Case 6 question 1

Incorrect, try again! GLP-1 agonists have shown good efficacy for weight loss. However, they increase risk of gallbladder disease and pancreatitis and for these reasons are not the best choice for this patient.

Good choice! Intra-gastric balloon (IGB) is a reasonable choice for this patient. In individuals with obesity seeking a weight-loss intervention who have failed a trial of conventional weight-loss strategies, AGA suggests the use of IGB therapy with lifestyle modification over lifestyle modification alone. Data from 7 randomized controlled trials (RCTs) showed IGBs resulted in patients losing an average of 15.46 lbs at 6 months, with sustained weight loss at 9 and 12 months compared with patients using only using lifestyle modifications.

Try again! Phenteramine-topiramate is an adrenergic agonist, which is FDA approved for the treatment of obesity, however it should be used with caution in patients with hypertension. It is also teratogenic and is not an appropriate choice in a woman of childbearing age who is trying to conceive.

Good choice! Bariatric surgery with gastric sleeve or RY gastric bypass is also a reasonable option for this patient, as she has class II obesity ( BMI 35-39) with a co-existing medical comorbidity (hypertension)

Try again! The AGA recommends against using Orlistat which is a lipase inhibitor , for weight loss, due to significant gastro-intestinal side effects.