Tackling Obesity and the New Weight Loss Drugs: What a Hospitalist Needs to Know-Slides

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This presentation by Dr. Yelena Burklin focuses on obesity pathophysiology, updated pharmacological treatments, and what hospitalists need to know when managing hospitalized patients using weight-loss medications. The session objectives aim to elucidate the mechanisms of obesity, review FDA-approved anti-obesity drugs, and apply knowledge through case-based examples to diagnose and manage adverse drug reactions.<br /><br />Obesity’s complex neuro-humoral regulation affects energy homeostasis, and its medical complications—many irreversible—necessitate integrated management including nutrition, physical activity, behavioral therapy, pharmacotherapy, and bariatric procedures. Notably, BMI thresholds to define obesity differ by ethnicity (e.g., lower in Asian populations).<br /><br />The FDA-approved anti-obesity medications discussed include phentermine/topiramate, naltrexone/bupropion, lipase inhibitors, GLP-1 receptor agonists (e.g., semaglutide), and emerging agents like tirzepatide, which targets GLP-1 and GIP receptors with favorable cardiovascular profiles. Some previously favored treatments such as lorcaserin and SGLT-2 inhibitors (not approved solely for obesity) have fallen out of favor.<br /><br />A case study illustrates the complexities hospitalists might encounter: a 32-year-old woman with obesity, altered mental status, seizures, hypertension, and a history of phentermine/topiramate use who abruptly discontinued the medication due to dysphagia, resulting in withdrawal seizures. Management included controlling seizures and blood pressure, evaluating the incidental findings, and considering alternative anti-obesity therapies given her medication intolerance.<br /><br />Looking ahead, innovative treatments such as amylin mimetics, ghrelin antagonists, cannabinoid receptor blockers, and triple receptor agonists are under development, offering promise for more effective obesity management.<br /><br />Hospitalists must be familiar with the indications, adverse effects, and withdrawal syndromes related to weight-loss drugs to optimize inpatient care and transition plans. The session encourages engagement via PollEv and provides contact information for further queries.

Keywords

obesity pathophysiology

pharmacological treatments

weight-loss medications

FDA-approved anti-obesity drugs

phentermine/topiramate

GLP-1 receptor agonists

tirzepatide

adverse drug reactions

hospitalist management

emerging obesity therapies