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ABSTRACT Pharmacological treatment of obesity is passing through many changes in the last decades; different agents have been approved, and newer options are leaning towards higher efficacy and a more favourable safety profile; however, medications approved for a longer time are still available and useful for many patients. This document is an 2024 Update Position Statement of Specialists from the Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso) and the Brazilian Society of Endocrinology and Metabolism (SBEM), with the aim of reviewing all the approved medications for the management of obesity in Brazil (sibutramine, orlistat, liraglutide, semaglutide and bupropion/naltrexone fixed dose), with the addition of tirzepatide, that is approved in other countries and likely approved soon in Brazil. The review is focused on efficacy, safety profile and the impact of drugs (based on existing studies) on different comorbidities. decades however patients 202 Abeso (Abeso SBEM, SBEM , (SBEM) sibutramine, sibutramine (sibutramine orlistat liraglutide bupropionnaltrexone bupropion naltrexone dose, dose dose) tirzepatide based studies comorbidities 20 (SBEM 2

https://doi.org/10.20945/2359-4292-2024-0422

Brazilian evidence-based guideline for screening, diagnosis, treatment, and follow-up of metabolic dysfunction-associated steatotic liver disease (MASLD) in adult individuals with overweight or obesity: A joint position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM), Brazilian Society of Hepatology (SBH), and Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso) evidencebased evidence based screening diagnosis treatment followup follow up dysfunctionassociated dysfunction associated MASLD (MASLD obesity SBEM, SBEM , (SBEM) SBH, SBH (SBH) Abeso (Abeso (SBEM (SBH
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Moreira, Rodrigo Oliveira

; Valerio, Cynthia Melissa

; Villela-Nogueira, Cristiane Alves

; Cercato, Cintia

; Gerchman, Fernando

; Lottenberg, Ana Maria Pita

; Godoy-Matos, Amélio Fernando

; Oliveira, Ricardo de Andrade

; Mello, Carlos Eduardo Brandão

; Álvares-da-Silva, Mário Reis

; Leite, Nathalie Carvalho

; Cotrim, Helma Pinchemel

; Parisi, Edison Roberto

; Silva, Giovanni Faria

; Miranda, Paulo Augusto Carvalho

; Halpern, Bruno

; Oliveira, Claudia Pinto

Archives of Endocrinology and Metabolism

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2023, Volume 67 N. 6 elocation e230123

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as Nonalcoholic fatty liver disease (NAFLD), is one of the most common hepatic diseases in individuals with overweight or obesity. In this context, a panel of experts from three medical societies was organized to develop an evidence-based guideline on the screening, diagnosis, treatment, and follow-up of MASLD. Material and methods: A MEDLINE search was performed to identify randomized clinical trials, meta-analyses, cohort studies, observational studies, and other relevant studies on NAFLD. In the absence of studies on a certain topic or when the quality of the study was not adequate, the opinion of experts was adopted. Classes of Recommendation and Levels of Evidence were determined using prespecified criteria. Results: Based on the literature review, 48 specific recommendations were elaborated, including 11 on screening and diagnosis, 9 on follow-up, 14 on nonpharmacologic treatment, and 14 on pharmacologic and surgical treatment. Conclusions: A literature search allowed the development of evidence-based guidelines on the screening, diagnosis, treatment, and follow-up of MASLD in individuals with overweight or obesity. Introduction dysfunctionassociated dysfunction associated MASLD, , (MASLD) NAFLD, NAFLD (NAFLD) obesity context evidencebased evidence based diagnosis treatment followup follow up methods trials metaanalyses, metaanalyses meta analyses, analyses meta-analyses adequate adopted criteria Results review 4 elaborated 1 followup, up, Conclusions (MASLD (NAFLD

https://doi.org/10.20945/2359-4292-2023-0123

“Anti-obesity medications” or “medications to treat obesity” instead of “weight loss drugs” – why language matters – an official statement of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO) and the Brazilian Society of Endocrinology and Metabolism (SBEM) Antiobesity Anti obesity medications weight drugs ABESO (ABESO SBEM (SBEM
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Halpern, Bruno

; Mancini, Marcio C.

; Sande-Lee, Simone van de

; Miranda, Paulo Augusto Carvalho

Archives of Endocrinology and Metabolism

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2023, Volume 67 N. 4 elocation e230174

Abstract: En | Text: En | PDF: En

ABSTRACT Obesity is largely undertreated, in part because of the stigma surrounding the disease and its treatment. The use of the term “weight loss drugs” to refer to medications for the treatment of obesity may contribute to this stigma, leading to the idea that anyone who wants to lose weight could use them and that short-term use, only in the active weight loss phase would be enough. On the contrary, the use of terms such as “medications to treat obesity” or “anti-obesity medications” conveys the idea that the treatment is directed at the disease rather than the symptom. This joint statement by the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO) and the Brazilian Society of Endocrinology and Metabolism (SBEM) intends to alert the press, healthcare professionals and scientific community about the importance of the appropriate use of language, with the aim of improving obesity care. undertreated drugs shortterm short enough contrary antiobesity anti symptom ABESO (ABESO SBEM (SBEM press language care

https://doi.org/10.20945/2359-4292-2023-0174

The new obesity classification based on weight history is not proposed as a guideline
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Halpern, Bruno

; Mancini, Marcio C.

; Melo, Maria Edna de

; Lamounier, Rodrigo N.

; Moreira, Rodrigo O.

; Carra, Mario K.

; Cercato, Cintia

; Boguszewski, Cesar Luiz

Archives of Endocrinology and Metabolism

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dec 2022, Volume 66 N. 6 Pages 936 - 937

Abstract: En | Text: En | PDF: En

https://doi.org/10.20945/2359-3997000000571

Proposal of an obesity classification based on weight history: an official document by the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO)
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Halpern, Bruno

; Mancini, Marcio C.

; Melo, Maria Edna de

; Lamounier, Rodrigo N.

; Moreira, Rodrigo O.

; Carra, Mario K.

; Kyle, Theodore K.

; Cercato, Cintia

; Boguszewski, Cesar Luiz

Archives of Endocrinology and Metabolism

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jun 2022, Volume 66 N. 3 Pages 139 - 151

Abstract: En | Text: En | PDF: En

ABSTRACT Obesity is a chronic disease associated with impaired physical and mental health. A widespread view in the treatment of obesity is that the goal is to normalize the individual's body mass index (BMI). However, a modest weight loss (usually above 5%) is already associated with clinical improvement, while weight losses of 10%-15% bring even further benefits, independent from the final BMI. The percentage of weight reduction is accepted as a treatment goal since a greater decrease in weight is frequently difficult to achieve due to metabolic adaptation along with environmental and lifestyle factors. In this document, the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO) propose a new obesity classification based on the maximum weight attained in life (MWAL). In this classification, individuals losing a specific proportion of weight are classified as having “reduced” or “controlled” obesity. This simple classification – which is not intended to replace others but to serve as an adjuvant tool – could help disseminate the concept of clinical benefits derived from modest weight loss, allowing individuals with obesity and their health care professionals to focus on strategies for weight maintenance instead of further weight reduction. In future studies, this proposed classification can also be an important tool to evaluate possible differences in therapeutic outcomes between individuals with similar BMIs but different weight trajectories.

https://doi.org/10.20945/2359-3997000000465

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Halpern, Bruno

; Mancini, Marcio C.

; Melo, Maria Edna de

; Lamounier, Rodrigo N.

; Moreira, Rodrigo O.

; Carra, Mario K.

; Kyle, Theodore K.

; Cercato, Cintia

; Boguszewski, Cesar Luiz

Archives of Endocrinology and Metabolism

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apr 2022, Volume 66 N. 2 Pages 139 - 151

Abstract: En | Text: En | PDF: En

https://doi.org/10.20945/2359-3997000000465

Enseñanzas de la pandemia de COVID-19 en América Latina: la vulnerabilidad genera más vulnerabilidad
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Halpern, Bruno

; Ranzani, Otavio T.

Revista Panamericana de Salud Pública

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2022, Volume 46 elocation e59

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.26633/rpsp.2022.59

Irisin and its relationship with metabolic health: more questions than answers
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Halpern, Bruno

Archives of Endocrinology and Metabolism

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apr 2021, Volume 65 N. 2 Pages 121 - 123

Abstract: En | Text: En | PDF: En

https://doi.org/10.20945/2359-3997000000355 371 downloads

Intermittent fasting for obesity and related disorders: unveiling myths, facts, and presumptions
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Halpern, Bruno

; Mendes, Thiago Bosco

Archives of Endocrinology and Metabolism

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feb 2021, Volume 65 N. 1 Pages 14 - 23

Abstract: En | Text: En | PDF: En

ABSTRACT Intermittent fasting (IF) is an increasingly popular method of weight loss, as an alternative to daily caloric restriction (DCR). Several forms of IF exist, such as alternate-day fasting or time-restricted feeding regimens. Some of its proponents claim several health benefits unrelated to caloric restriction or weight loss, which rely mainly on animal models. Although several studies published in the last few years confirm that IF can be a useful and safe therapeutical option for obesity and related disorders, no superiority to conventional caloric restriction diets have emerged. There are still several questions left answered. In this Review, we discuss some of the claims, unveiling myths, facts, and presumptions about several models of IF. The focus of this article is obesity, but there is a brief discussion of the potential benefits of IF on overall human health.

https://doi.org/10.20945/2359-3997000000322 3434 downloads

10.

Updated Cardiovascular Prevention Guideline of the Brazilian Society of Cardiology - 2019
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Précoma, Dalton Bertolim

; Oliveira, Gláucia Maria Moraes de

; Simão, Antonio Felipe

; Dutra, Oscar Pereira

; Coelho, Otávio Rizzi

; Izar, Maria Cristina de Oliveira

; Póvoa, Rui Manuel dos Santos

; Giuliano, Isabela de Carlos Back

; Alencar Filho, Aristóteles Comte de

; Machado, Carlos Alberto

; Scherr, Carlos

; Fonseca, Francisco Antonio Helfenstein

; Santos Filho, Raul Dias dos

; Carvalho, Tales de

; Avezum Jr., Álvaro

; Esporcatte, Roberto

; Nascimento, Bruno Ramos

; Brasil, David de Pádua

; Soares, Gabriel Porto

; Villela, Paolo Blanco

; Ferreira, Roberto Muniz

; Martins, Wolney de Andrade

; Sposito, Andrei C.

; Halpern, Bruno

; Saraiva, José Francisco Kerr

; Carvalho, Luiz Sergio Fernandes

; Tambascia, Marcos Antônio

; Coelho-Filho, Otávio Rizzi

; Bertolami, Adriana

; Correa Filho, Harry

; Xavier, Hermes Toros

; Faria-Neto, José Rocha

; Bertolami, Marcelo Chiara

; Giraldez, Viviane Zorzanelli Rocha

; Brandão, Andrea Araújo

; Feitosa, Audes Diógenes de Magalhães

; Amodeo, Celso

; Souza, Dilma do Socorro Moraes de

; Barbosa, Eduardo Costa Duarte

; Malachias, Marcus Vinícius Bolívar

; Souza, Weimar Kunz Sebba Barroso de

; Costa, Fernando Augusto Alves da

; Rivera, Ivan Romero

; Pellanda, Lucia Campos

; Silva, Maria Alayde Mendonça da

; Achutti, Aloyzio Cechella

; Langowiski, André Ribeiro

; Lantieri, Carla Janice Baister

; Scholz, Jaqueline Ribeiro

; Ismael, Silvia Maria Cury

; Ayoub, José Carlos Aidar

; Scala, Luiz César Nazário

; Neves, Mario Fritsch

; Jardim, Paulo Cesar Brandão Veiga

; Fuchs, Sandra Cristina Pereira Costa

; Jardim, Thiago de Souza Veiga

; Moriguchi, Emilio Hideyuki

; Schneider, Jamil Cherem

; Assad, Marcelo Heitor Vieira

; Kaiser, Sergio Emanuel

; Lottenberg, Ana Maria

; Magnoni, Carlos Daniel

; Miname, Marcio Hiroshi

; Lara, Roberta Soares

; Herdy, Artur Haddad

; Araújo, Cláudio Gil Soares de

; Milani, Mauricio

; Silva, Miguel Morita Fernandes da

; Stein, Ricardo

; Lucchese, Fernando Antonio

; Nobre, Fernando

; Griz, Hermilo Borba

; Magalhães, Lucélia Batista Neves Cunha

; Borba, Mario Henrique Elesbão de

; Pontes, Mauro Ricardo Nunes

; Mourilhe-Rocha, Ricardo

Arquivos Brasileiros de Cardiologia

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oct 2019, Volume 113 N. 4 Pages 787 - 891

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20190204 40841 downloads

11.

Elevated irisin and alanine aminotransferase levels in hypothyroidism: role of oxidative stress?
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Halpern, Bruno

Archives of Endocrinology and Metabolism

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apr 2016, Volume 60 N. 2 Pages 89 - 91

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/2359-3997000000166 1762 downloads

12.

Brown adipose tissue: what have we learned since its recent identification in human adults
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Halpern, Bruno

; Mancini, Marcio Correa

; Halpern, Alfredo

Arquivos Brasileiros de Endocrinologia & Metabologia

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dec 2014, Volume 58 N. 9 Pages 889 - 899

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O tecido adiposo marrom, órgão essencial para a termorregulação de animais hibernantes e pequenos devido à sua capacidade desacopladora, era até poucos anos considerado presente apenas em recém-nascidos na espécie humana. A identificação do tecido adiposo marrom em adultos com o desenvolvimento e uso da tomografia de emissão de pósitron marcado com 18-fluorodesoxiglicose (PET-FDG) gerou questões sobre sua real importância para nosso metabolismo. Nesta revisão, discutiremos o que aprendemos nesse tempo, assim como conceitos antigos e novos, alguns marginalizados por décadas, como a termogênese induzida por dieta. Arq Bras Endocrinol Metab. 2014;58(9):889-99

Brown adipose tissue, an essential organ for thermoregulation in small and hibernating mammals due to its mitochondrial uncoupling capacity, was until recently considered to be present in humans only in newborns. The identification of brown adipose tissue in adult humans since the development and use of positron emission tomography marked with 18-fluorodeoxyglucose (PET-FDG) has raised a series of doubts and questions about its real importance in our metabolism. In this review, we will discuss what we have learnt since its identification in humans as well as both new and old concepts, some of which have been marginalized for decades, such as diet-induced thermogenesis. Arq Bras Endocrinol Metab. 2014;58(9):889-99

https://doi.org/10.1590/0004-2730000003492 13653 downloads

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