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Review
. 2024 Sep 7;404(10456):972-987.
doi: 10.1016/S0140-6736(24)01210-8. Epub 2024 Aug 16.

Obesity in adults

Ildiko Lingvay  1 , Ricardo V Cohen  2 , Carel W le Roux  3 , Priya Sumithran  4
Affiliations
Review

Obesity in adults

Ildiko Lingvay et al. Lancet. .

Abstract

Obesity has increased in prevalence worldwide and WHO has declared it a global epidemic. Population-level preventive interventions have been insufficient to slow down this trajectory. Obesity is a complex, heterogeneous, chronic, and progressive disease, which substantially affects health, quality of life, and mortality. Lifestyle and behavioural interventions are key components of obesity management; however, when used alone, they provide substantial and durable response in a minority of people. Bariatric (metabolic) surgery remains the most effective and durable treatment, with proven benefits beyond weight loss, including for cardiovascular and renal health, and decreased rates of obesity-related cancers and mortality. Considerable progress has been made in the development of pharmacological agents that approach the weight loss efficacy of metabolic surgery, and relevant outcome data related to these agents' use are accumulating. However, all treatment approaches to obesity have been vastly underutilised.

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Conflict of interest statement

Declaration of interests IL received research funding (paid to University of Texas Southwestern Medical Center, Dallas, TX, USA) from NovoNordisk, Sanofi, Merck, Pfizer, Mylan, and Boehringer-Ingelheim; received advisory or consulting fees and non-financial support from Novo Nordisk, Eli Lilly, Sanofi, AstraZeneca, Boehringer-Ingelheim, Johnson & Johnson, Intercept, TARGETPharma, Merck, Pfizer, Valeritas, Zealand Pharma, Shionogi, Carmot Therapeutics, Structure Therapeutics, Bayer, Translational Medical Academy, Mediflix, Biomea, Metsera, The Comm Group, and WebMD; and serves on the Data Safety Monitoring Board for Jaeb Center for Health Research. CWlR reports grants from the Irish Research Council, Science Foundation Ireland, Anabio, and the Health Research Board; he serves on advisory boards and speakers panels of Novo Nordisk, Herbalife, GI Dynamics, Eli Lilly, Johnson & Johnson, Glia, Irish Life Health, Boehringer-Ingelheim, Currax, Zealand Pharma, and Rhythm Pharma; CWlR is a member of the Irish Society for Nutrition and Metabolism outside the area of work commented on here; he was the chief medical officer and director of the Medical Device Division of Keyron in 2021 (both of these are unremunerated positions); and was a previous investor in Keyron, which develops endoscopically implantable medical devices intended to mimic the surgical procedures of sleeve gastrectomy and gastric bypass (no patients have been included in any of Keyron's studies and the institution is not listed on the stock market); was gifted stock holdings in September 2021 and divested all stock holdings in Keyron in September, 2021; continues to provide scientific advice to Keyron for no remuneration; and CLR provides obesity clinical care in the Beyond BMI clinic and is a shareholder in the clinic. RVC reports payment or honoraria for lectures from Johnson & Johnson Brazil, Medtronic, Janssen Pharmaceuticals, Novo Nordisk, and Abbott; is on the scientific advisory board for GI Dynamics; and declares research grants paid to the Center for Obesity and Diabetes, Oswaldo Cruz German Hospital, São Paulo, Brazil from Johnson & Johnson, Medtech, and Medtronic. PS reports research grants paid to her institution from the National Health and Medical Research Council; declares co-authorship of manuscripts with medical writing assistance from Novo Nordisk and Eli Lilly; and an unpaid position in the leadership group of the Obesity Collective.

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