title: Efficacy comparison of medications approved for chronic weight management.
abstract: For the first time, patients who are obese are able to benefit from 5 different FDA approved pharmacologic agents for chronic weight management. Although weight loss from all of these medications was limited to 5% to 10% of total body weight loss in the Phase III clinical trials, patients are capable of losing more weight when a cumulative approach of diet, exercise, and multiple medications are used. A pilot study of adding phentermine to lorcaserin yielded double the weight loss than lorcaserin alone. A higher percentage of total body weight is lost with use of combination phentermine/topiramate compared to orlistat, lorcaserin, and bupropion/naltrexone but there are more contraindications to its use and potential cardiovascular adverse effects due to adrenergic agonism. Lorcaserin and bupropion/naltrexone yielded similar weight loss but carry different adverse effect profiles and interactions with other psychiatric medications may preclude use of one over the other. When choosing a medication for obesity, several factors need to be considered, such as comorbidities, medication interactions, and risk of potential adverse effects.
authors.affiliation: Weill Cornell Medical College, Department of Endocrinology, Diabetes, & Metabolism, Comprehensive Weight Control Center, New York, New York, USA.
authors.forename: Rekha B
authors.initials: RB
authors.lastname: Kumar
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Aronne
mesh_terms: D000328:Adult; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D001067:Appetite Depressants / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use; D001835:Body Weight / Q000187:drug effects; D002986:Clinical Trials as Topic; D017326:Clinical Trials, Phase III as Topic; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D009765:Obesity / Q000188:drug therapy*; D010645:Phentermine / Q000627:therapeutic use; D010865:Pilot Projects; D000077236:Topiramate; D015431:Weight Loss / Q000187:drug effects
chemical_list: D019440:Anti-Obesity Agents; D001067:Appetite Depressants; D001552:Benzazepines; D000077236:Topiramate; D005632:Fructose; C506658:lorcaserin; D010645:Phentermine