Latest evidence in obesity management : Pre-test

1.

A 32-year-old man is in your office for a well-person check.
His height is 6′3″ (1.9 m), he weighs 254 lb (115 kg), and his BMI is 31.7 kg/m². Based on recently published Lancet Diabetes & Endocrinology (Lancet) Commission definitions and diagnostic criteria, what can you conclude about this patient’s obesity status?

A. Confirmation of excess adiposity by direct fat measurement (eg, dual-energy x-ray absorptiometry [DXA]) is needed for a diagnosis of clinical obesity
B. If his waist circumference is elevated, he should be assessed for changes in tissue, organ, and/or personal function
C. If his waist circumference is in normal range, his diagnosis would be preclinical obesity
D. His BMI is high enough that a diagnosis of clinical obesity can be made without further assessment

2.

Your patient has clinical obesity and was receiving phentermine for weight loss when they were hospitalized for myocardial infarction. Which of the following reflects evidence on incretin-based antiobesity medications (AOMs) that should be considered when modifying your patient’s treatment?

A. Both semaglutide and tirzepatide are approved to reduce the risk of major adverse cardiovascular events (MACE) for this patient
B. Neither semaglutide nor tirzepatide is approved to reduce the risk of MACE for this patient
C. Semaglutide showed significant MACE risk reduction within 3 months of starting treatment
D. Tirzepatide showed similar MACE risk reduction in patients who achieve BMI <25 kg/m² or ≥25 kg/m²

3.

Your patient agrees that an incretin-based AOM would be a good option for their obesity management. In addition to obesity, they have metabolic dysfunction–associated steatohepatitis (MASH) with moderate fibrosis and chronic kidney disease (CKD). Which AOM would you recommend to best address their overall health?

A. Dulaglutide
B. Liraglutide
C. Semaglutide
D. Tirzepatide

4.

Your patient started a tirzepatide 15 mg prescription 1 year ago, and she has had a 19% weight loss. She is happy with her results so far, but her rate of weight loss has slowed, and she wonders if she should change to another agent to avoid weight regain and maintain her weight loss. How should you counsel her based on available evidence?

A. She should add a second incretin-based AOM because it will increase her rate of weight loss and ensure weight loss maintenance
B. She should consider bariatric surgery because weight loss with incretin-based AOMs lasts approximately 18 months
C. She should continue with tirzepatide because weight loss maintenance has been demonstrated for up to 3 years
D. She should switch to another incretin-based agent because she is losing response to tirzepatide

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The Latest in Obesity Management: Current Evidence for Primary Care

Jay H. Shubrook, DO, FACOFP, FAAFP

Pretest

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