[The history of the pharmacotherapy of obesity]

The obesity epidemic is a major public health problem nowadays. The pathophysiology of obesity, which underlies its chronic, progressive, self-sustaining course, determines the difficulties in developing effective and safe methods for body weight control. The article is dedicated to the consideration of the evolution of conservative treatment of obesity, in particular, the history of pharmacotherapy of this disease, characterized by many ups and downs, is presented. The paper discusses, in chronological order, the emergence, efficacy, mechanisms of action, and described side effects of drugs that were investigated and used for weight loss at one time or another, as well as the reasons why many of them were subsequently withdrawn from the market. Until recently, long-term effective and safe pharmacotherapy of obesity remained an insurmountable challenge. Only in the last two decades has the understanding of the molecular mechanisms of appetite control reached a level that allows for a more productive search and development of promising drugs aimed at the pathogenetic treatment of obesity. This article discusses the status of currently available drugs for weight loss, as well as the prospects for drug treatment of obesity. The results of clinical trials of advanced therapeutic molecules, including gastrointestinal hormone receptor agonists, reinforce the belief that a breakthrough in the drug treatment of obesity is possible.