Current pharmacotherapies for obesity: A practical perspective

J Am Assoc Nurse Pract. 2017 Oct;29(S1):S43-S52. doi: 10.1002/2327-6924.12519.

Abstract

Background and purpose: To review the currently available pharmacotherapies for obesity management with a particular focus on the United States.

Methods: Narrative review based on literature searches and the latest prescribing information (up to July 2017).

Conclusions: Obesity pharmacotherapies may assist those individuals who have obesity, or overweight with comorbidities, who have failed to maintain weight loss with lifestyle modifications alone (caloric restriction and increased physical activity). Currently approved options in the United States include phentermine for short-term use and five obesity pharmacotherapies that can be used long-term (orlistat, lorcaserin, phentermine-topiramate, naltrexone-bupropion, and liraglutide 3.0 mg). If the use of an obesity pharmacotherapy is indicated, treatment should be selected to provide the most appropriate option for each individual and their circumstances. Variables such as contraindications, individual comorbidities, patient choice, patient readiness to incorporate additional behavioral changes (e.g., alcohol prohibition), and cost should guide choices.

Implications for practice: Each of the obesity pharmacotherapies has advantages and disadvantages that can help guide treatment choice. Those receiving treatment may also have individual preferences based on factors such as administration route, frequency of dosing, and/or safety profile. In addition, some options may be particularly appropriate for patients with common obesity-related complications such as depression or diabetes.

Keywords: Nurse practitioners; obesity; pharmacotherapy; weight management.

Publication types

  • Review

MeSH terms

  • Adult
  • Anti-Obesity Agents / adverse effects*
  • Anti-Obesity Agents / pharmacology*
  • Anti-Obesity Agents / therapeutic use
  • Benzazepines / adverse effects
  • Benzazepines / pharmacology
  • Benzazepines / therapeutic use
  • Female
  • Humans
  • Lactones / adverse effects
  • Lactones / pharmacology
  • Lactones / therapeutic use
  • Liraglutide / adverse effects
  • Liraglutide / pharmacology
  • Liraglutide / therapeutic use
  • Middle Aged
  • Naltrexone / adverse effects
  • Naltrexone / pharmacology
  • Naltrexone / therapeutic use
  • Obesity / drug therapy*
  • Orlistat
  • Phentermine / adverse effects
  • Phentermine / pharmacology
  • Phentermine / therapeutic use
  • Risk Reduction Behavior
  • United States

Substances

  • Anti-Obesity Agents
  • Benzazepines
  • Lactones
  • Naltrexone
  • lorcaserin
  • Liraglutide
  • Orlistat
  • Phentermine