title: Current pharmacotherapy for obesity: extrapolation of clinical trials data to practice.
abstract: BACKGROUND
  When used prudently and in combination with lifestyle modification, pharmacotherapy has an important role in the management of obesity.
  
  
  METHODS
  This review covers targets for antiobesity drugs, challenges and limitations, failed translation of basic science to clinical practice, methodological and regulatory issues in clinical trials of pharmacotherapy, efficacy and risks of drugs currently approved for obesity, and clinical practice issues when using antiobesity drugs with emphasis on recently approved drugs.
  
  
  CONCLUSIONS
  Drugs currently approved for long-term therapy of obesity offer modest benefits for most patients, substantial benefits for some and no benefits for others. Numerous methodological problems including exclusion of the type of patients who are most often seen in clinical practices, inadequate enrollment of men and minorities, exclusion of patients taking antidepressants, high dropout rates, lack of follow-up after treatment discontinuation, and less than ideal imputation methods in data analysis limit the interpretation of clinical trials data and generalizability. Single-drug therapies offer small to moderate weight-loss benefits, but are generally better tolerated. Efficacy is enhanced with combination drug therapies, but so are the hazards. Clinicians should base their decisions on the expected and observed benefit-to-risk balance.
authors.affiliation: Duke University Medical Centre, Obesity Clinical Trials Programme , Box 3292, Durham, NC 27710 , USA kishore.gadde@duke.edu.
authors.forename: Kishore M
authors.initials: KM
authors.lastname: Gadde
mesh_terms: D019440:Anti-Obesity Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D009765:Obesity / Q000188:drug therapy* / Q000503:physiopathology; D057170:Translational Research, Biomedical; D015431:Weight Loss / Q000187:drug effects
chemical_list: D019440:Anti-Obesity Agents