Medications for obesity: mechanisms and applications

Medications can significantly increase weight loss compared with placebo in most trials. In general, patients can expect a weight loss of 8% to 10% from baseline provided they adhere to the weight-loss program and take medications regularly. All medications have side effects that need to be considered before initiating treatment, however. For sibutramine, there is an increase in blood pressure and heart rate that may require discontinuation of the drug in a small percentage of patients. For orlistat, the principal side effect is gastrointestinal in origin resulting from the increased activity of the lower bowel. Cannabinoid receptor antagonists, once a promising target, are no longer under study. Other medications are in clinical trials and on their way.