From the Guidelines
New Zealand's guidelines for weight loss treatment should prioritize pharmacotherapy in addition to lifestyle intervention for adults with overweight and obesity, as recommended by the AGA clinical practice guideline 1. The guideline suggests the use of semaglutide 2.4 mg, liraglutide 3.0 mg, phentermine-topiramate ER, and naltrexone-bupropion ER for long-term management of overweight and obesity, based on moderate certainty evidence. Key points to consider in weight loss treatment include:
- The use of pharmacotherapy in addition to lifestyle intervention for adults with a body mass index of 30 kg/m2 or higher, or 27 kg/m2 or higher with weight-related complications 1
- The recommendation against the use of orlistat due to low certainty evidence 1
- The identification of the use of Gelesis100 oral superabsorbent hydrogel as a knowledge gap, indicating a need for further research 1
- The importance of lifestyle modifications, including reduced calorie intake and increased physical activity, as a foundation for weight loss treatment
- The potential role of behavioral therapy and other supportive measures in achieving and maintaining weight loss.
From the Research
NZ Guideline for Weight Loss Treatment
The New Zealand guideline for weight loss treatment is focused on a comprehensive approach that includes diet, exercise, and behavior modifications.
- Weight loss interventions varied in strategy and suitability for individual patients, with some studies using a Kaupapa Māori approach 2.
- The most effective weight loss interventions are those that combine diet, exercise, and behavior modifications in culturally appropriate ways 2.
Pharmacological Interventions
Some studies have investigated the effectiveness of pharmacological interventions for weight loss in New Zealand.
- Orlistat and liraglutide have been shown to be effective in reducing weight and improving metabolic risk factors in patients with obesity 3.
- Orlistat has been found to be effective in reducing weight and improving metabolic risk factors in obese patients, particularly those with type 2 diabetes 4.
- Cinnamon, a natural lipase inhibitor, has also been found to be effective in reducing BMI and improving glycemic targets, although its effects are different from those of orlistat 5.
Dietary Strategies
Dietary strategies are also an important component of weight loss treatment in New Zealand.
- An energy deficit is the most important factor in weight loss, and a low-calorie diet with a low fat or carbohydrate content has been recommended 6.
- Some macronutrient composition-based diets, such as the ketogenic diet or high-protein diet, may be effective for weight loss, although their potential risks and long-term effectiveness are unknown 6.
- Meal timing is also an important factor in weight management, and higher-calorie breakfasts in combination with overnight fasting may help to prevent obesity 6.