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Obesity Pharmacotherapy - OMA Obesity Algorithm 2023

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4 Effects of Concomitant Medications on Weight Concomitant Pharmacotherapy Limitations in the reported effects on body weight   ➤ The reported weight effects of concomitant non-anti-obesity medications should be interpreted with caution, because the data describing these weight effects: • Are mostly derived f rom observations of studies not specif ically designed to evaluate the effects of these medications on body weight. • Are mostly derived f rom comparisons of the reported effects f rom different studies, rather than derived f rom a direct head-to- head comparison within the same controlled clinical trial. • Studies often report variable weight effects, depending on the condition being treated (e.g., psychiatric medications being used for multiple psychiatric conditions), dataset, analysis [head-to- head versus meta-analysis, and specif ic agents having especially inconsistent reported effects (e.g., haloperidol, sertraline)]. • The reported effect is mostly expressed as mean values, with the potential for wide variances in individual weight responses to a particular drug. Pharmacotherapy That Might Alter Body Weight Cardiovascular Medications May increase body weight: • Some beta-blockers   ▶ Propranolol may increase body weight   ▶ Atenolol may increase body weight   ▶ Metoprolol may increase body weight   ▶ (Carvedilol may not increase body weight) • Older and/or less lipophilic dihydropyridine ("dipine") calcium channel blockers may increase body weight gain due to edema possibly because they are more vasodilatory), compared to non- dihydropyridines and lipophilic dihydropyridines. The increased edema may exacerbate obesity-related edema (and sleep apnea related peripheral edema), and also confound body weight as a measure of body fat.   ▶ Nifedipine may increase body weight   ▶ Amlodipine may increase body weight

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