When to prescribe Medications for Obesity ?

The role of Pharmacotherapy in Obesity management in 2024

00:13 🩺 Obesity is becoming increasingly prevalent in women's health, impacting conditions like PCOS and metabolic syndrome, necessitating early intervention.
00:54 🧬 Genetic factors and intrauterine environment play significant roles in predisposing individuals to obesity.
03:27 🩸 Puberty presents challenges in obesity management due to hormonal changes and increased insulin resistance.
04:08 🛌 Environmental factors such as improper sleep, lack of exercise, and obstructive sleep apnea contribute to chronic weight gain.
05:20 🩺 Endocrinological disorders such as hypothyroidism, PCOS, and Cushing's syndrome must be considered in obesity management.
06:44 🧠 The brain, gut, and endocrine system play crucial roles in obesity, with the brain's control over homeostatic, hedonic, and executive functions being particularly significant.
08:12 🍽️ Distinguishing between stomach hunger and head hunger is essential to understand the psychological aspect of overeating.
10:01 🍔 Hormones like ghrelin and peptides YY regulate hunger and satiety, while dopamine and opioid pathways drive pleasure in eating.
12:19 🧠 Executive function plays a vital role in self-regulation of eating habits, although it's challenging to control.
14:25 ⚖️ Weight loss is not linear; it requires a gradual, stepwise approach to adaptation and maintenance to prevent metabolic handicap.
16:18 💊 Pharmacotherapy for weight loss is indicated for individuals with BMI over 30 or over 25 with complications, showing effectiveness comparable to bariatric surgery.
17:55 💊 Pharmacotherapy for obesity management is increasingly effective and evolving over time.
18:10 🌱 In India, pharmacotherapy for weight loss has lower weight indication thresholds compared to Western guidelines.
18:52 💊 Only two drugs are approved for weight loss in India: orlistat and semaglutide.
19:35 🔄 Injectable semaglutide 2.4 mg isn't available in India yet, but oral semaglutide can be used off-label for weight loss.
20:19 🧠 Serendipity led to the discovery of GLP-1 receptor agonists for weight loss, originally developed for diabetes management.
21:43 🍽️ GLP-1 receptor agonists like semaglutide reduce food-seeking behavior and cravings, leading to weight loss.
23:04 📊 Clinical trials demonstrate significant weight loss with GLP-1 receptor agonists, especially in women and in conditions like PCOS.
25:04 💉 Semaglutide is available in oral, injectable for diabetes and injectable for weight loss (Vovi) forms, with only oral available in India currently.