Obesity is a complex health issue with growing prevalence worldwide. It is also becoming more prevalent in the population of older adults (i.e., 65 years of age and older), affecting frequency and severity as well as other comorbidities, quality of life and consequently, life expectancy. In this article we review currently available data on pharmacotherapy of obesity in the population of older adults and its role in obesity management. Even though there is growing evidence, in particular in the general population, of favourable efficacy and safety profiles of glucagon-like peptide-1 (GLP-1) receptor agonists liraglutide and semaglutide, and recently dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide, concise guidelines for older adults are not available to this day. We further discuss specific approaches to frequently represented phenotype of obesity in older adults, in particular sarcopenic obesity and rationale when to treat and how. In older adults with obesity there is a need for more drug trials focusing not only on weight loss, but also on geriatric endpoints including muscle mass preservation, bone quality and favourable fat distribution changes to get enough data for evidence-based recommendation on obesity treatment in this growing sub-population.
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Obezita představuje kvůli své celosvětově rostoucí prevalenci a celé řadě komorbidit a chronických komplikací jeden z nejzásadnějších problémů současného zdravotnictví. Kombinace obezity, arteriální hypertenze, dyslipidemie a inzulinorezistence/diabetu 2. typu, často označovaná jako metabolický syndrom, vede k výraznému zvýšení rizika kardiovaskulární morbidity a mortality a mnoha dalších onemocnění. V tomto článku podáváme přehled aktuálních možností léčby obezity. V rámci popisu farmakoterapie se věnuje- me zejména lékům, které jsou v současné době v České republice dostupné. Podáváme také přehled vlivu různých typů antidiabetik na tělesnou hmotnost a diskutujeme perspektivy léčby se zaměřením na antiobezitika, jejichž uvedení na trh se postupně blíží. Stručně také uvádíme přehled principů léčby obezity s využitím bariatrické chirurgie a bariatrické endoskopie.
Obesity is one of the most important health problems due to its increasing prevalence worldwide and a wide range of comorbidities and chronic complications. The combination of obesity, arterial hypertension, dyslipidemia and insulin resistance/type 2 diabetes often referred to as the Metabolic Syndrome leads to a significant increase in the risk of cardiovascular morbidity and mortality and numerous others pathologies. In this article, we review current treatment options for obesity. We are primarily focusing on description of pharmacotherapies that are currently available in the Czech Republic. We also give an overview of the effects of different types of antidiabetic drugs on body weight and discuss treatment perspectives, focusing on antiobesity drugs that are gradually approaching introduction to Czech market. We also briefly review the principles of obesity treatment using bariatric surgery and bariatric endoscopy.
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