Fig. 2.

Overview of lifestyle and pharmacological treatment for obesity.

Obesity is associated with several weight-related comorbidities, including cardiovascular disease, hypertension, dyslipidemia, metabolic associated fatty liver disease, lung disease, and obstructive sleep apnea. The cornerstone of treatment for obesity is lifestyle modification, namely the prescription of a hypocaloric diet and increased physical activity. The Mediterranean diet may have additional health benefits that are relevant to COVID-19, including antioxidant and anti-inflammatory properties. For patients with a BMI ≥30 kg/m² or BMI ≥27 kg/m² in the presence of obesity-related comorbidities who do not reach weight loss goals, pharmacotherapy should be considered as an adjunct to lifestyle modification. In the US, the FDA-approved medications for obesity include phentermine/topiramate, orlistat, naltrexone/bupropion, liraglutide, and semaglutide. Sodium-glucose cotransporter-2 inhibitors are not FDA-approved for weight loss but are also used in the clinic for this purpose.

Abbreviations: CA, carbonic anhydrase; GABA, gamma aminobutyric acid; GI, gastrointestinal; GLP1-RA, glucagon-like peptide 1 receptor agonist; MAFLD, metabolic associated fatty liver disease; OSA, obstructive sleep apnea; SGLT2i, sodium-glucose cotransporter-2 inhibitor.