Long-Term Efficacy and Safety of Anti-Obesity Treatment: Where Do We Stand?

Jan 7, 2021Current obesity reports

How Well and How Safely Do Weight Loss Treatments Work Over Time?

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Abstract

Recent anti-obesity medications can result in placebo-subtracted weight reductions ranging from 2.9% to 6.8% over at least 12 months.

Phentermine/topiramate showed the highest weight reduction at 6.8%, followed by liraglutide at 5.4%.
Naltrexone/bupropion and lorcaserin resulted in weight reductions of 4.0% and 3.1%, respectively.
Orlistat had the lowest weight reduction at 2.9% among the medications analyzed.
Lorcaserin was withdrawn from the market due to an increased cancer risk identified in safety trials.
FDA-approved anti-obesity medications are costly and may have adverse effects, necessitating careful consideration of risks and benefits.

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PURPOSE OF REVIEW: As a chronic and relapsing disease, obesity impairs metabolism and causes cardiovascular diseases. Although behavioral modification is important for the treatment of obesity, it is difficult to achieve an ideal weight or sustain the process of long-term weight loss. Therefore, the obesity control guidelines strongly recommend lifestyle interventions along with medical treatment for patients who are overweight. There is sufficient evidence supporting that pharmacotherapy in combination with behavior-based interventions can result in significant weight loss and improved cardiometabolism.

RECENT FINDINGS: Recent meta-analyses of new anti-obesity drugs and their weight-loss efficacy have shown that the overall placebo-subtracted weight reduction (%) for at least 12 months ranged from 2.9 to 6.8% for the following drugs: phentermine/topiramate (6.8%), liraglutide (5.4%), naltrexone/bupropion (4.0%), orlistat (2.9%), and lorcaserin (3.1%). However, very recently, on February 13, 2020, the US Food and Drug Administration (FDA) ordered the withdrawal of lorcaserin from markets, as a clinical trial to assess drug safety showed an increased risk of cancer. Currently, the anti-obesity medications that have been approved by the FDA for chronic weight management are orlistat, phentermine/topiramate, naltrexone/bupropion, and liraglutide. However, they are costly and may have adverse effects in some individuals. Therefore, drug therapy should be initiated in obese individuals after weighing its benefits and risks. One of the strategies for long-term obesity control is that anti-obesity medications should be tailored for specific patients depending on their chronic conditions, comorbidities, and preferences.

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Long-Term Efficacy and Safety of Anti-Obesity Treatment: Where Do We Stand?

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