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(2|⊕⊕⚪⚪), 1.7 In patients with T2DM who are overweight or obese, we suggest the use of antidiabetic medications that have additional actions to promote weight loss (such as glucagon-like peptide-1 [GLP-1] analogs or sodium-glucose-linked transporter-2 [SGLT-2] inhibitors), in addition to the first-line agent for T2DM and obesity, metformin. Lipids and CV Health. Endocrine Society. Disclosures for the coauthors are listed in the original published guidelines. Please consult An Endocrine Society Clinical Practice Guideline for reference in the meantime It includes detailed, graded treatment recommendations and tables of pharmacotherapy for obesity including their advantages and disadvantages and drugs that cause weight gain with suggested alternatives. (1|⊕⊕⊕⚪), 1.4 We suggest assessment of efficacy and safety at least monthly for the first 3 months, then at least every 3 months in all patients prescribed weight loss medications. Our latest Scientific Statements, Obesity Pathogenesis and The Science of Obesity Management, provide a comprehensive overview of the state of science in the obesity field and identify areas … Register for ENDO 2021, the largest meeting on endocrinology in the world. (2|⊕⊕⚪⚪), 1.5 If a patient's response to a weight loss medication is deemed effective (weight loss ≥ 5% of body weight at 3 mo) and safe, we recommend that the medication be continued. } else { (2|⊕⊕⊕⚪), 1.8 In patients with cardiovascular disease who seek pharmacological treatment for weight loss, we suggest using medications that are not sympathomimetics such as lorcaserin and/or orlistat. 2016 Endocrine Society Guidelines: Growth Hormone (GH) Deficiency Published on October 27, 2016 October 27, 2016 • 11 Likes • 6 Comments If the medication is ineffective or the patient experiences side effects, the prescription should be stopped and an alternative medication or approach considered. According to a new guideline from the European Society of Endocrinology, patients with obesity should be routinely tested for thyroid function. Other tools such as weight loss medications and bariatric surgery can be combined with behavioral changes to reduce food intake and increase physical activity. ... Endocrine Surgery. The Endocrine Society funded the guidelines. Get updates on the latest breakthroughs, clinical practice guidelines, and career development opportunities, straight to your inbox. if (header.indexOf("+") !== -1) { Home > Publications > Guidelines > European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity Pages in this section Publications. No individual performance data or any other personal information collected from evaluations will be shared with third parties. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence. Nutrition and Obesity. When patients need medications that can have an impact on weight such as antidepressants, antipsychotic drugs and medications for treating epilepsy, they should be fully informed and provided with estimates of each option’s anticipated effect on weight. (1|⊕⊕⊕⚪), 2.7 In women with a BMI > 27 kg/m2 with comorbidities or BMI > 30 kg/m2seeking contraception, we suggest oral contraceptives over injectable medications due to weight gain with injectables, provided that women are well-informed about the risks and benefits (ie, oral contraceptives are not contraindicated). $(this).parent().next(".subcategory").toggle(); Other recommendations include: + 1.0 Care of the patient who is overweight or obese, + 2.0 Drugs that cause weight gain and some alternatives, + 3.0 Off label use of drugs approved of other indications for chronic obesity management, Watch this expert CME/CE-certified presentation highlighting expert recommendations on the variety of continuous glucose monitoring devices for optimizing management of individual patients with type 1 and type 2 diabetes. Renewing your membership is the best way to ensure that you remain a key part of our efforts to support the global endocrine community. From bench to bedside and all the stages in between, the Hormone Health Network is committed to supporting patient and public education. Since some diabetes medications are associated with weight gain, people with diabetes who are obese or overweight should be given medications that promote weight loss or have no effect on weight as first- and second-line treatments. The Endocrine Society may also track aggregate responses to questions in activities and evaluations and use these data to inform the ongoing evaluation and improvement of its CME program. var header = $(this).text(); Any guideline for the treatment of obesity must include it, as it is the most effective therapy for this disease [3,4]. ... Obesity GUIDELINES Pocket Guide . Approved By. Doctors should discuss medications’ potential effects on weight with patients. Clinicians should discuss possible weight effects of glucose-lowering medications with patients and consider the use of antihyperglycemic medications that are weight neutral or promote weight loss. The guideline, titled “Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline,” was co-sponsored by the European Society of Endocrinology and The Obesity Society. The endocrine system and obesity can have a push-pull relationship. Late Endocrine Effects of Cancer Therapy. The 2016 guideline on the pharmacological management of obesity addresses: The Endocrine Society recommends that diet, exercise and behavioral modifications be part of all obesity management approaches. Clinical practice guidelines from the Endocrine Society, European Society of Endocrinology, and Pediatric Endocrine Society [53, 54] . This guideline was co-sponsored by the European Society of Endocrinology and The Obesity Society. Doctors and patients should engage in a shared-decision making process to evaluate the options. } Participants: The participants include an Endocrine Society-appointed Task Force of 6 experts, a methodologist, and a medical writer. (1|⊕⊕⊕⊕), 1.6 If medication for chronic obesity management is prescribed as adjunctive therapy to comprehensive lifestyle intervention, we suggest initiating therapy with dose escalation based on efficacy and tolerability to the recommended dose and not exceeding the upper approved dose boundaries. These are effective blood pressure treatments that are less likely to contribute to weight gain than the alternative medication, beta-adrenergic blockers. The Clinical Guidelines Subcommittee of the Endocrine Society deemed prevention and treatment of pediatric obesity a priority area in need of practice guidelines and appointed a Task Force to formulate evidence-based recommendations. Pediatric Obesity—Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline Last updated: 2017 Published: The Journal of Clinical Endocrinology & Metabolism 2017; 102:709–757 Certain types of medication – angiotensin converting enzyme inhibitors, angiotensin receptor blockers and calcium channel blockers – should be used as a first-line treatment for high blood pressure in obese people with Type 2 diabetes. Objective: To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity. $(this).text(header.replace("-", "+")); Society guidance in development. If a patient responds well to a weight loss medication and loses 5 percent or more of their body weight after three months, the medication should be continued. These AACE/ACE evidence-based clinical practice guidelines address key aspects of obesity care: screening, diagnosis, clinical evaluation, treatment options, ... Cosponsored by American Association of Clinical Endocrinology and The Obesity Society READ MORE. Get updates on the latest breakthroughs, clinical practice guidelines, and career development opportunities, straight to your inbox. guideline. }); J Clin Endocrinol Metab. Published online January 31, 2017. Then take the next step: Set up your free website account and get exclusive access to even more great tools & content! Childhood Obesity Task Force Position Statement – Childhood Obesity is a Disease. Objective: To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity. We also suggest that the insulin therapy strategy be considered a preferential trial of basal insulin prior to premixed insulins or combination insulin therapy. The Obesity GUIDELINES Pocket Guide is based on the latest guidelines of The Endocrine Society and was developed with their collaboration. Endocrine Society… Caroline M. Apovian (Chair), Louis J. Aronne, Daniel H. Bessesen, Marie E. McDonnell, M. Hassan Murad, Uberto Pagotto, Donna H. Ryan, and Christopher D. Still. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. Expert faculty explore the evidence behind different diets in NAFLD/NASH. Register for ENDO 2021, the largest meeting on endocrinology in the world. Children or teens with a body mass index (BMI) ≥85th percentile should be evaluated for related conditions such as metabolic syndrome, diabetes, prediabetes, or hypertension. This guideline was funded by the Endocrine Society. easo.org easo.org The global obesity epidemic is on the rise, and endocrinologists are at the forefront of diagnosing its underlying causes and prescribing treatment plans. The Endocrine Society, with the participation of the European Society of Endocrinology, has promoted the creation of an expert panel to propose a clinical practice guideline for postoperative management of patients, candidates to bariatric surgery, that places a particular emphasis on evidence-based medical aspects. (2|⊕⊕⊕⚪), 2.10 We suggest the use of antihistamines with less central nervous system activity (less sedation) to limit weight gain. Management of Adults with Congential Adrenal Hyperplasia. Participants: The participants include an Endocrine Society-appointed Task Force of 6 experts, … This is preferable to using either insulin alone or insulin with sulfonylurea. Guideline Highlights The guidelines were developed by 6 experts selected by the Endocrine Society. Obesity and Appetite Regulation The global obesity epidemic is on the rise, and endocrinologists are at the forefront of diagnosing its underlying causes and prescribing treatment plans. Our comprehensive agenda will cover all aspects of endocrinology over four days of programming that includes more than 90 live sessions and another 80 sessions available on-demand. Some endocrine disorders — such as hypothyroidism and … (2|⊕⊕⊕⚪), 2.9 We suggest the use of nonsteroidal anti-inflammatory drugs and disease-modifying antirheumatic drugs when possible in patients with chronic inflammatory disease like rheumatoid arthritis because corticosteroids commonly produce weight gain. In January, 2015, the Endocrine Society released new guidelines on the treatment of obesity to include the following: [101, 102] Diet, exercise, and behavioral modification should be included in all obesity management approaches for body mass index (BMI) of 25 kg/m 2 or higher. Pediatric Obesity – Assessment, Treatment and prevention: An Endocrine Society Clinical Practice guideline Download Diagnosis and Management of Lipodystrophy Syndrome Here you can find and browse EASO Obesity Guidelines, which form a key element of the education we share with the European obesity community. (1|⊕⊕⊕⚪), 2.6 We recommend considering weight gain potential in choosing an antiepileptic drug (AED) for any given patient, and the use of a shared decision-making process that provides patients with quantitative estimates of the expected weight effect of the drugs to make an informed decision about drug choice. Patients who have been unable to successfully lose weight and maintain a goal weight may be candidates for prescription medication if they meet the criteria on the drug’s label. European Society of Endocrinology has released its Clinical Practice Guideline on Endocrine work-up in obesity. The Endocrine Society recommends that diet, exercise and behavioral modifications be part of all obesity management approaches. The guideline, titled "Pediatric Obesity -- Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline," was published online … Objective: To formulate clinical practice guidelines for the pharmacological management of obesity. (Ungraded Best Practice Recommendation). Our latest Scientific Statements, Obesity Pathogenesis and The Science of Obesity Management, provide a comprehensive overview of the state of science in the obesity field and identify areas of future research. (1|⊕⊕⊕⚪), 2.5 We recommend using weight-neutral antipsychotic alternatives when clinically indicated, rather than those that cause weight gain, and the use of a shared decision-making process that provides patients with quantitative estimates of the expected weight effect of the alternative treatments to make an informed decision about drug choice. Participants: An Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer. However, testing for other endocrine-related conditions should be guided by the presence of symptoms. European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity Authors: R Pasquali, F Casanueva, M Haluzik, L van Hulsteijn, S Ledoux, M P Monteiro, J Salvador, F Santini, H Toplak and O M Dekkers Participants: An Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer. Endocrine Society is a global community of physicians and scientists dedicated to accelerating scientific breakthroughs and improving patient health and well being. For (2|⊕⊕⚪⚪), 3.1 We suggest against the off-label use of medications approved for other disease states for the sole purpose of producing weight loss. Obesity is an emerging condition, with a prevalence of ~20%. Our comprehensive agenda will cover all aspects of endocrinology over four days of programming that includes more than 90 live sessions and another 80 sessions available on-demand. $(document).ready(function(){ The Science of Obesity Management: An Endocrine Society Scientific Statement George A. Bray, 1 William E. Heisel, 2 Ashkan Afshin, 2 Michael D. Jensen, 3 William H. Dietz, 4 On February 1, the Endocrine Society issued a Clinical Practice Guideline advising healthcare providers on how to prevent and treat childhood obesity with lifestyle changes. Other factors that need to be taken into consideration include the expected length of treatment. Evidence:This evidence-based guideline was developed using the Grading of Recommendations, Assessment,Development,andEvaluation(GRADE)systemtodescribethestrengthofrecommen- … 2021 Copyright Endocrine Society. Evidence:This evidence-based guideline was developed using the Grading of Recommendations, Assessment,Development,andEvaluation(GRADE)systemtodescribethestrengthofrecommen- … Androgens (male and female). Toward these objectives, the ACC and AHA have collaborated with the National Heart, Lung, and Blood I… A trial of such therapy can be attempted in the context of research and by healthcare providers with expertise in weight management dealing with a well-informed patient. What should our patients with NAFLD eat? The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. Objective To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity. All rights reserved. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. Cosponsoring Associations: The European Society of Endocrinology and the Pediatric Endocrine Society. (2|⊕⚪⚪⚪), 2.1 We recommend weight-losing and weight-neutral medications as first- and second-line agents in the management of a patient with T2DM who is overweight or obese. Other tools such as weight loss medications and bariatric surgery can be combined with behavioral changes to … The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. The first-line insulin for this type of patient should be basal insulin. This guideline was co-sponsored by the European Society of Endocrinology and The Obesity Society. Then take the next step: Set up your free website account and get exclusive access to even more great tools & content! Objective: To formulate clinical practice guidelines for the pharmacological management of obesity. (2|⊕⚪⚪⚪), 2.8 We suggest monitoring the weight and waist circumference of patients on antiretroviral therapy due to unavoidable weight gain, weight redistribution, and associated cardiovascular risk. This guideline was co-sponsored by the European Society of Endocrinology and The Obesity Society. Dr Styne has disclosed no relevant financial relationships. In patients with uncontrolled high blood pressure or a history of heart disease, the medications phentermine and diethylpropion should not be used. Join us as we plan for the future by renewing today! }); Full Guideline: Pharmacological Management of Obesity Pharmacological Management of Obesity Guideline Resources, Accelerating Breakthroughs & Improving Care, Management of chronic obesity, including managing comorbid conditions, Monitoring progress of weight loss using medication, Choosing alternative medications that are weight-losing or weight-neutral in the management of other medical conditions such as T2D, depression and other mental health conditions, chronic inflammatory diseases and arthritis, and epilepsy. JCEM | February 2016 This guideline was funded by the Endocrine Society. Accelerating Breakthroughs & Improving Care. (1|⊕⊕⊕⊕), 2.4 When antidepressant therapy is indicated, we recommend a shared decision-making process that provides patients with quantitative estimates of the expected weight effect of the antidepressant to make an informed decision about drug choice. All rights reserved. The Endocrine Society convened a task force of experts to develop evidence-based guidelines for the pharmacological management of obesity. The goals of the American College of Cardiology (ACC) and the American Heart Association (AHA) are to prevent cardiovascular diseases (CVD); improve the management of people who have these diseases through professional education and research; and develop guidelines, standards, and policies that promote optimal patient care and cardiovascular health. Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. (1|⊕⊕⊕⚪), 2.2 In obese patients with T2DM requiring insulin therapy, we suggest adding at least one of the following: metformin, pramlintide, or GLP-1 agonists to mitigate associated weight gain due to insulin. This guideline was co-sponsored by the European Society of Endocrinology and The Obesity Society. $(this).text(header.replace("+", "-")); This guideline was funded by the Endocrine Society. easo.org easo.org . 2021 Copyright Endocrine Society. If deemed ineffective (weight loss < 5% at 3 mo) or if there are safety or tolerability issues at any time, we recommend that the medication be discontinued and alternative medications or referral for alternative treatment approaches be considered. This guideline was co-sponsored by the European Society of Endocrinology and The Obesity Society. (2|⊕⊕⊕⚪), 2.3 We recommend angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and calcium channel blockers rather than β-adrenergic blockers as first-line therapy for hypertension in patients with T2DM who are obese. $(".toggleSubCategory").click(function () { It is now available online and will be published in the February 2015 print issue of the Journal of Clinical Endocrinology & Metabolism. Reference 1.1 We recommend that diet, exercise, and behavioral modification be included in all obesity management approaches for body mass index (BMI) ≥ 25 kg/m, 1.2 In order to promote long-term weight maintenance, we suggest the use of approved 1 weight loss medication (over no pharmacological therapy) to ameliorate comorbidities and amplify adherence to behavior changes, which may improve physical functioning and allow for greater physical activity in individuals with a BMI ≥ 30 kg/m, 1.3 In patients with uncontrolled hypertension or a history of heart disease, we recommend against using the sympathomimetic agents phentermine and diethylpropion. The guidelines address medication use in addition to good nutrition and physical activity to promote chronic weight management. Endocrine Society is a global community of physicians and scientists dedicated to accelerating scientific breakthroughs and improving patient health and well being. 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