J Menopausal Med.  2014 Dec;20(3):90-96. 10.6118/jmm.2014.20.3.90.

Pharmacotherapy for Obesity

• Joo JK
• Lee KS

• KMID: 2325469
• DOI: http://doi.org/10.6118/jmm.2014.20.3.90

Abstract

Obesity is an important risk factor for metabolic disease and various cancers. Treatments of obesity include lifestyle intervention, pharmacotherapy, and bariatric surgery. If weight loss with lifestyle intervention is only modest, pharmacotherapy might be needed. Pharmacotherapy agents can be grouped by treatment period as short term or long term use agent. Several sympathomimetic drugs such as benzphetamine, diethylpropion, phendimetrazine and phentermine, are approved for short term treatment due to their safety issues. For long term treatment, orlistat, lorcaserin, and combination of phentermine/topiramate are approved by U.S. Food and Drug Administration (FDA). Orlistat partially blocks intestinal digestion of fat, therefore producing weight loss. Lorcaserin is a serotonin 2C receptor agonist. The combination of phentermine/topiramate produces a mean weight loss of 8-10 kg. Side effects of each drug are quite different. For obesity patient, side effects are important factor when choosing drugs. The goal of this article is to review currently available anti-obesity drugs.

Keyword

Anti-obesity agents; Lorcaserin; Obesity; Phentermine; Topiramte

MeSH Terms

Anti-Obesity Agents
Bariatric Surgery
Benzphetamine
Diethylpropion
Digestion
Drug Therapy*
Humans
Life Style
Metabolic Diseases
Obesity*
Phentermine
Receptor, Serotonin, 5-HT2C
Risk Factors
Sympathomimetics
United States Food and Drug Administration
Weight Loss
Anti-Obesity Agents
Benzphetamine
Diethylpropion
Phentermine
Receptor, Serotonin, 5-HT2C
Sympathomimetics

Figure

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  Fig. 1 Flow chart for pharmacologic treatment of obesity. [Reprinted from "Pharmacotherapy for obesity", by Kim KK, 2011, J Korean Med Assoc, 54, pp.409-18. Copyright 2011 by the Korean Medical Association. Reprinted with permission].

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  Fig. 2 Change in glycemic parameters by study week from Behavioral Modification and Lorcaserin for Obesity and Overweight Management in Diabetes Mellitus (BLOOM-DM) trial. Values are mean ± standard error of the mean (SEM); *P ≤ 0.001; **P < 0.05 compared to placebo. BID: twice daily, HbA1c: glycated hemoglobin, LS: least square, QD: once daily. [Reprinted from "Randomized placebo-controlled clinical trial of lorcaserin for weight loss in type 2 diabetes mellitus: the BLOOM-DM study", by O'Neil PM, Smith SR, Weissman NJ, Fidler MC, Sanchez M, Zhang J, et al., 2012, Obesity (Silver Spring), 20, pp.1426-36. Copyright 2012 by John Wiley & Sons, Inc. Reprinted with permission].

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  Fig. 3 Mean (95% confidence interval [CI]) percentage weight loss from baseline to week 108 from SEQUEL trial. LOCF: last observation carried forward, LS: least-squares, PHEN/TPM CR: controlled-release phentermine/topiramate. [Reprinted from "Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study", by Garvey WT, Ryan DH, Look M, Gadde KM, Allison DB, Peterson CA, et al., 2012, Am J Clin Nutr, 95, pp.297-308. Copyright 2012 by the American Society for Nutrition. Reprinted with permission].

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