Obesity and Type 2 Diabetes: Two Diseases with a Need for Combined Treatment Strategies - EASO Can Lead the Way

Deborah R Leitner, Gema Frühbeck, Volkan Yumuk, Karin Schindler, Dragan Micic, Euan Woodward, Hermann Toplak, Deborah R Leitner, Gema Frühbeck, Volkan Yumuk, Karin Schindler, Dragan Micic, Euan Woodward, Hermann Toplak

Abstract

Obesity is a chronic metabolic disease affecting adults and children worldwide. It has become one of the leading causes of death, as obesity is known to be the main risk factor for a number of non-communicable diseases, in particular type 2 diabetes. This close relationship led to the connotation 'diabesity', highlighting the fact that the majority of individuals with diabetes are overweight or obese. Until today the BMI is still used to classify overweight and obesity. Since reduced muscle mass is highly prevalent throughout the BMI range, the measurement of body composition is strongly recommended. Moreover, it is essential for monitoring the course of weight reduction, which is part of every effective anti-obesity treatment. Weight reduction can be achieved via different weight loss strategies, including lifestyle intervention (diet and exercise), pharmacotherapy, or bariatric surgery. However, not all of these strategies are suitable for all patients, and any further needs should be considered. Besides, attention should also be drawn to concomitant therapies. These therapies may promote additional weight gain and further trigger the deterioration of blood glucose control. Thus, therapeutic strategies are warranted, which can be easily used for the management of obese patients with type 2 diabetes to achieve their glycemic and weight loss goals.

Keywords: Diabesity; Diabetes; Obesity.

© 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

References

    1. Yumuk V, Tsigos C, Fried M, Schindler K, Busetto L, Micic D, Toplak H, Obesity Management Task Force of the European Association for the Study of Obesity European guidelines for obesity management in adults. Obes Facts. 2015;8:402–424.
    1. WHO Obesity and Overweight. Fact sheet No.311. 2016. (last accessed September 28, 2017)
    1. Prospective Studies Collaboration. Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373:1083–1096.
    1. Fried M, Yumuk V, Oppert JM, Scopinaro N, Torres AJ, Weiner R, Yashkov Y, Frühbeck G, European Association for the Study of Obesity. International Federation for the Surgery of Obesity - European Chapter Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Facts. 2013;6:449–468.
    1. Frühbeck G, Toplak H, Woodward E, Yumuk V, Maislos M, Oppert JM, Executive Committee of the European Association for the Study of Obesity Obesity: the gateway to ill health - an EASO position statement on a rising public health, clinical and scientific challenge in Europe. Obes Facts. 2013;6:117–120.
    1. Dyson PA. The therapeutics of lifestyle management on obesity. Diabetes Obes Metab. 2010;12:941–946.
    1. International Diabetes Federation Diabetes Atlas, 2nd ed. Brussels, International Diabetes Federation, 2003. (last accessed September 28, 2017).
    1. Hossain P, Kawar B, El Nahas M. Obesity and diabetes in the developing world - a growing challenge. N Engl J Med. 2007;356:213–215.
    1. Oldridge NB, Stump TE, Nothwehr FK, Clark DO. Prevalence and outcomes of comorbid metabolic and cardiovascular conditions in middle- and older-age adults. J Clin Epidemiol. 2001;54:928–934.
    1. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond) 2008;32:1431–1437.
    1. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, Singh GM, Gutierrez HR, Lu Y, Bahalim AN, Farzadfar F, Riley LM, Ezzati M, Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group National, regional, and global trends in body-mass index since 1980:systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011;377:557–567.
    1. Blundell JE, Dulloo AG, Salvador J, Frühbeck G, EASO SAB Working Group on BMI Beyond BMI - phenotyping the obesities. Obes Facts. 2014;7:322–328.
    1. Gomez-Ambrosi J, Silva C, Galofre JC, Escalada J, Santos S, Millan D, Vila N, Ibanez P, Gil MJ, Valenti V, Rotellar F, Ramirez B, Salvador J, Frühbeck G. Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity. Int J Obes (Lond) 2012;36:286–294.
    1. Cameron AJ, Sicree RA, Zimmet PZ, Alberti KG, Tonkin AM, Balkau B, Tuomilehto J, Chitson P, Shaw JE. Cut-points for waist circumference in Europids and South Asians. Obesity (Silver Spring) 2010;18:2039–2046.
    1. WHO Expert Consultation Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–163.
    1. Tsigos C, Hainer V, Basdevant A, Finer N, Fried M, Mathus-Vliegen E, Micic D, Maislos M, Roman G, Schutz Y, Toplak H, Zahorska-Markiewicz B, Obesity Management Task Force of the European Association for the Study of Obesity Management of obesity in adults: European clinical practice guidelines. Obes Facts. 2008;1:106–116.
    1. Yumuk V, Frühbeck G, Oppert JM, Woodward E, Toplak H. An EASO position statement on multidisciplinary obesity management in adults. Obes Facts. 2014;7:96–101.
    1. Beaudart C, McCloskey E, Bruyere O, Cesari M, Rolland Y, Rizzoli R, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, Bautmans I, Bertiere MC, Brandi ML, Al-Daghri NM, Burlet N, Cavalier E, Cerreta F, Cherubini A, Fielding R, Gielen E, Landi F, Petermans J, Reginster JY, Visser M, Kanis J, Cooper C. Sarcopenia in daily practice: assessment and management. BMC Geriatr. 2016;16:170.
    1. Morley JE, Anker SD, von Haehling S. Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology-update 2014. J Cachexia Sarcopenia Muscle. 2014;5:253–259.
    1. Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JE. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7:28–36.
    1. Otto M, Kautt S, Kremer M, Kienle P, Post S, Hasenberg T. Handgrip strength as a predictor for post bariatric body composition. Obes Surg. 2014;24:2082–2088.
    1. Grebitus C, Hartmann M, Reynolds N. Global obesity study on drivers for weight reduction strategies. Obes Facts. 2015;8:77–86.
    1. Tsai SA, Lv N, Xiao L, Ma J. Gender differences in weight-related attitudes and behaviors among overweight and obese adults in the United States. Am J Mens Health. 2016;10:389–398.
    1. Poirier P, Despres JP. Exercise in weight management of obesity. Cardiol Clin. 2001;19:459–470.
    1. Willis LH, Slentz CA, Bateman LA, Shields AT, Piner LW, Bales CW, Houmard JA, Kraus WE. Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults. J Appl Physiol. 2012;113:1831–1837.
    1. Geliebter A, Ochner CN, Dambkowski CL, Hashim SA. Obesity-related hormones and metabolic risk factors: a randomized trial of diet plus either strength or aerobic training versus diet alone in overweight participants. J Diabetes Obes. 2014;1:1–7.
    1. Look ARG. Eight-year weight losses with an intensive lifestyle intervention: the Look AHEAD study. Obesity (Silver Spring) 2014;22:5–13.
    1. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, Golan R, Fraser D, Bolotin A, Vardi H, Tangi-Rozental O, Zuk-Ramot R, Sarusi B, Brickner D, Schwartz Z, Sheiner E, Marko R, Katorza E, Thiery J, Fiedler GM, Bluher M, Stumvoll M, Stampfer MJ, Dietary Intervention Randomized Controlled Trial Group Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229–241.
    1. Larsen RN, Mann NJ, Maclean E, Shaw JE. The effect of high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: a 12 month randomised controlled trial. Diabetologia. 2011;54:731–740.
    1. Krebs JD, Elley CR, Parry-Strong A, Lunt H, Drury PL, Bell DA, Robinson E, Moyes SA, Mann JI. The Diabetes Excess Weight Loss (DEWL) Trial: a randomised controlled trial of high-protein versus high-carbohydrate diets over 2 years in type 2 diabetes. Diabetologia. 2012;55:905–914.
    1. Esposito K, Maiorino MI, Ciotola M, Di Palo C, Scognamiglio P, Gicchino M, Petrizzo M, Saccomanno F, Beneduce F, Ceriello A, Giugliano D. Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial. Ann Intern Med. 2009;151:306–314.
    1. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005;293:43–53.
    1. Wadden TA, West DS, Neiberg RH, Wing RR, Ryan DH, Johnson KC, Foreyt JP, Hill JO, Trence DL, Vitolins MZ, Look ARG. One-year weight losses in the Look AHEAD study: factors associated with success. Obesity (Silver Spring) 2009;17:713–722.
    1. Wycherley TP, Buckley JD, Noakes M, Clifton PM, Brinkworth GD. Long-term effects of a very low-carbohydrate weight loss diet on exercise capacity and tolerance in overweight and obese adults. J Am Coll Nutr. 2014;33:267–273.
    1. Cawthon PM, Fox KM, Gandra SR, Delmonico MJ, Chiou CF, Anthony MS, Sewall A, Goodpaster B, Satterfield S, Cummings SR, Harris TB, Health A, Body Composition S. Do muscle mass, muscle density, strength, and physical function similarly influence risk of hospitalization in older adults? Am Geriatr Soc. 2009;57:1411–1419.
    1. Hainer V, Toplak H, Stich V. Fat or fit: what is more important? Diabetes Care. 2009;32((suppl 2)):S392–397.
    1. Lindström J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, Uusitupa M, Tuomilehto J, Finnish Diabetes Prevention Study Group The Finnish Diabetes Prevention Study (DPS): lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003;26:3230–3236.
    1. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM, Diabetes Prevention Program Research G Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.
    1. Lean ME, Powrie JK, Anderson AS, Garthwaite PH. Obesity, weight loss and prognosis in type 2 diabetes. Diabet Med. 1990;7:228–233.
    1. Williamson DF, Thompson TJ, Thun M, Flanders D, Pamuk E, Byers T. Intentional weight loss and mortality among overweight individuals with diabetes. Diabetes Care. 2000;23:1499–1504.
    1. Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, Hill JO, Brancati FL, Peters A, Wagenknecht L, Look ARG. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34:1481–1486.
    1. Look ARG, Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010;170:1566–1575.
    1. Foster GD, Borradaile KE, Sanders MH, Millman R, Zammit G, Newman AB, Wadden TA, Kelley D, Wing RR, Pi-Sunyer FX, Reboussin D, Kuna ST, Sleep AHEAD Research Group of Look AHEAD Research Group A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Arch Intern Med. 2009;169:1619–1626.
    1. Rubin RR, Wadden TA, Bahnson JL, Blackburn GL, Brancati FL, Bray GA, Coday M, Crow SJ, Curtis JM, Dutton G, Egan C, Evans M, Ewing L, Faulconbridge L, Foreyt J, Gaussoin SA, Gregg EW, Hazuda HP, Hill JO, Horton ES, Hubbard VS, Jakicic JM, Jeffery RW, Johnson KC, Kahn SE, Knowler WC, Lang W, Lewis CE, Montez MG, Murillo A, Nathan DM, Patricio J, Peters A, Pi-Sunyer X, Pownall H, Rejeski WJ, Rosenthal RH, Ruelas V, Toledo K, Van Dorsten B, Vitolins M, Williamson D, Wing RR, Yanovski SZ, Zhang P, Look ARG. Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial. Diabetes Care. 2014;37:1544–1553.
    1. Franz MJ. The role of weight loss in the management of type 2 diabetes. US Endocrinol. 2016;12:14–15.
    1. Eeg-Olofsson K, Cederholm J, Nilsson PM, Zethelius B, Nunez L, Gudbjörnsdottir S, Eliasson B. Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients. Diabetologia. 2009;52:65–73.
    1. Van Gaal L, Scheen A. Weight management in type 2 diabetes: current and emerging approaches to treatment. Diabetes Care. 2015;38:1161–1172.
    1. Toplak H, Woodward E, Yumuk V, Oppert JM, Halford JC, Frühbeck G. 2014 EASO position statement on the use of anti-obesity drugs. Obes Facts. 2015;8:166–174.
    1. Sjöholm K, Pajunen P, Jacobson P, Karason K, Sjöström CD, Torgerson J, Carlsson LM, Sjöström L, Peltonen M. Incidence and remission of type 2 diabetes in relation to degree of obesity at baseline and 2 year weight change: the Swedish Obese Subjects (SOS) study. Diabetologia. 2015;58:1448–1453.
    1. Thibault R, Huber O, Azagury DE, Pichard C. Twelve key nutritional issues in bariatric surgery. Clin Nutr. 2016;35:12–17.
    1. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, Navaneethan SD, Singh RP, Pothier CE, Nissen SE, Kashyap SR, STAMPEDE Investigators Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes. N Engl J Med. 2017;376:641–651.
    1. Sharma AM, Pischon T, Hardt S, Kunz I, Luft FC. Hypothesis: beta-adrenergic receptor blockers and weight gain: a systematic analysis. Hypertension. 2001;37:250–254.
    1. Hamed SA. Antiepileptic drugs influences on body weight in people with epilepsy. Expert Rev Clin Pharmacol. 2015;8:103–114.
    1. Garland EJ, Remick RA, Zis AP. Weight gain with antidepressants and lithium. J Clin Psychopharmacol. 1988;8:323–330.
    1. Mitri J, Hamdy O. Diabetes medications and body weight. Expert Opin Drug Saf. 2009;8:573–584.
    1. Yang T, Soodvilai S. Renal and vascular mechanisms of thiazolidinedione-induced fluid retention. PPAR Res. 2008;2008:943614.
    1. Jensen-Otsu E, Austin GL. Antidepressant use is associated with increased energy intake and similar levels of physical activity. Nutrients. 2015;7:9662–9671.
    1. Baptista T, Zarate J, Joober R, Colasante C, Beaulieu S, Paez X, Hernandez L. Drug induced weight gain, an impediment to successful pharmacotherapy: focus on antipsychotics. Curr Drug Targets. 2004;5:279–299.
    1. Toplak H, Hoppichler F, Wascher TC, Schindler K, Ludvik B. Obesity and type 2 diabetes (in German) Wien Klin Wochenschr. 2016;128((suppl 2)):S196–200.
    1. Abrahamian H, Kautzky-Willer A, Riessland-Seifert A, Fasching P, Ebenbichler C, Hofmann P, Toplak H. Mental disorders and diabetes mellitus (in German) Wien Klin Wochenschr. 2016;128((suppl 2)):S170–178.
    1. Gitlin M. Lithium side effects and toxicity: prevalence and management strategies. Int J Bipolar Disord. 2016;4:27.
    1. Perez-Iglesias R, Crespo-Facorro B, Martinez-Garcia O, Ramirez-Bonilla ML, Alvarez-Jimenez M, Pelayo-Teran JM, Garcia-Unzueta MT, Amado JA, Vazquez-Barquero JL. Weight gain induced by haloperidol, risperidone and olanzapine after 1 year: findings of a randomized clinical trial in a drug-naive population. Schizophr Res. 2008;99:13–22.
    1. Hermes E, Nasrallah H, Davis V, Meyer J, McEvoy J, Goff D, Davis S, Stroup TS, Swartz M, Lieberman J, Rosenheck R. The association between weight change and symptom reduction in the CATIE schizophrenia trial. Schizophr Res. 2011;128:166–170.
    1. El-Khatib F, Rauchenzauner M, Lechleitner M, Hoppichler F, Naser A, Waldmann M, Trinka E, Unterberger I, Bauer G, Luef GJ. Valproate, weight gain and carbohydrate craving: a gender study. Seizure. 2007;16:226–232.
    1. Corman CL, Leung NM, Guberman AH. Weight gain in epileptic patients during treatment with valproic acid: a retrospective study. Can J Neurol Sci. 1997;24:240–244.
    1. Mattson RH, Cramer JA, Collins JF. A comparison of valproate with carbamazepine for the treatment of complex partial seizures and secondarily generalized tonic-clonic seizures in adults. The Department of Veterans Affairs Epilepsy Cooperative Study No. 264 Group. N Engl J Med. 1992;327:765–771.
    1. Gaspari CN, Guerreiro CA. Modification in body weight associated with antiepileptic drugs. Arq Neuropsiquiatr. 2010;68:277–281.
    1. Lampl Y, Eshel Y, Rapaport A, Sarova-Pinhas I. Weight gain, increased appetite, and excessive food intake induced by carbamazepine. Clin Neuropharmacol. 1991;14:251–255.
    1. DeToledo JC, Toledo C, DeCerce J, Ramsay RE. Changes in body weight with chronic, high-dose gabapentin therapy. Ther Drug Monit. 1997;19:394–396.
    1. Baulac M, Cavalcanti D, Semah F, Arzimanoglou A, Portal JJ. Gabapentin add-on therapy with adaptable dosages in 610 patients with partial epilepsy: an open, observational study. The French Gabapentin Collaborative Group. Seizure. 1998;7:55–62.
    1. Berthon BS, MacDonald-Wicks LK, Wood LG. A systematic review of the effect of oral glucocorticoids on energy intake, appetite, and body weight in humans. Nutr Res. 2014;34:179–190.
    1. Manaboriboon B, Silverman ED, Homsanit M, Chui H, Kaufman M. Weight change associated with corticosteroid therapy in adolescents with systemic lupus erythematosus. Lupus. 2013;22:164–170.
    1. Berenson AB, Rahman M. Changes in weight, total fat, percent body fat, and central-to-peripheral fat ratio associated with injectable and oral contraceptive use. Am J Obstet Gynecol. 2009;200:329. e321–328.
    1. Ben-Menachem E. Weight issues for people with epilepsy - a review. Epilepsia. 2007;48((suppl 9)):42–45.

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