Obesity Care in Special Populations

Chun-Heng KuoTaiwan Speaker Obesity Care in Special PopulationsThis presentation, delivered by Chun-Heng Kuo, MD, MMSc, PhD, provides a comprehensive framework for obesity management across two distinct clinical cohorts: women of reproductive age and elderly populations. For women of reproductive age, the presentation defines a "Reproductive Continuum of Care" spanning fertility, preconception, pregnancy, and postpartum. It details obesity-related risks, including a 4% decline in conception rates per BMI unit, gestational diabetes (GDM), and intergenerational metabolic transmission. A critical clinical focus is the "Glucagon-like peptide-1 (GLP-1) receptor agonist Paradox," which weighs the metabolic benefits of preconception use against the risk of rapid weight rebound following discontinuation. Additionally, it advocates for localized Taiwan 2024 gestational weight gain (GWG) guidelines, which set tighter weight gain constraints than the Institute of Medicine (IOM) standards. In elderly populations, the focus shifts to the dangers of sarcopenic obesity and the "Obesity Paradox". Management transitions from pure weight loss to a "muscle-centric" strategy prioritizing a protein intake of 1.2–1.5 g/kg and resistance training to overcome anabolic resistance. The deck evaluates the Incretin Revolution and introduces the future of care: Activin Receptor Blockers (e.g., Bimagrumab), which promote muscle hypertrophy while reducing adiposity. Ultimately, geriatric care is defined by the preservation of physical function and quality of life.