The Evolution of Medications for Obesity Management

This narrative review provides an overview of progress in the development of obesity medications, including a synthesis of data describing the efficacy and safety of currently available agents and emerging therapeutic options. Historically, many obesity medications have been withdrawn from the market due to safety concerns. However, expansion in scientific knowledge of the mechanisms regulating appetite and energy balance has led to the development of medications with greater safety and efficacy. The current generation of injectable incretin analogs, semaglutide and tirzepatide, is associated with mean weight loss in the range of 15%-20% over approximately 12-18 months. These agents confer additional substantial cardiometabolic benefits, including reductions in adverse cardiovascular and kidney outcomes, and improvements in glycaemia, blood pressure, lipid profile and steatohepatitis. As therapeutic options continue to expand, obesity medications are poised to play a critical role in the management of cardiometabolic disease.