Hepatology (Baltimore, Md.)Oct 13, 2020

Medicine for Weight Loss in Liver Disease and Transplant Patients: Using Research to Unlock Untapped Benefits

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 4, 2026

Abstract

Thirty percent of patients with cirrhosis are obese, with prevalence exceeding 40% after liver transplant.

Liraglutide is generally safe for use in patients with cirrhosis and liver transplant recipients.
Phentermine-topiramate may offer the highest weight loss potential but requires caution due to potential neuropsychiatric and cardiovascular issues.
There is limited data on the use of approved weight loss medications in patients with cirrhosis and liver transplant recipients.
Emerging evidence suggests potential for alternative medicines in weight loss, but further research is necessary.
Individualized medication decisions should consider the patient's renal and liver function, comorbidities, and other medications.

Simplified

BACKGROUND AND AIMS: Thirty percent of patients with cirrhosis are obese and the prevalence of obesity increases after transplant to >40% post-transplant. There are currently four weight loss medications approved by the FDA for treatment of obesity (orlistat, phentermine-topiramate, naltrexone-bupropion, and liraglutide). The aim of this review was to investigate the data on the use of these weight loss medications and alternative medicines in patients with cirrhosis and in liver transplant recipients (LTRs).

APPROACH AND RESULTS: While there is paucity of data for these medications in patients with cirrhosis and LTRs, Liraglutide appears to be generally safe in view of its pharmacokinetic properties. Phentermine-topiramate seems to have the highest weight loss potential but special consideration should be given to neuropsychiatric disorders, cardiovascular comorbidities, and drug interactions. There are emerging data on use of alternative medicines for weight loss but more data are needed.

CONCLUSIONS: The use of weight loss medications is feasible in this patient population but the decision of which medication to prescribe should be individualized based on the degree of renal and hepatic impairment, other co-morbidities, and concomitant medications.

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Medicine for Weight Loss in Liver Disease and Transplant Patients: Using Research to Unlock Untapped Benefits

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