Decoding Obesity Management Medications and the Journey to Informed Treatment Choices for Patients

Dec 6, 2024Mayo Clinic proceedings

Understanding Obesity Medications and Helping Patients Make Informed Treatment Decisions

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Abstract

Incretin-based obesity management medications (OMMs) may result in 15% to 20% weight loss.

Public interest in OMMs has increased dramatically.
Cost and access to OMMs are significant barriers for many patients.
Patients with a body mass index of 35 kg/m² or higher may consider various intervention options.
Unrealistic perceptions about risk versus efficacy and misconceptions about long-term outcomes are common among patients.
Key considerations for informed treatment decisions include adverse effects, patient expectations, and equitable access to care.

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Incretin-based obesity management medications (OMMs) fill a treatment gap in a stepped-care model between lifestyle change alone and metabolic bariatric surgery, resulting in weight loss of 15% to 20% of body weight. Public interest in and demand for OMMs has recently increased dramatically. Unfortunately, cost and access to OMMs remain a significant barrier for many patients. Although these medications have the potential to produce large weight loss outcomes, many unanswered questions remain regarding informed choice and optimization of obesity care protocols, especially for patients with a body mass index of 35 kg/mor higher who may be considering various intervention options such as lifestyle changes, OMMs, endoscopic weight loss procedures, and/or metabolic bariatric surgery. When considering strategies to aid patients in decision making about obesity treatment, several considerations warrant discussion because patients may have unrealistic perceptions about risk vs efficacy and may hold numerous misconceptions about long-term behavior change and outcomes. This article outlines considerations for informed obesity treatment decision making and reviews aspects of obesity treatment specific to OMMs, including adverse effects, patient expectations for treatment outcome, equitable access to care, the impact of weight bias on patient care, the risk of weight recurrence, and the need for long-term multicomponent treatment to achieve weight loss and weight maintenance. 2

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Decoding Obesity Management Medications and the Journey to Informed Treatment Choices for Patients

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