Medical Management of Diabesity

The intricate relationship between obesity and T2DM is well recognised, as evidenced by the coining of the term 'diabesity' by Dr Ethan Sims that encompasses the two.Most patients with type 2 diabetes are obese and the global rise in obesity largely explains the epidemic rise in incidence and prevalence of type 2 diabetes(T2DM) over the last few decades. Obesity has been linked to insulin resistance and predisposes to metabolic abnormalities including prediabetes, type diabetes and the metabolic syndrome.Weight reduction is an essential component to prevent progression from prediabetes to T2DM in obese individuals and also forms an essential component of all T2DM management strategies in association with other lifestyle modifications, diet and pharmacotherapy. Obesity management today is a high priority preventive as well as treatment intervention for diabetes and various chronic diseases. Achieving effective weight loss and sustaining it is a huge practical challenge for all obese individuals, more so for the obese type 2 diabetic individuals who many times are prescribed various antihyperglycemic therapies that may be associated with weight gain. This chapter focusses on current treatment strategies for patients with coexisting obesity and T2DM and the role of different anti-obesity agents in the medical management of diabesity.