Information

Obesity is a chronic disease that has become a major health problem in most industrialized countries because of its high prevalence, causal relationship with serious medical illnesses, and economic impact.  In the United States it is estimated that obesity is responsible for 300,000 deaths per year, and that the direct costs (medical expenses) of obesity exceed $50 billion per year, ranking obesity as the second most expensive of all chronic diseases.

The metabolic syndrome, which is associated with abdominal obesity, represents a clustering of cardiovascular disease risk factors.  The risk factors include excess abdominal fat, insulin-resistant glucose metabolism (elevated fasting glucose, impaired glucose tolerance, hyperinsulinemia, impaired insulin-mediated glucose disposal, type 2 diabetes mellitus), dyslipidemia (elevated serum triglyceride, low serum HDL-cholesterol concentration), and high blood pressure.

Weight loss is the treatment of choice for obese patients who have the metabolic syndrome because it improves all metabolic syndrome components simultaneously.  Moreover, many of these beneficial effects are apparent after only modest weight losses of 5% to 10% of initial body weight.  The current therapeutic tools that are available for weight management include behavior management to change diet and physical activity habits, pharmacotherapy, and surgery.  Dietary intervention is the cornerstone of weight loss therapy because it is easier for most obese persons to achieve negative energy balance by decreasing food intake than by increasing physical activity.  The difficulty in achieving long-term weight management with lifestyle modification has led to an increased interest in pharmacotherapy for obesity.

Currently, there are 8 drugs that have been approved by the United States Food and Drug Administration for treatment of obesity.  Only two of these medications, sibutramine and orlistat, are approved for long-term usage.  There are several new drugs are in various stages of investigation in the developmental pipeline.  In addition, there are ongoing clinical trials involving several medications that are currently approved for other specific medical indications that have shown promise for use in achieving weight loss.

The objective of this program is to educate participants about the prevalence and health consequences of obesity and the metabolic syndrome, the health benefits of weight loss, and currently accepted treatment approaches that can lead to effective weight loss and improved health in obese patients.

Upon completion of this CME activity, participants should be able to:

• The pathophysiology of obesity and its comorbid disorders
• The relationship of metabolic syndrome and obesity to cardiovascular disease
• The different nonpharmacologic and pharmacologic approaches to treatment of obesity

This CME activity is designed to meet the educational needs of primary care physicians (general medicine, internal medicine, family practice), specialists in obesity and diabetes, and other healthcare professionals providing healthcare services to obese patients.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME). The Obesity Society is accredited by the ACCME to provide continuing medical education for physicians.

The Obesity Society designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit^TM toward the Physicians Recognition Award. Each physician should claim credit only those hours of credit that he/she actually spent in the activity.

The estimated time to complete this activity is 1.0 hour.

A participant in this activity should review and evaluate the presentation for content and usefulness in his/her practice, and complete the posttest, evaluation, and registration forms.

June 2007 through December 2007. Original release date: November 2004

This online CME enduring material was prepared from materials previously used in a live CME activity developed in 2003 through a joint sponsorship agreement between NAASO and Ortho-McNeil Pharmaceutical.   In October 2004, these materials were reviewed by the members of the Obesity Online Editorial Board (Steven Haffner, MD; Samuel Klein, MD, MS; Christie Ballantyne, MD; and F. Xavier Pi-Sunyer, MD, MPH) to ensure the continued scientific accuracy and medical relevance of information presented and its independence from commercial bias.

Steven Haffner, MD, is a consultant for Sanofi-Synthelabo. He is a member of the speakers bureaus for Pfizer, GlaxoSmithKline, and AstraZeneca.

Samuel Klein, MD, MS, receives research support from the National Institutes of Health and Transneuronix.  He is a member of the speakers bureau for Merck Research Laboratories, and serves on the Council on Obesity and Diabetes Education sponsored by Roche Laboratories, and the Enteromedics Medical Advisory Board.

Christie M. Ballantyne, MD, is engaged in research activities for AstraZeneca, diaDexus, GlaxoSmithKline, Merck, Novartis, Pfizer, Reliant, and Schering-Plough. He is a consultant for AstraZeneca, Merck, Novartis, Pfizer, Reliant, and Schering-Plough and is a member of the speakers bureaus for AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Novartis, Pfizer, Reliant, and Schering-Plough. He has received honoraria from AstraZeneca, Bristol Myers-Squibb, Kos, Merck, Novartis, Pfizer, Reliant, and Schering-Plough.

F. Xavier Pi-Sunyer, MD, MPH, receives research support from Johnson & Johnson and Sanofi-Synthelabo.  He is a consultant for Johnson & Johnson, Sanofi-Synthelabo, Ortho-McNeil Pharmceutical, and Roche.

In accordance with The Obesity Society’s Policy on Disclosure of Relationships, all individuals involved in the planning, development, and delivery of educational activities are required to sign a conflict of interest statement in which they disclose any relevant financial interests or other affiliations with industry or other associations which may have direct and substantial interest in the subject matter of the CME activity. Such disclosure allows program participants to better evaluate the objectivity of the information presented in the program.

Obesity Online and this enduring material are supported by an unrestricted educational grant from Sanofi-Synthelabo, Inc., a member of the sanofi-aventis Group. Support for the original live CME activity used for development of this enduring material was provided in the form of an unrestricted educational grant from Ortho-McNeil Pharmaceuticals, Inc.