Pharmacotherapy in the treatment of obesity

The incorporation of pharmacotherapy into the comprehensive office-based management of obesity can improve outcomes significantly for patients meeting specific clinical guidelines in whom diet and lifestyle change alone is not successful. With an improved understanding of the mechanisms of action of various pharmacotherapies, it becomes possible for the primary care physician to help obese patients select successful therapeutic approaches and strategies. Some agents work primarily on central nervous system mechanisms related to satiety, while other agents affect metabolism and absorption of nutrients. It is of critical importance not to use pharmacotherapy alone, but rather combined with an aggressive program of diet and lifestyle change. The temptation of patients to find a magic pill that will close the refrigerator door is not likely to lead to a successful result. By gearing patients' expectations to realistic and achievable weight-loss goals, practitioners can reduce the risks of comorbid diseases, enhance ongoing treatment of existing comorbidities, and improve the overall quality of life for the obese patient.