CK注:以往ADA标准各版本全文译文:
CK注:2023标准已有内容:
CK注:本章节更新的内容包括:
对语言进行了修改,以强调肥胖是一种慢性病。
增加推荐8.5,以强调应将较小和较大的体重减轻视为个体基础上的治疗目标。值得注意的是,较大(10%或更多)的体重减轻可能具有疾病缓解效应,包括糖尿病缓解,并可能改善长期心血管结局。
增加双重GLP-1/葡萄糖依赖性促胰岛素多肽(GIP)受体激动剂(替西帕替/ tirzepatide)作为有减重效力的降糖选择。
指南共识 l 2023 l ADA糖尿病标准 l 08
肥胖和体重管理
以预防和治疗糖尿病
8.1 使用以患者为中心、非主观(判断)的语言,促进个人与医务人员之间的合作,包括以人为本的语言(例如,“伴肥胖人士/ person with obesity”而非“肥胖人士/obese person”)。E
8.2 在每年访视或更频繁的访视中测量身高和体重并计算身体质量指数(BMI)。评估体重轨迹,以获得信息知晓治疗注意事项。E
8.3 基于临床考虑,例如存在合并症心力衰竭或明显的无法解释的体重增加或减少,可能需要更频繁地监测和评估体重(B)。如果医疗状况恶化与体重显著增加或减少相关,则应考虑住院评估,尤其应关注药物使用、食物摄入和血糖状态之间的关联。E
8.4 在称重过程中,应提供便利条件以保护隐私。E
8.5 糖尿病、超重或肥胖者可受益于轻中度或较大幅度的体重减轻。
较大的持续体重减轻(> 10%)通常带来较大的获益,包括疾病缓解效应和2型糖尿病可能缓解,并可能改善长期心血管结局和死亡率。B
营养、体育活动和行为治疗
8.6 对于大多数2型糖尿病伴超重或肥胖人群,推荐进行营养、体育活动和行为治疗,以实现并保持体重减轻≥5%。额外的体重减轻通常会进一步改善糖尿病和心血管风险的管理。B
8.7 此类干预应包括高频率咨询(6个月内≥16次),并侧重于营养变化、身体活动和行为策略,以实现500-750 kcal/天的能量赤字(energy deficit)。A
8.8 当推荐采取减重干预措施时,应考虑个人的意愿、动机和生活环境以及医疗状况。C
8.9 造成能量赤字的行为改变,无论其常量营养成分如何,均可导致体重减轻。营养推荐应根据个人喜好和营养需求进行个体化。A
8.10 评估可能影响营养模式和食物选择的系统性、结构性和社会经济因素,如粮食不安全和饥饿、获得健康食物的机会、文化环境和健康的社会决定因素。C
8.11 对于达到减重目标的人群,推荐在可能的情况下实施长期(≥1年)的体重维持计划。此类计划应至少每月提供联系和支持,建议持续监测体重(每周或更频繁)和其他自我监测策略,并鼓励定期体育活动(200-300分钟/周)。A
8.12 受过培训的执业医师可在医疗环境中并在密切监测下,为仔细选择的个人开出使用结构化、极低卡路里膳食(800–1000 kcal/天)的短期营养干预处方。应整合长期、全面的体重维持策略和咨询,以维持体重减轻。B
药物治疗
8.14 2型糖尿病伴超重或肥胖人群在选择降糖药物时,应考虑药物对体重的影响。B
8.15 尽可能减少与体重增加相关的合并症的药物治疗。E
8.16 对于2型糖尿病伴BMI≥27 kg/m2的特定人群,肥胖药物治疗作为营养、体育活动和行为咨询的辅助治疗有效。必须考虑潜在的获益和风险。A
代谢手术
8.18 对于筛选出的BMI≥40 kg/m2(亚裔美国人BMI≥37.5 kg/m2)的手术候选人和BMI35.0–39.9kg/m2(亚裔美国人32.5–37.4kg/m2)的成年人,如果通过非手术方法未能实现持久的体重减轻和合并症(包括高血糖症)改善,则应推荐选择代谢手术治疗2型糖尿病。A
8.19 对于BMI30.0–34.9kg/m2(亚裔美国人为27.5–32.4kg/m2)的成人患者,通过非手术方法未能实现持久的体重减轻并改善合并症(包括高血糖症)者,代谢手术可被视为治疗2型糖尿病的一种选择。A
8.20 代谢手术应在有多学科团队的高容量中心进行,这些团队应熟悉并有管理肥胖、糖尿病和胃肠手术的经验。E
8.21 应评估考虑接受代谢手术的患者是否存在可能影响手术结果的共病心理状况以及社会和情境情况。B
8.22 接受代谢手术的人员应接受长期的医疗和行为支持以及常规的微量营养素、营养和代谢状态监测。B
8.23 如果怀疑有减重后低血糖症,临床评估应排除导致低血糖症的其他潜在疾病,管理包括教育、由具有减重后低血糖症经验的营养师进行的医学营养治疗,以及根据需要进行的药物治疗。应考虑将持续血糖监测作为一项重要辅助措施,通过提醒个体注意低血糖症来提高安全性,尤其是对于严重低血糖症或无症状低血糖的个体。E
8.24 应对接受代谢手术的患者进行常规评估,以评估是否需要持续的精神健康服务来帮助其适应手术后的医疗和心理社会变化。C
8.5 糖尿病、超重或肥胖者可受益于轻中度或较大幅度的体重减轻。
较大的持续体重减轻(> 10%)通常带来较大的获益,包括疾病缓解效应和2型糖尿病可能缓解,并可能改善长期心血管结局和死亡率。B
使用BMI记录体重状况
超重:BMI25–29.9kg/m2;
肥胖I级:BMI30 -34.9kg/m2;
肥胖II级:BMI35-39.9kg/m2;
肥胖症III级:BMI≥40 kg/m2)
但注意可能发生错误分类,特别是在肌肉非常发达或虚弱的个体中。
在某些人群中,尤其是亚洲和亚裔美国人,由于身体成分和心脏代谢风险的差异,定义超重和肥胖的BMI切点低于其他人群(表8.1) (30,31)。
*亚裔美国人的推荐切点(专家意见)。
策略可能包括(表8.1):
营养改变
身体活动
行为咨询
药物治疗
医疗装置
代谢手术。
健康差距对那些因种族或族裔、社会经济地位、性别、残疾或其他因素而系统地遭遇更大健康障碍的人产生不利影响。大量研究表明,这些差异可能会显著影响健康结局,包括增加肥胖、糖尿病和糖尿病相关并发症的风险。医务人员应评估:
可能影响食物选择、健康食物获取和营养模式的系统性、结构性和社会经济因素;
行为模式,如邻里安全和安全户外活动空间的可用性;
环境暴露;
获得医疗保健;
社会背景;
与不同程度体重减轻相关的药物包括:
二甲双胍、
α-葡萄糖苷酶抑制剂、
钠-葡萄糖共转运体2抑制剂、
胰高血糖素样肽1受体激动剂、
双重胰高血糖素样肽1/葡萄糖依赖性促胰岛素多肽受体激动剂(替西帕肽/ tirzepatide)
与体重增加相关的药物实例包括(67):
抗精神病药物(如氯氮平、奥氮平、利培酮)、
一些抗抑郁药物(如三环类抗抑郁药物、
一些选择性5-羟色胺再摄取抑制剂和单胺氧化酶抑制剂)、
糖皮质激素、
可注射孕激素、
一些抗惊厥药物(如加巴喷丁、普瑞巴林)
表8.2 FDA批准的治疗成人超重或肥胖的药物
图8.1
引用:ElSayed NA, Aleppo G, Aroda VR, etal., American Diabetes Association. 8. Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of Care in Diabetes—2023. Diabetes Care 2023;46(Suppl. 1):S128–S139
1. Narayan KMV, Boyle JP, Thompson TJ, Gregg EW, Williamson DF. Effect of BMI on lifetime risk for diabetes in the U.S. Diabetes Care 2007;30:1562–1566
2. Knowler WC, Barrett-Connor E, Fowler SE, et al.; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–403
3. Garvey WT, Ryan DH, Henry R, et al. Prevention of type 2 diabetes in subjects with prediabetes and metabolic syndrome treated with phentermine and topiramate extended release. Diabetes Care 2014;37:912–921
4. Torgerson JS, Hauptman J, Boldrin MN, Sjöström L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004;27:155–161
5. le Roux CW, Astrup A, Fujioka K, et al.; SCALE Obesity Prediabetes NN8022-1839 Study Group. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet 2017;389:1399–1409
6. Booth H, Khan O, Prevost T, et al. Incidence of type 2 diabetes after bariatric surgery: population-based matched cohort study. Lancet Diabetes Endocrinol 2014;2:963–968
7. UKPDS Group. UK Prospective Diabetes Study 7: response of fasting plasma glucose to diet therapy in newly presenting type II diabetic patients. Metabolism 1990;39:905–912
8. Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord 1992;16:397–415
9. Pastors JG, Warshaw H, Daly A, Franz M, Kulkarni K. The evidence for the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care 2002;25:608–613
10. Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia 2011;54:2506–2514
11. Jackness C, Karmally W, Febres G, et al. Very low-calorie diet mimics the early beneficial effect of Roux-en-Y gastric bypass on insulin sensitivity and β-cell function in type 2 diabetic patients. Diabetes 2013;62:3027–3032
12. Rothberg AE, McEwen LN, Kraftson AT, Fowler CE, Herman WH. Very-low-energy diet for type 2 diabetes: an underutilized therapy? J Diabetes Complications 2014;28:506–510
13. Hollander PA, Elbein SC, Hirsch IB, et al. Role of orlistat in the treatment of obese patients with type 2 diabetes. A 1-year randomized double-blind study. Diabetes Care 1998;21:1288–1294
14. Garvey WT, Ryan DH, Bohannon NJV, et al. Weight-loss therapy in type 2 diabetes: effects of phentermine and topiramate extended release. Diabetes Care 2014;37:3309–3316
15. O’Neil PM, Smith SR, Weissman NJ, et al. Randomized placebo-controlled clinical trial of lorcaserin for weight loss in type 2 diabetes mellitus: the BLOOM-DM study. Obesity (Silver Spring) 2012;20:1426–1436
16. Hollander P, Gupta AK, Plodkowski R, et al.; COR-Diabetes Study Group. Effects of naltrexone sustained-release/bupropion sustained-release combination therapy on body weight and glycemic parameters in overweight and obese patients with type 2 diabetes. Diabetes Care 2013;36:4022–4029
17. Davies MJ, Bergenstal R, Bode B, et al.; NN8022-1922 Study Group. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial. JAMA 2015;314:687–699
18. Rubino F, Nathan DM, Eckel RH, et al.; Delegates of the 2nd Diabetes Surgery Summit. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by International Diabetes Organizations. Obes Surg 2017;27:2–21
19. Steven S, Hollingsworth KG, Al-Mrabeh A, et al. Very low-calorie diet and 6 months of weight stability in type 2 diabetes: pathophysiological changes in responders and nonresponders. Diabetes Care 2016;39:808–815
20. Jensen MD, Ryan DH, Apovian CM, et al.; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol 2014;63(25 Pt B):2985–3023
21. Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet 2018;391:541–551
22. Lean MEJ, Leslie WS, Barnes AC, et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lancet Diabetes Endocrinol 2019;7:344–355
23. Kahan S, Fujioka K. Obesity pharmacotherapy in patients with type 2 diabetes. Diabetes Spectr 2017;30:250–257
24. Cao P, Song Y, Zhuang Z, et al. Obesity and COVID-19 in adult patients with diabetes. Diabetes 2021;70:1061–1069
25. Richardson S, Hirsch JS, Narasimhan M, et al.; the Northwell COVID-19 Research Consortium. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 2020;323:2052–2059
26. Chu Y, Yang J, Shi J, Zhang P, Wang X. Obesity is associated with increased severity of disease in COVID-19 pneumonia: a systematic review and meta-analysis. Eur J Med Res 2020;25:64
27. Popkin BM, Du S, Green WD, et al. Individuals with obesity and COVID-19: a global perspective on the epidemiology and biological relationships. Obes Rev 2020;21:e13128
28. AMA Manual of Style Committee. AMA Manual of Style: A Guide for Authors and Editors. 11th ed. New York, Oxford University Press, 2020
29. American Medical Association. Person-First Language for Obesity H-440.821. Accessed 12 October 2022. Available from https://policysearch.ama-assn.org/policyfinder/detail/obesity?uri=%2FAMADoc%2FHOD.xml-H-440.821.xml
30. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–163
31. Araneta MRG, Kanaya A, Hsu WC, et al. Optimum BMI cutpoints to screen Asian Americans for type 2 diabetes. Diabetes Care 2015;38:814–820
32. Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Am Coll Cardiol 2017;70:776–803
33. Bosch X, Monclús E, Escoda O, et al. Unintentional weight loss: clinical characteristics and outcomes in a prospective cohort of 2677 patients. PLoS One 2017;12:e0175125
34. Wilding JPH. The importance of weight management in type 2 diabetes mellitus. Int J Clin Pract 2014;68:682–691
35. Van Gaal L, Scheen A. Weight management in type 2 diabetes: current and emerging approaches to treatment. Diabetes Care 2015;38:1161–1172
36. Kushner RF, Batsis JA, Butsch WS, et al. Weight history in clinical practice: the state of the science and future directions. Obesity (Silver Spring) 2020;28:9–17
37. Warren J, Smalley B, Barefoot N. Higher motivation for weight loss in African American than Caucasian rural patients with hypertension and/or diabetes. Ethn Dis 2016;26:77–84
38. Rothberg AE, McEwen LN, Kraftson AT, et al. Impact of weight loss on waist circumference and the components of the metabolic syndrome. BMJ Open Diabetes Res Care 2017;5:e000341
39. Wing RR, Bolin P, Brancati FL, et al.; Look AHEAD Research Group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med 2013;369:145–154
40. Look AHEAD Research Group. Eight-year weight losses with an intensive lifestyle intervention: the look AHEAD study. Obesity (Silver Spring) 2014;22:5–13
41. Gregg EW, Jakicic JM, Blackburn G, et al.; Look AHEAD Research Group. Association of the magnitude of weight loss and changes in physical fitness with long-term cardiovascular disease outcomes in overweight or obese people with type 2 diabetes: a post-hoc analysis of the Look AHEAD randomised clinical trial. Lancet Diabetes Endocrinol 2016;4:913–921
42. Baum A, Scarpa J, Bruzelius E, Tamler R, Basu S, Faghmous J. Targeting weight loss interventions to reduce cardiovascular complications of type 2 diabetes: a machine learning-based post-hoc analysis of heterogeneous treatment effects in the Look AHEAD trial. Lancet Diabetes Endocrinol 2017;5:808–815
43. Schauer PR, Bhatt DL, Kirwan JP, et al.; STAMPEDE Investigators. Bariatric surgery versus intensive medical therapy for diabetes—5-year outcomes. N Engl J Med 2017;376:641–651
44. Ikramuddin S, Korner J, Lee WJ, et al. Durability of addition of Roux-en-Y gastric bypass to lifestyle intervention and medical management in achieving primary treatment goals for uncontrolled type 2 diabetes in mild to moderate obesity: a randomized control trial. Diabetes Care 2016;39:1510–1518
45. Gadde KM, Allison DB, Ryan DH, et al. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet 2011;377:1341–1352
46. Davies M, Færch L, Jeppesen OK, et al.; STEP 2 Study Group. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet 2021;397:971–984
47. Marso SP, Daniels GH, Brown-Frandsen K, et al.; LEADER Steering Committee; LEADER Trial Investigators. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016;375:311–322
48. Wing RR, Bolin P, Brancati FL, et al.; Look AHEAD Research Group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med 2013;369:145–154
49. Rosenstock J, Wysham C, Frías JP, et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet 2021;398:143–155
50. Frías JP, Davies MJ, Rosenstock J, et al.; SURPASS-2 Investigators. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes. N Engl J Med 2021;385:503–515
51. Franz MJ, Boucher JL, Rutten-Ramos S, VanWormer JJ. Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. J Acad Nutr Diet 2015;115:1447–1463
52. Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 2009;360:859–873
53. de Souza RJ, Bray GA, Carey VJ, et al. Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial. Am J Clin Nutr 2012;95:614–625
54. Johnston BC, Kanters S, Bandayrel K, et al. Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis. JAMA 2014;312:923–933
55. Leung CW, Epel ES, Ritchie LD, Crawford PB, Laraia BA. Food insecurity is inversely associated with diet quality of lower-income adults. J Acad Nutr Diet 2014;114:1943–53.e2
56. Kahan S, Manson JE. Obesity treatment, beyond the guidelines: practical suggestions for clinical practice. JAMA 2019;321:1349–1350
57. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW; American College of Sports Medicine. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009;41:459–471
58. Gudzune KA, Doshi RS, Mehta AK, et al. Efficacy of commercial weight-loss programs: an updated systematic review. Ann Intern Med 2015;162:501–512
59. Bloom B, Mehta AK, Clark JM, Gudzune KA. Guideline-concordant weight-loss programs in an urban area are uncommon and difficult to identify through the internet. Obesity (Silver Spring) 2016;24:583–588
60. Tsai AG, Wadden TA. The evolution of very-low-calorie diets: an update and meta-analysis. Obesity (Silver Spring) 2006;14:1283–1293
61. Johansson K, Neovius M, Hemmingsson E. Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2014;99:14–23
62. Batsis JA, Apolzan JW, Bagley PJ, et al. A systematic review of dietary supplements and alternative therapies for weight loss. Obesity (Silver Spring) 2021;29:1102–1113
63. Bessell E, Maunder A, Lauche R, Adams J, Sainsbury A, Fuller NR. Efficacy of dietary supplements containing isolated organic compounds for weight loss: a systematic review and meta-analysis of randomised placebo-controlled trials. Int J Obes 2021;45:1631–1643
64. Maunder A, Bessell E, Lauche R, Adams J, Sainsbury A, Fuller NR. Effectiveness of herbal medicines for weight loss: a systematic review and meta-analysis of randomized controlled trials. Diabetes Obes Metab 2020;22:891–903
65. Hill-Briggs F, Adler NE, Berkowitz SA, et al. Social determinants of health and diabetes: a scientific review. Diabetes Care 2020;44:258–279
66. Cai X, Yang W, Gao X, Zhou L, Han X, Ji L. Baseline body mass index and the efficacy of hypoglycemic treatment in type 2 diabetes: a meta-analysis. PLoS One 2016;11:e0166625
67. Domecq JP, Prutsky G, Leppin A, et al. Clinical review: drugs commonly associated with weight change: a systematic review and meta-analysis. J Clin Endocrinol Metab 2015;100:363–370
68. Drugs.com. Phentermine [FDA prescribing information]. Accessed 17 October 2022. Available from https://www.drugs.com/pro/phentermine.html
69. Apovian CM, Aronne LJ, Bessesen DH, et al.; Endocrine Society. Pharmacological management of obesity: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2015;100:342–362
70. Fujioka K, O’Neil PM, Davies M, et al. Early weight loss with liraglutide 3.0 mg predicts 1-year weight loss and is associated with improvements in clinical markers. Obesity (Silver Spring) 2016;24:2278–2288
71. Fujioka K, Plodkowski R, O’Neil PM, Gilder K, Walsh B, Greenway FL. The relationship between early weight loss and weight loss at 1 year with naltrexone ER/bupropion ER combination therapy. Int J Obes 2016;40:1369–1375
72. Sullivan S. Endoscopic medical devices for primary obesity treatment in patients with diabetes. Diabetes Spectr 2017;30:258–264
73. Kahan S, Saunders KH, Kaplan LM. Combining obesity pharmacotherapy with endoscopic bariatric and metabolic therapies. Techniques and Innovations in Gastrointestinal Endoscopy. 2020;22:154–158
74. Greenway FL, Aronne LJ, Raben A, et al. A randomized, double-blind, placebo-controlled study of Gelesis100: a novel nonsystemic oral hydrogel for weight loss. Obesity (Silver Spring) 2019;27:205–216
75. O’Brien R, Johnson E, Haneuse S, et al. Microvascular outcomes in patients with diabetes after bariatric surgery versus usual care: a matched cohort study. Ann Intern Med 2018;169:300–310
76. Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet 2015;386:964–973
77. Halperin F, Ding SA, Simonson DC, et al. Roux-en-Y gastric bypass surgery or lifestyle with intensive medical management in patients with type 2 diabetes: feasibility and 1-year results of a randomized clinical trial. JAMA Surg 2014;149:716–726
78. Sjöström L, Lindroos AK, Peltonen M, et al.; Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683–2693
79. Sjöström L, Peltonen M, Jacobson P, et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 2014;311:2297–2304
80. Adams TD, Davidson LE, Litwin SE, et al. Health benefits of gastric bypass surgery after 6 years. JAMA 2012;308:1122–1131
81. Sjöström L, Narbro K, Sjöström CD, et al.; Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741–752
82. Sjöström L, Gummesson A, Sjöström CD, et al.; Swedish Obese Subjects Study. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol 2009;10:653–662
83. Sjöström L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA 2012;307:56–65
84. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med 2007;357:753–761
85. Arterburn DE, Olsen MK, Smith VA, et al. Association between bariatric surgery and long-term survival. JAMA 2015;313:62–70
86. Adams TD, Arterburn DE, Nathan DM, Eckel RH. Clinical outcomes of metabolic surgery: microvascular and macrovascular complications. Diabetes Care 2016;39:912–923
87. Sheng B, Truong K, Spitler H, Zhang L, Tong X, Chen L. The long-term effects of bariatric surgery on type 2 diabetes remission, microvascular and macrovascular complications, and mortality: a systematic review and meta-analysis. Obes Surg 2017;27:2724–2732
88. Fisher DP, Johnson E, Haneuse S, et al. Association between bariatric surgery and macrovascular disease outcomes in patients with type 2 diabetes and severe obesity. JAMA 2018;320:1570–1582
89. Billeter AT, Scheurlen KM, Probst P, et al. Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetes mellitus. Br J Surg 2018;105:168–181
90. Aminian A, Zajichek A, Arterburn DE, et al. Association of metabolic surgery with major adverse cardiovascular outcomes in patients with type 2 diabetes and obesity. JAMA 2019;322:1271–1282
91. Syn NL, Cummings DE, Wang LZ, et al. Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174,772 participants. Lancet 2021;397:1830–1841
92. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes for Health Professionals. Accessed 17 October 2022. Available from https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/diabetes
93. Isaman DJM, Rothberg AE, Herman WH. Reconciliation of type 2 diabetes remission rates in studies of Roux-en-Y gastric bypass. Diabetes Care 2016;39:2247–2253
94. Sjöholm K, Pajunen P, Jacobson P, et al. Incidence and remission of type 2 diabetes in relation to degree of obesity at baseline and 2 year weight change: the Swedish Obese Subjects (SOS) study. Diabetologia 2015;58:1448–1453
95. Arterburn DE, Bogart A, Sherwood NE, et al. A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obes Surg 2013;23:93–102
96. Cohen RV, Pinheiro JC, Schiavon CA, Salles JE, Wajchenberg BL, Cummings DE. Effects of gastric bypass surgery in patients with type 2 diabetes and only mild obesity. Diabetes Care 2012;35:1420–1428
97. Brethauer SA, Aminian A, Romero-Talamás H, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg 2013;258:628–636; discussion 636–637
98. Hsu CC, Almulaifi A, Chen JC, et al. Effect of bariatric surgery vs medical treatment on type 2 diabetes in patients with body mass index lower than 35: five-year outcomes. JAMA Surg 2015;150:1117–1124
99. Hariri K, Guevara D, Jayaram A, Kini SU, Herron DM, Fernandez-Ranvier G. Preoperative insulin therapy as a marker for type 2 diabetes remission in obese patients after bariatric surgery. Surg Obes Relat Dis 2018;14:332–337
100. Yu H, Di J, Bao Y, et al. Visceral fat area as a new predictor of short-term diabetes remission after Roux-en-Y gastric bypass surgery in Chinese patients with a body mass index less than 35 kg/m2. Surg Obes Relat Dis 2015;11:6–11
101. Kirwan JP, Aminian A, Kashyap SR, Burguera B, Brethauer SA, Schauer PR. Bariatric surgery in obese patients with type 1 diabetes. Diabetes Care 2016;39:941–948
102. Rubin JK, Hinrichs-Krapels S, Hesketh R, Martin A, Herman WH, Rubino F. Identifying barriers to appropriate use of metabolic/bariatric surgery for type 2 diabetes treatment: policy lab results. Diabetes Care 2016;39:954–963
103. Fouse T, Schauer P. The socioeconomic impact of morbid obesity and factors affecting access to obesity surgery. Surg Clin North Am 2016;96:669–679
104. Flum DR, Belle SH, King WC, et al.; Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med 2009;361:445–454
105. Courcoulas AP, Christian NJ, Belle SH, et al.; Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA 2013;310:2416–2425
106. Arterburn DE, Courcoulas AP. Bariatric surgery for obesity and metabolic conditions in adults. BMJ 2014;349:g3961
107. Young MT, Gebhart A, Phelan MJ, Nguyen NT. Use and outcomes of laparoscopic sleeve gastrectomy vs laparoscopic gastric bypass: analysis of the American College of Surgeons NSQIP. J Am Coll Surg 2015;220:880–885
108. Aminian A, Brethauer SA, Kirwan JP, Kashyap SR, Burguera B, Schauer PR. How safe is metabolic/diabetes surgery? Diabetes Obes Metab 2015;17:198–201
109. Birkmeyer NJO, Dimick JB, Share D, et al.; Michigan Bariatric Surgery Collaborative. Hospital complication rates with bariatric surgery in Michigan. JAMA 2010;304:435–442
110. Altieri MS, Yang J, Telem DA, et al. Lap band outcomes from 19,221 patients across centers and over a decade within the state of New York. Surg Endosc 2016;30:1725–1732
111. Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg 2011;254:410–420; discussion 420–422
112. Nguyen NT, Slone JA, Nguyen XMT, Hartman JS, Hoyt DB. A prospective randomized trial of laparoscopic gastric bypass versus laparoscopic adjustable gastric banding for the treatment of morbid obesity: outcomes, quality of life, and costs. Ann Surg 2009;250:631–641
113. Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg 2018;153:427–434
114. Birkmeyer JD, Finks JF, O’Reilly A, et al.; Michigan Bariatric Surgery Collaborative. Surgical skill and complication rates after bariatric surgery. N Engl J Med 2013;369:1434–1442
115. Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures—2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, the Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists—executive summary. Endocr Pract 2019;25:1346–1359
116. Service GJ, Thompson GB, Service FJ, Andrews JC, Collazo-Clavell ML, Lloyd RV. Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery. N Engl J Med 2005;353:249–254
117. Sheehan A, Patti ME. Hypoglycemia after upper gastrointestinal surgery: clinical approach to assessment, diagnosis, and treatment. Diabetes Metab Syndr Obes 2020;13:4469–4482
118. Lee D, Dreyfuss JM, Sheehan A, Puleio A, Mulla CM, Patti ME. Glycemic patterns are distinct in post-bariatric hypoglycemia after gastric bypass (PBH-RYGB). J Clin Endocrinol Metab 2021;106:2291–2303
119. Salehi M, Vella A, McLaughlin T, Patti ME. Hypoglycemia after gastric bypass surgery: current concepts and controversies. J Clin Endocrinol Metab 2018;103:2815–2826
120. Conason A, Teixeira J, Hsu CH, Puma L, Knafo D, Geliebter A. Substance use following bariatric weight loss surgery. JAMA Surg 2013;148:145–150
121. Bhatti JA, Nathens AB, Thiruchelvam D, Grantcharov T, Goldstein BI, Redelmeier DA. Self-harm emergencies after bariatric surgery: a population-based cohort study. JAMA Surg 2016;151:226–232
122. Peterhänsel C, Petroff D, Klinitzke G, Kersting A, Wagner B. Risk of completed suicide after bariatric surgery: a systematic review. Obes Rev 2013;14:369–382
123. Jakobsen GS, Småstuen MC, Sandbu R, et al. Association of bariatric surgery vs medical obesity treatment with long-term medical complications and obesity-related comorbidities. JAMA 2018;319:291–301
124. King WC, Chen JY, Mitchell JE, et al. Prevalence of alcohol use disorders before and after bariatric surgery. JAMA 2012;307:2516–2525
125. Young-Hyman D, Peyrot M. Psychosocial Care for People with Diabetes. 1st ed. Alexandria, VA, American Diabetes Association, 2012
126. Greenberg I, Sogg S, M Perna F. Behavioral and psychological care in weight loss surgery: best practice update. Obesity (Silver Spring) 2009;17:880–884
127. Evert AB, Dennison M, Gardner CD, et al. Nutrition therapy for adults with diabetes or prediabetes: a consensus report. Diabetes Care 2019;42:731–754
128. IBM. Micromedex Red Book. Accessed 9 November 2022. Available from https://www.ibm.com/products/micromedex-red-book
129. Data.Medicaid.gov. NADAC (National Average Drug Acquisition Cost). Accessed 4 October 2022. Available from https://data.medicaid.gov/dataset/dfa2ab14-06c2-457a-9e36-5cb6d80f8d93
130. U.S. National Library of Medicine. Phentermine–phentermine hydrochloride capsule. Accessed 17 October 2022. Available from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=737eef3b-9a6b-4ab3-a25c-49d84d2a0197
131. Nalpropion Pharmaceuticals. Contrave (naltrexone HCl/bupropion HCl) extended-release tablets. Accessed 17 October 2022. Available at https://contrave.com
132. CHEPLAPHARM and H2-Pharma. Xenical (orlistat). Accessed 17 October 2022. Available from https://xenical.com
133. Vivus. Qsymia (phentermine and topiramate extended-release) capsules. Accessed 17 October 2022. Available from https://qsymia.com
134. Novo Nordisk. Saxenda (liraglutide injection 3 mg). Accessed 17 October 2022. Available from https://www.saxenda.com
135. Aronne LJ, Wadden TA, Peterson C, Winslow D, Odeh S, Gadde KM. Evaluation of phentermine and topiramate versus phentermine/topiramate extended-release in obese adults. Obesity (Silver Spring) 2013;21:2163–2171
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