Review
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World J Meta-Anal. Nov 26, 2014; 2(4): 135-153
Published online Nov 26, 2014. doi: 10.13105/wjma.v2.i4.135
Anti-obesity drugs currently used and new compounds in clinical development
Armindo Martins, Sandra Morgado, Manuel Morgado
Armindo Martins, Manuel Morgado, CICS-UBI-Health Sciences Research Center, University of Beira Interior, 6201-001 Covilhã, Portugal
Sandra Morgado, Manuel Morgado, Hospital Centre of Cova da Beira, 6200-251 Covilhã, Portugal
Author contributions: Martins A analysis and interpretation of data, drafting of manuscript, statistical analysis and technical support; Morgado S acquisition of data, drafting of manuscript and critical revision of manuscript for important intellectual content; Morgado M concept and study design, analysis and interpretation of data, drafting of manuscript and critical revision of manuscript for important intellectual content.
Correspondence to: Manuel Morgado, MD, PhD, Hospital Centre of Cova da Beira, E.P.E., Quinta do Alvito, 6200-251 Covilhã, Portugal. manuelaugustomorgado@gmail.com
Telephone: +351-275-329002 Fax: +351-275-329099
Received: February 22, 2014
Revised: June 30, 2014
Accepted: August 27, 2014
Published online: November 26, 2014
Abstract

Obesity is a chronic disease which requires treatment. As lifestyle interventions alone hardly ever result in long-term weight loss, pharmacotherapy is an important adjunct to lifestyle measures to improve the induction and maintenance of weight loss. Owing to the limited options currently available for the pharmacological treatment of obesity, it is imperative to develop new safe compounds. This study aims to review the current medications approved by European Medicines Agency and United States Food and Drug Administration (FDA) for the treatment of obesity, focusing essentially on their benefits and risks, as well as on the new drugs which are presently under clinical trials. Moreover, it lists the anti-obesity agents that have been recently withdrawn from the market. A revision of the scientific literature was carried out, through a search on Pubmed for papers published from January 2010 to January 2013. Orlistat (Xenical®) is currently the only long-term pharmacotherapy for obesity available in the European market, as rimonabant and sibutramine were withdrawn in 2008 and 2010, respectively, due to serious psychiatric and cardiovascular adverse effects. Lorcaserin (Belviq®) and the association of phentermine and topiramate (QsymiaTM) were recently approved by FDA. Orlistat suppresses appetite inhibiting gastrointestinal lipase, being its adverse effects mostly gastrointestinal. Lorcaserin activates 5-HT2C receptors, phentermine is a norepinephrine releasing drug, and topiramate is an anticonvulsivant drug with weight loss properties.

Keywords: Obesity, Weight loss, Pharmacological treatment, European Medicines Agency, Food and Drug Administration, Clinical trials

Core tip: Obesity is a chronic disease which requires treatment. As lifestyle interventions alone hardly ever result in long-term weight loss, pharmacotherapy is an important adjunct to lifestyle measures to improve the induction and maintenance of weight loss. This study reviews the current medications approved by European Medicines Agency and United States Food and Drug Administration for the treatment of obesity, focusing essentially on their benefits and risks, as well on the new drugs under clinical trials. An original algorithm for assessment and treatment of overweight and obese patients in clinical practice was also developed.