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Obesity rates are continuing to increase in the USA and in many other westernised countries across the globe. Currently 1/3 of Americans are overweight (body mass index (BMI) >25 kg/m2) and another 1/3 are obese (BMI>25 kg/m2). The upward trends in the incidence and prevalence continue unabated. Obesity leads to a myriad of health problems ranging from an increased rate of conversion to diabetes, hypertension and other cardiovascular diseases, orthopaedic problems and even cancer. In addition to these medical complications and the resulting associated medical and lost productivity, obesity is associated with reduced quality of life. Bias and discrimination in the workplace and social stigmatisation are real issues and together take a toll on patients with obesity. In contrast to the epidemic, current treatments for obesity are limited. Diet and lifestyle interventions are effective but weight regain is the norm rather than the rule. Bariatric (metabolic) surgery is effective; however, safety concerns continue and many patients do not choose surgery as an option in spite of solid data showing reduced mortality over the long term. Between these two options is a huge gap: only one medication is approved …
Competing interests SRS has been reimbursed as a consultant ore received research support from by Arena, Amylin, BMS, Jenrin Discoveries Zafgen, Takeda. SRS has also conducted research for, and served as a consultant to, Orexigen pharmaceuticals who sponsored the reviewed paper.