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LIRAGLUTIDE Bariatric surgery - Health outcomes
Liraglutide is the only currently available FDA-ap- Surgical group was 5.5 times more likely to have re-
proved injectable weight loss medication. Liraglutide mission. Remission of type 2 diabetes was related
is indicated as an adjunct to a low-calorie diet and to weight loss and lower baseline HbA1c levels. Bar-
increased physical activity for chronic weight man- iatric surgery significantly reduces the likelihood of
agement in adults with obesity or who are over- hypertriglyceridemia and low HDL cholesterol at two
weight (BMI 27 kg/m2) in the presence of at least years follow up.
one weight-related comorbid conditions.
The most common reported side effects are nau-
sea, hypoglycemia, diarrhea, constipation, vomiting,
headache, decreased appetite, dyspepsia, fatigue,
dizziness, abdominal pain and increased lipase. It is
particularly attractive for patients with hyperglycemia.

METFORMIN
Metformin improves insulin sensitivity, has a good
safety profile, and long-term clinical experience. The
weight loss attributable to metformin is small. Hence,
its usefulness as monotherapy for obesity treatment
is limited.

RATIONAL USE OF MEDICATIONS IN
OBESITY MANAGEMENT
The scientific literature on drug treatment for obe-
sity is limited. Obesity requires long term treatment.
Barriers to the initiation or sustained use of obesity
medications include – Costs, Safety concerns, Per-
ception of limited efficacy, reluctance to view obesity
as a disease requiring medical treatment.

SURGICAL MANAGEMENT
Surgical treatment of obesity
Generally, the criteria include:

BMI of over 35 with obesity-related medical compli-
cations, such as high blood pressure, diabetes, ele-
vated cholesterol, or sleep apnea.
BMI of over 40 without medical complications.
Bariatric surgery in adults
Bariatric surgery is an effective weight loss interven-
tion.
In a systematic review, patients predominantly with
BMI ≥35 kg/m2 receiving bariatric surgery had be-
tween 52.5% and 77% excess weight loss at ten years
post surgery.
Laparoscopic banding,
Bilio-pancreatric diversion +/-,
Roux-en-Y gastric bypass

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