Comprehensive obesity care: Leveraging lifestyle modifications, obesity medications, and bariatric procedures to improve clinical and nutrition outcomes

Obesity is common, affecting >40% of Americans and increasing at rapid rates worldwide. Defined by the presence of excess body fat, obesity is tied to a multitude of poor health conditions, including cardiovascular disease, insulin resistance, and malignancy. Although lifestyle modifications such as diet and physical activity are cornerstones of management and crucial to enhance the health benefits achieved via targeted treatment plans, highly efficacious obesity medications are also now available. In particular, glucagon-like peptide-1 receptor agonists, have been found to be safe and efficacious, inducing clinically significant weight loss that is sustainable. Their effect on nutrition status is still being defined. In addition to medications, bariatric endoscopy and bariatric surgery are also highly effective options for durable weight loss, although these treatments are associated with malnutrition if they are not appropriately monitored. This review aims to define the current landscape of obesity medicine today, highlighting both current therapies and discussing their associated nutrition considerations, to educate the nutrition-focused provider. Multimodal therapies, combining medications and procedures, are an active area of research and will likely define care in future years.