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Drugs for Treating Obesity

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From Obesity to Diabetes

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 274))

Abstract

Older medications approved for chronic weight management (orlistat, naltrexone/bupropion, liraglutide 3 mg and, in the USA, phentermine/topiramate) have not been widely adopted by health care providers. Those medications produce only modest additional weight loss when used to augment lifestyle intervention. However, semaglutide 2.4 mg weekly has recently emerged and produces much more weight loss – on average 15% weight loss at 1 year. Semaglutide’s enhanced efficacy and that its class (GLP-1 receptor analogs) is well-known may result in more clinicians adopting pharmacotherapy. Furthermore, the first dedicated cardiovascular outcome trial powered for superiority testing an anti-obesity medication (SELECT) is underway with semaglutide 2.4 mg. A positive outcome will further promote the concept that weight management should be a primary target for cardiometabolic disease control. In phase 3, tirzepatide and cagrilintide/semaglutide combination are showing promise for even greater weight loss efficacy. Another recently approved medication takes a personalized medicine approach; setmelanotide is approved as a therapy for those with some of the ultra-rare genetic diseases characterized by severe, early onset obesity. This chapter reviews the currently available and anticipated medications for chronic weight management as well as those approved for the genetic and syndromic obesities.

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Acknowledgements

Conflict Statement: I report personal fees and non-financial support from Boeringer Ingelheim, Calibrate (ReDesign Health) Epitomee, Gila Therapeutics, IFA Celtic, Janssen, Novo Nordisk, Phenomix, Real Appeal (United Health), Ro, Sanofi, Scientific Intake and Wondr Health.

Author Contribution: I conceived and created this document in its entirety.

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  1. Pennington Biomedical Research Center, Baton Rouge, LA, USA

    Donna H. Ryan

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Correspondence to Donna H. Ryan .

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  1. Institute for Clinical Diabetology, German Diabetes Center, Düsseldorf, Germany

    Juergen Eckel

  2. NutriOmique Research group, Nutrition Department, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université/INSERM, Paris, France

    Karine Clément

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Ryan, D.H. (2021). Drugs for Treating Obesity. In: Eckel, J., Clément, K. (eds) From Obesity to Diabetes. Handbook of Experimental Pharmacology, vol 274. Springer, Cham. https://doi.org/10.1007/164_2021_560

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