The Evolving Role of Weight Loss Pharmacotherapy

Obesity is a complex disease, afflicting millions of individuals worldwide. Multiple treatment options exist, including dietary and lifestyle modifications, pharmacotherapy, endobariatrics, and surgery. Although diet and exercise remain crucial to the long-term management of obesity, their effectiveness as monotherapy is limited. Adjunctive therapy, therefore, has become a tool associated with more durable weight loss results. This article serves to explore the expanding pharmacologic options available for the treatment of obesity. Traditional pharmacotherapy includes phentermine/topiramate and bupropion/naltrexone, both of which have been shown to aid in weight loss. More recent novel therapies include glucagon-like peptide-1 (GLP-1) and GLP-1/glucose-dependent insulinotropic polypeptide receptor agonists, which have shown even more marked weight loss and improvement in obesity-associated comorbid conditions compared with alternative medications. Despite their effectiveness, barriers to widespread use include their cost, insurance approval, and side effect profile. Further studies are underway examining the role of pharmacotherapy in conjunction with endoscopic bariatric therapies as well as bariatric surgery.