Drug Treatment of the Overweight Patient
Abstract
Three medications with approval for long-term use in the treatment of obesity are currently available in the United States. Sibutramine (U.S. Food and Drug Administration [FDA] approved in 1997), orlistat (FDA approved in 1999), and rimonabant (available in Europe and given FDA approvable status in 2006 and expected to be marketed in 2007) represent modern approaches to medications used adjunctively for weight management. As demonstrated in large clinical trials of 2 to 4 years' duration, these medications significantly increase weight loss compared with placebo; weight loss with these drugs reaches a nadir between 20 and 28 weeks; weight loss, averaged 8%-10%, with the placebo contributing 4%-6% of that. Weight maintenance is demonstrated as long as adherence to medication continues. All medications have side effects that need to be considered. For sibutramine, there is a rise in blood pressure and heart rate that may require discontinuation of the drug in a small percent of patients. For orlistat, steatorrhea produces the principal gastrointestinal side effects. Rimonabant appears to have a favorable safety and tolerability profile. Nausea and gastrointestinal symptoms are the chief tolerability issue, but they are usually self-limited. In addition there are several drugs and drug combinations in phase 2 or phase 2 trials that will be reported on in the coming years.
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Phentermine has the potential to raise BP and heart rate.
“Given the increased release of norepinephrine promoted by phentermine, it has the potential to raise BP and heart rate.194,195”
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- Authors
- Bray, G. A., & Ryan, D. H.
- Affiliations
- Pennington Biomedical Research Center (US)
- ORCID
- Ryan, Donna H.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2007-05
- Volume
- 132
- Issue
- 6
- Pages
- 2239-2252
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2066499225
- Cited by
- 115
- References
- 90
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 2 · 2015: 5 · 2014: 2 · 2013: 5 · 2012: 10
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity, anti-obesity drugs, sibutramine, orlistat, rimonabant, weight maintenance, adverse drug reactions, elevated blood pressure, steatorrhea, gastrointestinal tolerance, long-term drug safety
- MeSH terms
- Rimonabant, Orlistat, Animals, Cyclobutanes, Humans, Lactones, Obesity, Piperidines, Pyrazoles, Treatment Outcome, Clinical Trials, Phase II as Topic, Anti-Obesity Agents, Overweight
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