Obesity: drugs and dietary supplements

In conjunction with lifestyle interventions, drugs are now recommended for obesity management when lifestyle interventions alone have not been effective and a patient's body mass index is 30 kg/m(2) or greater or 27 kg/m(2) or greater with the presence of one significant obesity-related comorbidity. Drugs should be viewed as potential long-term management because they control but do not resolve the underlying neurohormonal abnormalities often present in patients with obesity. Multiple trials of different drugs may be required before one that causes sufficient weight loss is identified. If 5% weight loss is not achieved at 12 weeks, the drug should be discontinued for lack of effectiveness. Drugs known to cause weight gain should be discontinued or their dosages should be decreased, or they should be replaced with more weight neutral drugs when possible. Dietary supplements and integrative medicine therapies have not been shown in studies to be effective for long-term management of obesity.