Pharmacologic Weight Loss: An Underutilized Practice in the Fight Against Obesity

Abstract

Obesity is considered one of the most contemporary threats to non-communicable disease such as cardiovascular disease, diabetes, musculoskeletal disorders and even some types of cancers. Its worldwide prevalence has nearly tripled between 1975 and 2016. In 2016, more than 1.9 billion adults aged 18 years and older were categorized as overweight, and of these over 650 million adults were obese. However, Weight management medications (WMM) are currently underutilized as an adjunct to behavioral and lifestyle interventions. By way of example, only 2% of eligible veterans received prescriptions for pharmacologic weight loss in the 2014-2015 fiscal years, and up to 1% of obese U.S. individuals filled a prescription for a WMM between 2009-2013. There are currently five FDA-approved medications for long-term weight loss medications. We analyzed 24 randomized clinical trials of the five drugs and interpreted findings. Of those 24, lorcaserin (Belviq®), naltrexone and bupropion (Contrave®), and phentermine and topiramate (Qsymia®) had four studies each, while liraglutide (Saxenda®), and orlistat (Xenical®) had six studies each. Underutilization of pharmacologic weight corrective therapies that have been statistically and clinically proven to be valuable tools in reducing obesity and its related risk factors. Studies of the five FDA-approved drugs have demonstrated clinically significant positive effects on weight loss with differing effects on both cardiovascular and glycemic markers/risk factors.