An Updated Approach to Antiobesity Pharmacotherapy: Moving Beyond the 5% Weight Loss Goal

Abstract

Despite professional society guidelines recommending that obesity be treated as a chronic disease by emphasizing the use of lifestyle modification in conjunction with pharmacotherapy, antiobesity medications are uncommonly prescribed in most clinical practices. The recent Food and Drug Administration approval of semaglutide 2.4 mg weekly to treat obesity-as well as other forthcoming advancements in diabetes and antiobesity medications-highlights the potential of pharmacotherapy to significantly augment weight loss efforts. In this Expert Endocrine Consult, we review the evolving role of antiobesity pharmacotherapy in clinical practice and suggest a framework for the use of these medications.

Keywords: antiobesity pharmacotherapy; obesity; weight loss.

Figure 1.

Percentage of study participants who met the following weight-reduction targets (>5, >10, >15, >20% weight loss) after 56-68 weeks of treatment, sorted by AOM. *Data are not available for >20% weight loss.

Figure 2.

Recommended approach to initiating AOM therapy in patients with BMI ≥30 kg/m² or ≥27 kg/m² with a weight-related comorbidity. *For treatment strategies specific to patients with T2DM, please see “Medications that Cause Weight Gain” “Type 2 Diabetes Mellitus”. **Engage in shared decision-making, considering patient-specific factors such as preferences on modes of delivery.