Abstract
Objective:
To review the literature regarding the past, present, and future pharmacologic agents used in the treatment of obesity.
Data Sources:
Articles were identified by searching MEDLINE (1966–April 2005) and International Pharmaceutical Abstracts (1970–April 2005) using the key words obesity, antiobesity agents, sibutramine, orlistat, phentermine, and leptin. Additional resources were identified by examining the references of the articles cited. Searches were limited by human subject and English language, but were not limited by time of publication.
Study Selection and Data Extraction:
Large-scale clinical studies of pharmacologic agents used to treat obesity were selected for this review including agents that were previously available, currently available, and those currently undergoing clinical trials.
Data Synthesis:
Thyroid hormone was the first antiobesity agent used. Several other agents have been withdrawn from the market due to adverse effects. Current therapies indicated for obesity management include orlistat, sibutramine, and noradrenergic agents. Future therapies include both newer agents and existing agents that are principally used for other indications, mainly diabetes, depression, and seizure disorders.
Conclusions:
Obesity is a major epidemic in the US, affecting over half of the population. Past experiences with the pharmacologic treatment of obesity have been disappointing and, in some cases, harmful to patients. Current options are available that include noradrenergic agents, orlistat, and sibutramine. However, these agents still have only demonstrated limited efficacy for short-term use plus some undesirable adverse effects. Newer treatment options are being evaluated as new pathways are being identified and other related factors are being discovered.
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