Updates on obesity pharmacotherapy

Ann N Y Acad Sci. 2018 Jan;1411(1):106-119. doi: 10.1111/nyas.13542.

Abstract

Obesity is a chronic, relapsing disease that necessitates a multidisciplinary approach to management. Behavioral changes are the foundation to management, but adjunctive therapy is often warranted, including pharmacologic therapies and/or bariatric surgery. Until recently, treatment options included only short-term therapy (≤12 weeks), and paths beyond that schedule were challenging, as knowledge of the biology of obesity was lacking. With increased recognition of obesity as a chronic, complex medical disease, newer agents have been approved as long-term therapy, and the cornerstone of treatment is chronic behavior and lifestyle change. In the last decade, the Food and Drug Administration (FDA) has approved several new weight loss medications for the chronic management of obesity. In this review paper, we provide the latest updates on obesity pharmacotherapy. The main areas we will cover include (1) pharmacological management of obesity, (2) a review of FDA-approved weight loss medications, (3) comanagement of obesity and its metabolic sequelae (type 2 diabetes mellitus, hypertension, and dyslipidemia), and (4) obesity-centric prescribing for mental illness, neurological disorders, and contraceptive planning.

Keywords: obesity; overweight; pharmacotherapy; weight loss.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Obesity Agents / adverse effects
  • Anti-Obesity Agents / pharmacology
  • Anti-Obesity Agents / therapeutic use*
  • Anticonvulsants / adverse effects
  • Anticonvulsants / pharmacology
  • Appetite Depressants / adverse effects
  • Appetite Depressants / pharmacology
  • Appetite Depressants / therapeutic use
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Contraception / methods
  • Contraceptives, Oral, Hormonal / adverse effects
  • Contraceptives, Oral, Hormonal / pharmacology
  • Contraindications, Drug
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / etiology
  • Drug Approval
  • Drug Interactions
  • Dyslipidemias / drug therapy
  • Dyslipidemias / etiology
  • Humans
  • Hypertension / drug therapy
  • Hypertension / etiology
  • Hypoglycemic Agents / therapeutic use
  • Multicenter Studies as Topic
  • Obesity / complications
  • Obesity / drug therapy*
  • Obesity / therapy
  • Psychotropic Drugs / adverse effects
  • Psychotropic Drugs / pharmacology
  • United States
  • United States Food and Drug Administration
  • Weight Gain / drug effects
  • Weight Loss / drug effects

Substances

  • Anti-Obesity Agents
  • Anticonvulsants
  • Appetite Depressants
  • Contraceptives, Oral, Hormonal
  • Hypoglycemic Agents
  • Psychotropic Drugs