Abstract：
Pharmacological management of obesity improves outcomes and decreases the risk of obesity-related complications. This American Gastroenterological Association guideline is intended to support practitioners in decisions about pharmacological interventions for overweight and obesity.
A multidisciplinary panel of content experts and guideline methodologists used the Grading of Recommendations Assessment, Development and Evaluation framework to prioritize clinical questions, identify patient-centered outcomes, and conduct an evidence synthesis of the following agents: semaglutide 2.4 mg, liraglutide 3.0 mg, phentermine-topiramate extended-release (ER), naltrexone-bupropion ER, orlistat, phentermine, diethylpropion, and Gelesis100 oral superabsorbent hydrogel. The guideline panel used the evidence-to-decision framework to develop recommendations for the pharmacological management of obesity and provided implementation considerations for clinical practice.
The guideline panel made 9 recommendations. The panel strongly recommended the use of pharmacotherapy in addition to lifestyle intervention in adults with overweight and obesity (body mass index ≥30 kg/m2, or ≥27 kg/m2 with weight-related complications) who have an inadequate response to lifestyle interventions. The panel suggested the use of semaglutide 2.4 mg, liraglutide 3.0 mg, phentermine-topiramate ER, and naltrexone-bupropion ER (based on moderate certainty evidence), and phentermine and diethylpropion (based on low certainty evidence), for long-term management of overweight and obesity. The guideline panel suggested against the use of orlistat. The panel identified the use of Gelesis100 oral superabsorbent hydrogel as a knowledge gap.
In adults with overweight and obesity who have an inadequate response to lifestyle interventions alone, long-term pharmacological therapy is recommended, with multiple effective and safe treatment options.
A multidisciplinary panel of content experts and guideline methodologists used the Grading of Recommendations Assessment, Development and Evaluation framework to prioritize clinical questions, identify patient-centered outcomes, and conduct an evidence synthesis of the following agents: semaglutide 2.4 mg, liraglutide 3.0 mg, phentermine-topiramate extended-release (ER), naltrexone-bupropion ER, orlistat, phentermine, diethylpropion, and Gelesis100 oral superabsorbent hydrogel. The guideline panel used the evidence-to-decision framework to develop recommendations for the pharmacological management of obesity and provided implementation considerations for clinical practice.
The guideline panel made 9 recommendations. The panel strongly recommended the use of pharmacotherapy in addition to lifestyle intervention in adults with overweight and obesity (body mass index ≥30 kg/m2, or ≥27 kg/m2 with weight-related complications) who have an inadequate response to lifestyle interventions. The panel suggested the use of semaglutide 2.4 mg, liraglutide 3.0 mg, phentermine-topiramate ER, and naltrexone-bupropion ER (based on moderate certainty evidence), and phentermine and diethylpropion (based on low certainty evidence), for long-term management of overweight and obesity. The guideline panel suggested against the use of orlistat. The panel identified the use of Gelesis100 oral superabsorbent hydrogel as a knowledge gap.
In adults with overweight and obesity who have an inadequate response to lifestyle interventions alone, long-term pharmacological therapy is recommended, with multiple effective and safe treatment options.
摘要：
肥胖的药物管理可改善预后并降低肥胖相关并发症的风险。该美国胃肠病学协会指南旨在支持从业人员做出有关超重和肥胖的药物干预措施的决定。
由内容专家和指南方法学家组成的多学科小组使用了建议评估的分级，开发和评估框架，以优先考虑临床问题，确定以患者为中心的结果，并对以下药物进行证据合成：司马鲁肽2.4毫克，利拉鲁肽3.0mg,苯丁胺-托吡酯缓释（ER），纳曲酮-安非他酮,奥利司他,芬特明,二乙基丙酸，和Gelesis100口服超吸收水凝胶。指南小组使用证据决策框架来制定肥胖的药理学管理建议，并为临床实践提供实施考虑因素。
指南小组提出了9条建议。专家组强烈建议对超重和肥胖（体重指数≥30kg/m2或体重相关并发症≥27kg/m2）的成年人对生活方式干预反应不足的成年人，除生活方式干预外，还应使用药物治疗。小组建议使用司马鲁肽2.4毫克，利拉鲁肽3.0mg,苯丁胺-托吡酯ER，和纳曲酮-安非他酮ER（基于中等确定性证据），和苯丁胺和二乙基丙酸（基于低确定性证据），用于超重和肥胖的长期管理。指南小组建议不要使用奥利司他。小组确定了使用Gelesis100口服超吸收水凝胶作为知识空白。
在超重和肥胖的成年人中，仅对生活方式干预反应不足，建议长期药物治疗，具有多种有效和安全的治疗选择。
由内容专家和指南方法学家组成的多学科小组使用了建议评估的分级，开发和评估框架，以优先考虑临床问题，确定以患者为中心的结果，并对以下药物进行证据合成：司马鲁肽2.4毫克，利拉鲁肽3.0mg,苯丁胺-托吡酯缓释（ER），纳曲酮-安非他酮,奥利司他,芬特明,二乙基丙酸，和Gelesis100口服超吸收水凝胶。指南小组使用证据决策框架来制定肥胖的药理学管理建议，并为临床实践提供实施考虑因素。
指南小组提出了9条建议。专家组强烈建议对超重和肥胖（体重指数≥30kg/m2或体重相关并发症≥27kg/m2）的成年人对生活方式干预反应不足的成年人，除生活方式干预外，还应使用药物治疗。小组建议使用司马鲁肽2.4毫克，利拉鲁肽3.0mg,苯丁胺-托吡酯ER，和纳曲酮-安非他酮ER（基于中等确定性证据），和苯丁胺和二乙基丙酸（基于低确定性证据），用于超重和肥胖的长期管理。指南小组建议不要使用奥利司他。小组确定了使用Gelesis100口服超吸收水凝胶作为知识空白。
在超重和肥胖的成年人中，仅对生活方式干预反应不足，建议长期药物治疗，具有多种有效和安全的治疗选择。
