Glucagon-like peptide 1 in the pathophysiology and pharmacotherapy of clinical obesity

Table 1 Current and previously Food and Drug Administration licenced anti-obesity pharmacotherapeutics

Drug	Mechanism	Year	Clinical use and limitations	Suspension reason
Currently FDA licenced drugs
Diethylpropion	NA releasing agent	1959	FDA approved for short term use (3 mo); not recommended with uncontrolled hypertension or heart disease	-
Phentermine		1959	FDA and EMA approved for long term use; treatment dependent weight loss	-
Orlistat (Xenical)	-	1999		-
Orlistat (Alli)	Pancreatic lipase inhibitor	2007		-
Phentermine-topamirate (Qysmia)	-	-	Approved for long term use; treatment dependent weight loss	-
Lorcaserin (Belviq)	5HT2c-R antagonist	2012	FDA approved for long term use, recommended in those with cardiovascular disease; treatment dependent weight loss	-
Liraglutide (Saxenda)	GLP-1 analogue	2014	FDA and EMA (2015) approved	-
Previously FDA licenced drugs
Dinitrophenol	Unknown	1938	-	Dermatitis, neuropathy, agranulocytosis, visual impairment, death
Aminorex	Unknown	1968	-	Chronic pulmonary hypertension
Amphetamines	Monoamine reuptake inhibitor	1971	-	Addiction, hypertension, myocardial toxicity
Fenfluramine	Serotonin reuptake inhibitor	1997	-	Valvular heart disease
Phenylpropanolamine	NA-R and DA-R agonist	2000	-	Haemorrhagic stroke
Rimonabant	CB1R antagonist	2009	-	Psychiatric disorders, depression, suicidal ideation
Sibutramine	Serotonin-NA reuptake inhibitor	2010	-	Risk of major cardiovascular events

The pancreatic lipase inhibitor Orlistat and GLP-1 analogue liraglutide are the only currently UK licenced anti-obesity agents). 5HT2c: Serotonin receptor; NA: Noradrenaline; DA: Dopamine; CB1R: Cannabinoid receptor; R: Receptor; FDA: Food and Drug Administration; EMA: European Medical Association.