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- Title
Obstetrician-Gynecologists' Strategies for Patient Initiation and Maintenance of Antiobesity Treatment with Glucagon-Like Peptide-1 Receptor Agonists.
- Authors
Gill, Lisa; Mackey, Suzanne
- Abstract
Obesity is a chronic disease affecting women at higher rates than men. In an obstetrics and gynecology setting, frequently encountered obesity-related complications are polycystic ovary syndrome, fertility and pregnancy complications, and increased risk of breast and gynecological cancers. Obstetrician-gynecologists (OBGYNs) are uniquely positioned to diagnose and treat obesity, given their role in women's primary health care and the increasing prevalence of obesity-related fertility and pregnancy complications. The metabolic processes of bodyweight regulation are complex, which makes weight-loss maintenance challenging, despite dietary modifications and exercise. Antiobesity medications (AOMs) can facilitate weight loss by targeting appetite regulation. There are four AOMs currently approved for long-term use in the United States, of which liraglutide 3.0 mg is among the most efficacious. Liraglutide 3.0 mg, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), is superior to placebo in achieving weight loss and improving cardiometabolic profile, in both clinical trial and real-world settings. In addition, women with fertility complications receiving liraglutide 1.8–3.0 mg can benefit from improved ovarian function and fertility. Liraglutide 3.0 mg is generally well tolerated, but associated with transient gastrointestinal side effects, which can be mitigated. In this review, we present the risks of obesity and benefits of weight loss for women, and summarize clinical development of GLP-1 RAs for weight management. Finally, we provide practical advice and recommendations for OBGYNs to open the discussion about bodyweight with their patients, initiate lifestyle modification and GLP-1 RA treatment, and help them persist with these interventions to achieve optimal weight loss with associated health benefits.
- Subjects
OBESITY complications; BREAST tumor risk factors; RISK factors in infertility; OBESITY; POLYCYSTIC ovary syndrome; PHYSICIAN-patient relations; GYNECOLOGY; OBSTETRICS; PREGNANCY complications; WEIGHT loss; HEALTH behavior; COMMUNICATION; GLUCAGON-like peptide-1 agonists; PHYSICIAN practice patterns; PSYCHOLOGY of physicians; FEMALE reproductive organ tumors; BEHAVIOR modification; PHARMACODYNAMICS; DISEASE risk factors
- Publication
Journal of Women's Health (15409996), 2021, Vol 30, Issue 7, p1016
- ISSN
1540-9996
- Publication type
Article
- DOI
10.1089/jwh.2020.8683