Position of the Bariatric and Metabolic Surgery Section of the Polish Association for the Study on Obesity on the use of pharmacotherapy to support the treatment of obesity before and after surgery

The position is based on current literature data and presents the state of knowledge on the date of the analysis. It may be updated if new research results are published.

Stanowisko powstało na podstawie literatury i przedstawia stan wiedzy na ww. temat na dzień przeprowadzenia analizy. Może ono ulec aktualizacji w przypadku pojawienia się wyników nowych istotnych badań.

Definition of the disease, factors influencing its progress, and its health effects

Obesity is a chronic, multifactorial disease with no tendency for spontaneous recurrence and with a tendency to recur. The lack of effective treatment for obesity is best at the stage of overweight, leading to progression of the disease to its third degree, called extreme or fatal obesity (BMI 40 kg/m2). Regardless of the original cause of the disease, excessive fat deposition in the body always carries a positive energy balance, that is, excess energy consumed over the expended. It should also be noted that obesity is increasingly seen as a psychosomatic disease, because in many cases, especially in patients with stage III disease, eating disorders such as binge eating syndrome, night-time eating syndrome, or food addiction are diagnosed [1-5].
Because no country in the world has a well-functioning system of comprehensive treatment of obesity, and patients often use advice and methods of fighting obesity that have little to do with treatment based on modern medical knowledge, the proportion of patients with the most advanced stages of obesity is growing steadily. Regardless of the region of the world, the proportion of patients with grade III obesity is higher among women than among men [6]. This can be attributed both to the higher prevalence of eating disorders and atypical depressive disorders among women, but also to the fact that women are more likely to use a “miracle diet” or unprofessional diet advice in places that offer fast results, as desired by the patient.
As the disease progresses, the number of complications increases, the quality of life decreases, and the risk of disability and premature death increases. The costs of health care (direct costs) and indirect costs also increase – medical exemptions, early pensions, overtime in the working-age population, and the care of others [7]. Therefore, for both individual and social reasons, it is important to treat obesity effectively.

What should be understood as effective treatment of obesity?

The...


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