Skip to main content

For chronic weight management in adult patients with a BMI ≥30 kg/m2, or ≥27 kg/m2 with one or more weight-related comorbidities, as an adjunct to a reduced-calorie diet and increased physical activity. Click for Limitations of Use.

Obesity is a Disease. Are You Diagnosing It?

Actor Portrayal.

Obesity is a Disease. Are You Diagnosing It?

Initiating Effective Treatment Begins With a Diagnosis

As a health care professional, you are uniquely positioned to identify appropriate patients and help them navigate long-term weight management

DID YOU KNOW?

About 70% of adults with 
obesity go undiagnosed1

DID
YOU KNOW?

About 70% of adults with 
obesity go undiagnosed1

Diagnosing Appropriate Patients

Body mass index (BMI), which is a ratio of weight vs height, is an objective measure for diagnosing obesity2

Patients with a BMI of ≥30 kg/m2 or ≥27 kg/m2 with 1 or more weight-related comorbidities may be candidates for treatment with Saxenda® as an adjunct to a reduced-calorie diet and increased physical activity.3

Using the BMI Charta

The BMI chart is a visual tool that can be used to quickly identify a patient’s BMI using their height and weight. The chart is useful in both seeing a patient’s current BMI category, as well as determining a healthy weight range to discuss with them.

aPlease note that this chart is intended to be used as a quick illustrative reference. For a more precise classification of BMI, the following formula should be used: BMI = 703 × weight (lb) / [height (in)]2.

Another Key Criteria: Waist Circumference2

Along with body mass index (BMI), waist circumference is an important measure for obesity-related health risks in patients with a BMI of <35 kg/m2

Men with a waist circumference of >40 inches are considered high risk if they are overweight2
Men with a waist circumference of >40 inches are considered high risk if they are overweight2
Women with a waist circumference of >35 inches are considered high risk if they are overweight2
Women with a waist circumference of >35 inches are considered high risk if they are overweight2

Measure waist circumference in 3 simple steps2

Place the tape measure horizontally around the patient’s bare middle, at the level of the upper hip bones

Keep the tape snug around the patient’s waist without compressing the skin and have the patient take a deep breath in, then out

Measure after the patient exhales

Documentation Matters

Remember to record your diagnosis so that patients' records adequately and accurately reflect the care provided

This helps support good patient care, and may also be used to establish treatment coverage, where appropriate and available.

ICD-10 recognizes obesity as a chronic disease. There are more than 35 obesity/BMI codes that you can use to properly diagnose your patients.

Here are some common ICD-10 codes to assist you4:

ICD 10 codes
ICD 10 codes

How to Diagnose Obesity

Key takeaways

More than 1 in 3 adults have obesity, but 70% go undiagnosed

Diagnosed patients tend to be more likely to lose weight

Measuring waist circumference, in addition to BMI, helps determine risk of cardiometabolic risk factors

Key takeways

RECOMMENDED CONTENT

Treatment with Saxenda® helped reduce waist circumference, a secondary end point3

Selected Important Safety Information

WARNING: RISK OF THYROID C-CELL TUMORS
Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Saxenda® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Saxenda® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC with use of Saxenda® and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Saxenda®.

Indications and Usage

  • Saxenda® (liraglutide) injection 3 mg is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obesity) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, or dyslipidemia)

Limitations of Use

  • Saxenda® is not indicated for the treatment of type 2 diabetes 
  • Saxenda® and Victoza® both contain the same active ingredient, liraglutide, and therefore should not be used together. Saxenda® should not be used in combination with any other GLP-1 receptor agonist 
  • Saxenda® has not been studied in patients taking insulin. Saxenda® and insulin should not be used together 
  • The safety and efficacy of Saxenda® in combination with other products for weight loss, including prescription drugs, over-the-counter drugs, and herbal preparations, have not been established

Important Safety Information

Contraindications

Saxenda® is contraindicated in:

  • Patients with a personal or family history of MTC or MEN 2 
  • Patients with a prior serious hypersensitivity reaction to liraglutide or to any of the product components 
  • Pregnancy

Warnings and Precautions

  • Risk of Thyroid C-cell Tumors: If serum calcitonin is measured and found to be elevated, the patient should be further evaluated. Patients with thyroid nodules noted on physical examination or neck imaging should also be further evaluated 
  • Acute Pancreatitis: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with liraglutide postmarketing. Observe patients carefully for signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Saxenda® promptly and if pancreatitis is confirmed, do not restart 
  • Acute Gallbladder Disease: Substantial or rapid weight loss can increase the risk of cholelithiasis; however, the incidence of acute gallbladder disease was greater in patients treated with Saxenda® than with placebo even after accounting for the degree of weight loss. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated 
  • Risk of Hypoglycemia with Concomitant Use of Anti-Diabetic Therapy: When Saxenda® is used with an insulin secretagogue (eg, a sulfonylurea) serious hypoglycemia can occur. Consider lowering the dose of the insulin secretagogue to reduce the risk of hypoglycemia. Monitor blood glucose parameters prior to starting Saxenda® and during treatment and adjust anti-diabetic drugs as needed 
  • Heart Rate Increase: Mean increases in resting heart rate of 2 to 3 beats per minute (bpm) were observed in patients treated with Saxenda®. Monitor heart rate at regular intervals and inform patients to report palpitations or feelings of a racing heartbeat while at rest during treatment with Saxenda®. Discontinue Saxenda® in patients who experience a sustained increase in resting heart rate 
  • Renal Impairment: Acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis, have been reported, usually in association with nausea, vomiting, diarrhea, or dehydration. Use caution when initiating or escalating doses of Saxenda® in patients with renal impairment 
  • Hypersensitivity Reactions: Serious hypersensitivity reactions (eg, anaphylaxis and angioedema) have been reported in patients treated with liraglutide. If a hypersensitivity reaction occurs, patients should stop taking Saxenda® and promptly seek medical advice 
  • Suicidal Behavior and Ideation: In clinical trials, 9 (0.3%) of 3,384 patients treated with Saxenda® and 2 (0.1%) of the 1,941 treated with placebo reported suicidal ideation; one of the patients treated with Saxenda® attempted suicide. Monitor patients on Saxenda® for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Discontinue treatment if patients experience suicidal thoughts or behaviors. Avoid Saxenda® in patients with a history of suicidal attempts or active suicidal ideation

Adverse Events

  • The most common adverse reactions, reported in ≥5% are: nausea, hypoglycemia, diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, and increased lipase

Drug Interactions

  • Saxenda® causes a delay of gastric emptying, and has the potential to impact the absorption of concomitantly administered oral medications. Monitor for potential consequences of delayed absorption of oral medications concomitantly administered with Saxenda®

Use in Specific Populations

  • There are no data on the presence of liraglutide in human breast milk; liraglutide was present in the milk of lactating rats 
  • Saxenda® has not been studied in patients below 18 years of age and is not recommended for use in pediatric patients 
  • Saxenda® slows gastric emptying. Saxenda® has not been studied in patients with preexisting gastroparesis

Please click here for Prescribing Information, including Boxed Warning.

 

Click below to expand

1. Ma J, Xiao L, Stafford RS. Underdiagnosis of obesity in adults in US outpatient settings. Arch Intern Med. 2009;169(3):312-316.

2. National Heart, Lung, and Blood Institute; National Institutes of Health; North American Association for the Study of Obesity. The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Bethesda, MD: National Institutes of Health; 2000. NIH Publication 00-4084.

3. Saxenda® [package insert]. Plainsboro, NJ: Novo Nordisk Inc; 2018.

4. International Classification of Diseases, tenth revision, clinical modification (ICD-10-CM). Commonly used CPT and ICD codes. Centers for Disease Control and Prevention website. https://www.cdc.gov/diabetes/prevention/pdf/commonly-used-cpt-icd-codes_tag508.pdf. Accessed November 10, 2019.