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Diabetes and Obesity Management

Episode 6 - Pharmacotherapy Versus Bariatric Surgery

During this segment, Peter Salgo, MD, and experts Jeffrey D. Dunn, PharmD, MBA; Yehuda Handelsman, MD, FACP, FACE, FNLA; Maria Lopes, MD, MS; and Kari Uusinarkaus, MD, FAAFP, FNLA, explore the costs and benefits of treating patients with pharmacotherapy or bariatric surgery in the context of the limited availability of resources.
Substantial and sustained weight loss results in improvements in obesity-related comorbidities, and clinicians may consider pharmacotherapy and/or bariatric surgery in appropriate patients. Peter Salgo, MD, comments that bariatric surgery is a more expensive option compared with pharmacotherapy.

Although pharmacotherapy may be less expensive, Yehuda Handelsman, MD, FACP, FACE, FNLA, notes that surgery is a first-choice option for many patients, especially for patients who have a body mass index of 35 or greater and need to lose a larger proportion of weight very quickly.

Maria Lopes, MD, MS, explains that in order to evaluate the financial benefits of pharmacotherapy and bariatric surgery, comparative effectiveness data are needed. Even more important, Dr Lopes states, are data to show that pharmacotherapy options are truly effective.

Jeffrey D. Dunn, PharmD, MBA, comments that because treating obesity is expensive, key stakeholders in healthcare need to figure out how to better spend the limited resources currently available for the management of obesity.

Together, Kari Uusinarkaus, MD, FAAFP, FNLA, and Drs Handelsman and Lopes conclude that a multi-stakeholder approach, with help from the government, is necessary. Dr Handelsman adds that because obesity is so expensive, prevention programs are essential.

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