Clinical efficacy and safety of antiobesity agents

Physicians are currently limited to very few options when considering antiobesity medication. The only drugs currently approved for use are anorexiants, and all of them are indicated for short-term use. However, a variety of research has shown that long-term use of medication combined with comprehensive lifestyle change is required for most patients to lose weight, and more important, to maintain that weight loss. Although fenfluramine has been withdrawn from the market, we are fortunate that researchers are looking toward classes of drugs with completely different mechanisms of action and, hopefully, fewer side effects in order to accommodate long-term use. The antiobesity formulary is likely to change during the next decade and will probably include peptide analogues such as leptin, new thermogenic agents like the beta 3-adrenoceptor agonists, lipase inhibitors, and safer anorexiants that combine serotonergic and adrenergic activity. Indeed, the lipase inhibitor tetrahydrolipstatin, or orlistat, is near FDA approval, and the anorexiant sibutramine has been recently approved. New advances in weight management medications should bring obesity treatment into every physician's office. It is also hoped that managed care organizations will realize the importance of these medications in reducing the significant comorbid conditions caused by obesity. Effective weight loss stands to contribute greatly to the long-term health outcomes of millions of Americans now dealing with weight-related conditions.