Cato, M.D., Louise A. Hesson, M.S.N., Suzette Y. Osei, M.D., Ph.D., Rosalind Kaplan, M.D., and Albert J. Stunkard, M.D. Randomized Trial of Lifestyle Modification and Pharmacotherapy for Obesity N Engl J Med. 2005 Nov 17;353(20):2111-20
Zhaoping Li, MD, PhD; Margaret Maglione, MPP; Wenli Tu, MS; Walter Mojica, MD; David Arterburn, MD, MPH; Lisa R. Shugarman, PhD; Lara Hilton, BA; Marika Suttorp, MS; Vanessa Solomon, MA; Paul G. Shekelle, MD, PhD; and Sally C. Morton, PhD Meta-Analysis: Pharmacologic Treatment of Obesity Ann Intern Med 2005; 532-546
Diabetes Prevention Program Research Group Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin N Engl J Med. 2002 Feb 7;346(6):393-403
Steven B. Heymsfield, MD; Andrew S. Greenberg, MD; Ken Fujioka, MD; Russell M. Dixon, MD; Robert Kushner, MD; Thomas Hunt, MD; John A. Lubina, PhD; Janet Patane, MPH; Barbara Self, MPH; Pam Hunt, PhD; Mark McCamish, PhD, MD Recombinant Leptin for Weight Loss in Obese and Lean Adults : A Randomized, Controlled, Dose-Escalation Trial JAMA. 1999;282:1568-1575
David E. Cummings, M.D., David S. Weigle, M.D., R. Scott Frayo, B.S., Patricia A. Breen, B.S.N., Marina K. Ma, E. Patchen Dellinger, M.D., and Jonathan Q. Purnell, M.D. Plasma Ghrelin Levels after Diet-Induced Weight Loss or Gastric Bypass Surgery N Engl J Med. 2002 May 23;346(21):1623-30
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