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A Review of Unmet Needs in Obesity Management

Abstract

The prevalence of obesity continues to escalate in the USA; however, there is no consensus regarding the optimal therapy for obesity. For the vast majority of severely obese patients, conventional medical therapies (i.e., diet, exercise, behavioral counseling) often fail over the long term. Existing pharmacotherapy adjunctive to behavioral therapy has limited effectiveness and an imperfect safety record. In contrast, bariatric surgery has a high degree of weight loss efficacy, yet only a small fraction of the qualifying obese population undergoes these procedures because of the associated perioperative risks and potential late complications. In addition, the role of bariatric surgery is unclear in certain patient populations, such as patients with lower body mass index (BMI, 30–35 kg/m2), the high-risk super-super obese patients (BMI > 60), the morbidly obese adolescent, and obese patients requiring weight reduction in preparation for other procedures, such as orthopedic, transplant, or vascular surgeries. In these circumstances, there is a need for an effective but less invasive treatment to bridge the gap between medical and surgical therapy. This review examines current treatment outcomes, identifies prominent areas of unmet clinical needs, and provides an overview of two minimally invasive “temporary procedures for weight loss” that may eventually address some of the unmet needs in obesity management.

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Acknowledgments

We wish to thank Paul Fabbrini of Telecue, Inc. for recording the panel discussion among the authors that inspired this review.

Disclosures

N. Nguyen and B. Pham have consulting agreements with ReShape. J. Ponce, B. Quebbemann, E. Patterson, and F. Favretti have been investigators for ReShape; W. Raum and G. Segato have been co-investigators for ReShape. J.K. Champion received an honorarium to participate in the development of this work. J.N. Buchwald has a consulting research writing agreement with ReShape. The authors thank ReShape Medical Corporation for financial support to develop this work.

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Nguyen, N., Champion, J.K., Ponce, J. et al. A Review of Unmet Needs in Obesity Management. OBES SURG 22, 956–966 (2012). https://doi.org/10.1007/s11695-012-0634-z

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Keywords

  • Bariatric surgery
  • Obesity
  • Endoscopy
  • Weight loss
  • Intragastric balloon