European Journal of Biomedical and Pharmaceutical Sciences

EVIDENCE-BASED MANAGEMENT OF OBESITY - ADVANCES IN LIFESTYLE INTERVENTIONS AND PHARMACOTHERAPY

Agaaj Shaikh*, Dr. Kelgaonkar Prajakta, Pratiksha Jadhav, Vedika Mali, Ashwini Khandagale

ABSTRACT

Obesity is a chronic, relapsing, multifactorial disease driven by interactions among biological, behavioural, environmental and social determinants. Contemporary management has therefore moved beyond the traditional concept of short-term calorie restriction toward long-term, complication-oriented care. Lifestyle intervention remains the foundation of treatment and should include an individualized dietary strategy, regular aerobic and resistance exercise, behavioural support, adequate sleep, stress management and attention to weight stigma. No single dietary pattern is consistently superior for all patients; sustained energy deficit, nutritional quality, adherence and preservation of lean mass are more important than macronutrient ideology. Intensive multicomponent programmes produce clinically meaningful weight loss and improve cardiometabolic risk, but physiological adaptations frequently limit long-term maintenance. Pharmacotherapy is increasingly used as an adjunct to lifestyle treatment, particularly when obesity-related complications are present or lifestyle intervention alone is insufficient. Older agents such as orlistat, naltrexone/bupropion and phentermine/topiramate remain useful in selected patients, whereas incretin-based therapies have transformed expectations for non-surgical weight reduction. Semaglutide 2.4 mg and the dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonist tirzepatide can produce double-digit mean weight loss, with evidence of benefits extending to glycaemia, cardiovascular outcomes, heart failure, sleep apnoea and physical function in appropriately selected populations. Weight regain after drug withdrawal emphasizes that obesity pharmacotherapy should generally be viewed as long-term treatment. This review summarizes evidence-based lifestyle management, established and newer anti-obesity medications, integration of treatment modalities, safety considerations and emerging directions in personalized obesity care.

Keywords: Obesity, weight management, lifestyle intervention, anti-obesity medication, GLP-1 receptor agonist and pharmacotherapy.