When are medications indicated for the treatment of obesity?

Updated: Jun 09, 2021
  • Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Few medications are available for the management of obesity. Generally, the medications approved by the US Food and Drug Administration (FDA) for obesity are intended for patients with a BMI of 30 or above (obese) or of 27 or above (overweight) with a weight-related risk factor (eg, diabetes, hypertension). All are indicated as adjuncts to caloric restriction, increased physical activity, and behavior modification.

Some examples of obesity medications include orlistat (Xenical [Rx], Alli [OTC]), a fixed-dose combination of immediate-release phentermine and extended-release topiramate (Qsymia), and a fixed-dose combination of bupropion and naltrexone (Contrave).

However, the list of potential antiobesity agents being investigated has increased considerably with the explosion in knowledge of the pathogenesis of obesity. Improved understanding of the neurocircuitry of the feeding-satiety cycle has provided many potential targets for designer therapeutic agents under development. (See the diagram below.)

Central nervous system neurocircuitry for satiety Central nervous system neurocircuitry for satiety and feeding cycles.

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