Weight-loss pharmacotherapy: A brief review

Abstract

Obesity is a common disease with a substantial burden on both individuals and the U.S. health care system as a whole. 61 The medical treatment of obesity has been confounded by worrisome adverse events and modest efficacy. However, many overweight and obese patients benefit from modest weight loss. Current guidelines recommend considering weight-loss pharmacotherapy for patients with a BMI ≥ 30 kg/m 2 or > 27 kg/m 2 with obesity-related comorbidities. New understanding of weight regulation and the complex interplay of the multiple overlapping systems - including the neuroendocrine axis, gut satiety signals, peripheral adiposity indicators, and the genetic, environmental, and cultural factors that influence obesity - have provided additional insight into potential therapeutic targets. Evidence suggests that targeting one pathway alone is unlikely to result in sustained weight loss and that combination therapies are needed. Combination therapies may include the combination of medications or the combination of one medication with intensive lifestyle modification therapy.