Pharmacotherapy For Adolescent Obesity, A Weighty Issue

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Obesity Treatment

In an accompanying editorial, Alain Joffe, M.D., M.P.H., from Johns Hopkins University, Baltimore, writes "Until public health efforts to prevent child and adolescent obesity are developed and successfully implemented on a broad scale, physicians are likely to encounter significant numbers of obese adolescents for the foreseeable future. ...appropriate management of this chronic health condition is a pressing but daunting task for physicians."

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"Obesity is by nature a chronic disease. Many obese individuals who lose weight regain it over time, often exceeding their original weight," Dr. Joffe writes. "What will be critical to determine is whether the weight loss (or slowing of weight gain) achieved by those treated with orlistat is sustainable over time. Once adolescents stop using orlistat, will they maintain their weight loss, or will maintenance required ongoing use of the medication?"

He concludes by saying "It would not be surprising that no single weight-loss medication will find favor with all adolescents; pharmacotherapy will need to be individualized following a comprehensive assessment of the adolescent including the presence or absence of various comorbidities [related disease]. ...Until [more] data are available, use of orlistat should be limited to settings that offer comprehensive assessment and management of obese adolescents. There is no justification for using it as a stand-alone treatment.

(JAMA. 2005;293:2932-2934)

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