Update on obesity pharmacotherapy
Abstract
There are two groups of approved drugs that can be used to manage weight in patients with obesity: medications approved for obesity per se and medications that affect body weight for obese patients who have complications from their obesity and are receiving these medications for chronic disease management. For obesity per se, treatment is with one of the three drugs currently approved for long-term treatment of obesity or one of a few others that can be used for short-term treatment. Among these, orlistat partially blocks intestinal digestion of fat and produces weight loss of 5-8 kg but major limitations are associated gastrointestinal symptoms; lorcaserin, a serotonin-2C agonist with few side effects, produces a mean weight loss of 4-7 kg; and the combination of phentermine and topiramate (extended release) produces a mean weight loss of 8-10 kg, but should only be used after verifying a woman is not pregnant. Failure to lose more than 3% of body weight within 3 months with any of these agents should lead to reevaluation of therapy. The short-term drugs for treating obesity per se are sympathomimetics, with phentermine being most widely used. The second group of drugs is for weight-centric prescribing for patients with a chronic disease such as diabetes, depression, or psychiatric disorders. For each disorder, some drugs produce weight gain, others are weight neutral, but the best choice for these patients is the combination of drugs that treat the underlying condition and…
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Phentermine and diethylpropion are Schedule IV controlled substances but are associated with low risk of dependency or abuse.
“Phentermine and diethylpropion are Schedule IV controlled substances but are associated with low risk of dependency or abuse.113,114,116”
From Obesity Management in Adults (2023) · cites this paper as [114]
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- Authors
- Bray, G. A., & Ryan, D. H.
- Affiliations
- Pennington Biomedical Research Center (US)
- Corresponding author
- Bray, George A.
- ORCID
- Ryan, Donna H.
- Venue
- Annals of the New York Academy of Sciences
- Publisher
- Wiley
- Published
- 2014-03-18
- Volume
- 1311
- Issue
- 1
- Pages
- 1-13
- ISSN
- 0077-8923 (ISSN-L)
- 1749-6632
- OpenAlex
- W1594742481
- Cited by
- 88
- References
- 9
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 1 · 2023: 8 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 6 · 2018: 6 · 2017: 9 · 2016: 12 · 2015: 23 · 2014: 8 · 2013: 1
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of the New York Academy of Sciences (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 pharmacotherapy, orlistat, lorcaserin, phentermine/topiramate, phentermine, sympathomimetic drugs, weight loss, weight gain, chronic disease management, obesity complications, gastrointestinal adverse effects
- MeSH terms
- Body Weight, Humans, Obesity, Weight Loss, Anti-Obesity Agents
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