Refractory and Resistant obesity: Dynamic Concepts, Contemporary Definitions.

Obesity is a chronic disease requiring a multi-disciplinary approach for its management. Despite multiple evolving and potent therapeutic options like GLP-1RA's and bariatric surgery, some patients do not achieve significant weight loss or expected metabolic outcomes. This manuscript highlights the concept of resistant and refractory obesity and provides an operational framework to assess adequacy of therapy, to rule out non-adherence, and to screen for non-adiposity related and iatrogenic causes of weight gain. This would help clinicians to assess clinical outcomes and plan management protocols in their clinical practice. Furthermore, a clear understanding of these concepts would streamline research in this area and facilitate policy making.