Recently published papers and news articles are covering exciting findings related to obesity complications, co-morbidities and treatments. There are over 200 such complications that are related to obesity.
Three of the complications may go unnoticed but have been shown to improve with treatment by one of the new highly effective obesity medications:
- Sleep apnea, a disorder in which a person’s breathing repeatedly stops and starts during sleep.
- Heart failure where the heart muscle is too stiff and doesn’t relax properly
- Fatty liver disease where excess fat builds up in the liver and can progress to become inflamed and scarred
If you’re someone who struggles with weight or a health care professional treating patients, here are some things to know about these 3 often under-diagnosed complications:
1-Know Signs and Symptoms
Sleep apnea is characterized by loud, chronic snoring and pausing in breathing during sleep, excessive daytime sleepiness, morning headaches, low energy and fatigue. Individuals may have an enlarged neck size and crowded tissue in the throat.
Heart failure is associated with shortness of breath, lung congestion, need to sleep with multiple pillows, fatigue and weakness and swelling in the legs.
Fatty liver disease most commonly has no symptoms but may present with mild right upper abdominal discomfort. Individuals with the highest risk are those with obesity and type 2 diabetes.
2-Diagnostic Testing and Referrals May be Needed
If sleep apnea is suspected, a sleep study conducted at home or overnight in the hospital will confirm the diagnosis. Your primary care professional or a sleep specialist can order the test.
To detect heart failure, evaluation may start with an electrocardiogram, chest x-ray and blood tests like a BNP. An echocardiogram will make the diagnosis and determine severity. Referral to a cardiologist is typically made.
Evaluation for fatty liver disease starts with blood tests like the FIB-4 score that can be ordered by the primary care professional. Additional imaging tests and sometimes a liver biopsy are ordered to make the diagnosis. A referral to a hepatologist or gastroenterologist would be made.
3-Understand New Treatments
Recent studies with highly effective obesity medications, semaglutide (Wegovy) or tirzepatide (Zepbound), have demonstrated that these 3 obesity related complications can be treated and improved when used along with healthy lifestyle management.
Treatment with tirzepatide results in over a 50% improvement in apnea and sleepiness scores, along with weight loss in people with moderate to severe obstructive sleep apnea.
Treatment with both tirzepatide and semaglutide lead to improvement in health status, symptoms and physical limitations, and greater improvements in exercise function along with weight loss in people with heart failure.
Treatment with semaglutide reduces inflammation and scarring in the liver along with improving weight loss in people with fatty liver disease and moderate or advanced liver scarring.
I’m hoping healthcare professionals and their patients will become more aware of the new treatments available for these often unrecognized health complications of obesity.
RK
Robert Kushner, MD
