Recent Studies on the Effectiveness and Safety of Anti-Obesity Medications: A Scoping Review.

Abstract

Obesity remains a major global public health challenge associated with increased morbidity, mortality, and reduced quality of life, necessitating effective treatment strategies beyond lifestyle modifications. The present scoping review aimed to synthesize recent evidence on the effectiveness and safety of anti-obesity medications (AOMs). A structured literature search was conducted in PubMed and Scopus in May 2025 to identify original studies published within the previous five years involving individuals with overweight or obesity receiving pharmacological interventions. A total of 42 articles representing 41 unique studies, predominantly randomized controlled trials (RCTs), were included in the evidence synthesis. The review encompassed glucagon-like peptide-1 receptor agonists (GLP-1 RA), including semaglutide, liraglutide, exenatide, and orforglipron; multi-receptor incretin agonists, including tirzepatide, retatrutide, and survodutide; amylin-based combination therapy (cagrilintide plus semaglutide); established non-incretin AOMs (orlistat, phentermine, phentermine/topiramate, and naltrexone/bupropion); microbiome-targeted therapies; and nutraceutical-based interventions. Among these, GLP-1 RA consistently demonstrated substantial weight-loss efficacy, with semaglutide achieving approximately 10-16% weight loss, while tirzepatide produced approximately 15-21% weight reduction over treatment durations of 20-70 weeks. Emerging multi-receptor incretin agonists also demonstrated promising efficacy, whereas established non-incretin AOMs, microbiome-targeted therapies, and nutraceutical-based interventions generally produced modest or more heterogeneous outcomes. Gastrointestinal adverse events (AEs) were the most frequently reported across incretin-based therapies. Overall, incretin-based therapies currently provide the greatest weight-loss benefit, although evidence for several emerging pharmacotherapies, microbiome-targeted therapies, and nutraceutical-based interventions remains limited. Further well-designed comparative trials, mechanistic studies, and long-term real-world investigations are needed to better establish the durability, safety, and clinical applicability of emerging AOMs.