Anti-obesity Pharmacotherapy: Where Do We Stand in 2023?

| November 1, 2023

by Harold Bays, MD, FOMA, FTOS, FACC, FNLA, FASPC

Dr. Bays is Medical Director/President, Louisville Metabolic and Atherosclerosis Research Center, and Clinical Associate Professor, University of Louisville School of Medicine in Louisville, Kentucky.

Funding: No funding was provided.

Disclosures: The author has no conflicts of interest relevant to the content of this article.

Bariatric Times. 2023;20(7–12):36.

The treatment of obesity is undergoing both an evolution and revolution. The safety and effectiveness of bariatric procedures continues to advance. Concurrently, newer, highly effective anti-obesity medications (AOMs) are now available, with many more in the development pipeline.1

While treatment of increased body fat remains a therapeutic target of AOMs, the effectiveness of highly effective AOMs goes well beyond treating body fat alone. It is not just about improving the weight of patients; it is about improving the health of patients. That is why current AOM development programs not only focus on body weight, but also the complications of obesity, such as diabetes mellitus, hypertension, dyslipidemia, obstructive sleep apnea, arthritis, and fatty liver. Perhaps the most ambitious programs are soon to be completed (the SELECT trial with semaglutide)2 or currently ongoing (the SURMOUNT-MMO trial with tirzepatide)1,3 studies assessing cardiovascular outcomes.

Along with the increasing use and effectiveness of these AOMs, an increased need exists for clinicians to understand the potential risks and intolerances of these newer and forthcoming agents. Space does not allow for a full description of potential cautions and contraindications of all anti-obesity drugs. However, the most common side effects with glucagon-like peptide-1 receptor agonists include nausea and vomiting, which can be somewhat mitigated with a dose-escalation approach.4

During this evolution and revolution in obesity care, obesity medicine clinicians may benefit from access to comprehensive discussions of the latest in guidance regarding healthful nutrition, physical activity, behavior modification, and medical/surgical treatments.5

In the past two years, the Obesity Medicine Association (OMA) has published over 20 Clinical Practice Statements on sentinel topics in obesity medicine. These free online resources are published in Obesity Pillars, the official journal of the OMA.

References

  1. Bays HE, Fitch A, Christensen S, et al. Anti-obesity medications and investigational agents: an Obesity Medicine Association (OMA) Clinical Practice Statement (CPS). Obesity Pillars. 2022;2:100018. 
  2. Ryan DH, Lingvay I, Colhoun HM, et al. Semaglutide effects on cardiovascular outcomes in people with overweight or obesity (SELECT) rationale and design. Am Heart J. 2020;229:61–69.   
  3. Bays HE, Burridge K, Richards J, Fitch A. Obesity Pillars roundtable: excessive weight reduction with highly effective anti-obesity medications (heAOMs). Obesity Pillars. 2022;4:100039. 
  4. Collins L, Costello RA. Glucagon-like peptide-1 receptor agonists. [Updated 2023 Jan 13]. In: StatPearls [Internet]. StatPearls Publishing; 2023.
  5. Fitch A, Alexander L, Francavilla Brown C, Bays HE. Comprehensive care for patients with obesity: an Obesity Medicine Association Position Statement. Obesity Pillars. 2023;7:100070. 

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Category: Current Issue, Medical Methods in Obesity Treatment

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