Pharmacotherapy of Obesity: Clinical Trials to Clinical Practice
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Purpose of Review
This review provides an overview of the current state of drug therapy for obesity, with a focus on four new drug therapies—lorcaserin, phentermine/topiramate, naltrexone/bupropion, and liraglutide 3.0 mg—which have been approved by the US Food and Drug Administration (FDA) for long-term management of obesity since 2012. Topics discussed in this paper include rationale for pharmacotherapy, history of antiobesity drugs, and efficacy and safety data from randomized controlled trials with implications for clinical practice.
Weight loss achieved by currently approved drugs ranges from approximately 3 to 9%, above and beyond weight loss with lifestyle counseling alone, after a year. Response and attrition rates in clinical trials indicate that the benefits of pharmacotherapy range from substantial for some patients, modest for others, and no benefits for others still.
Decisions regarding selection of a suitable drug from the available pharmacotherapy options and duration of treatment should be based on the expected and observed benefit-to-risk balance and tailored to the needs of each individual patient using the principles of shared decision-making.
KeywordsObesity Overweight Pharmacotherapy Pharmacologic treatment Weight loss medications Antiobesity drugs
Compliance with Ethical Standards
Conflict of Interest
Dr. Gadde reports grants from Bristol Myers Squibb, Eisai, and NIDDK in the past 3 years. In addition, Dr. Gadde has been awarded several patents related to obesity and body weight, in the name of his previous employer, Duke University, which licensed the patents to Orexigen Therapeutics. Dr. Gadde has not owned stocks in Orexigen in the past 3 years. He has not received and does not stand to receive any royalties related to his patents. The inventions disclosed in Dr. Gadde’s patents have not been discussed in this manuscript.
Dr. Raj has no disclosures.
Human and Animal Rights and Informed Consent
This review article does not contain any studies with human subjects or animals performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: •Of importance •• Of major importance
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