ECE2016 DEBATE Should we treat subclinical Cushing's syndrome? (2 abstracts)
Italy.
The ongoing obesity epidemic is one of the main concerns worldwide and for this reason preventive strategies to reduce the future global health and the economic costs of this disease are urgently needed. Diets for weight loss and physical activity represent the cornerstone of treatment for patients who are overweight and/or obese, in particular to improve the frequent comorbid conditions associated with obesity. Now and in the past multiple medications have been approved for chronic weight management in order to pharmacologically treating obesity like other chronic diseases. However, still a number of doubts has been attributed to the use of drugs to curb obesity mainly due to a series of factors:
i) The modest efficacy of the current medications options often limited to 510% body weight loss
ii) The lack of long-term studies clearly demonstrating a final beneficial effects of anti-obesity drugs when compared to bariatric surgery with respect to the cardiovascular events
iii) The previous experience of serious safety inducing a risk-to-benefit ratio no longer favourable toward anti-obesity drugs
iv) The limited possibility to provide an individualized pharmacotherapy in consideration of the heterogeneity featuring obesity phenotype
v) The economical cost of the drugs for the national Agencies when reimbursement is approved or for the single patient when not
All these reasons supporting the idea that we are not yet ready for pharmacological therapy of obesity will be critically revised during the lecture.