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. 2025 Nov;33 Suppl 1(Suppl 1):11-21.
doi: 10.1002/oby.24160. Epub 2024 Dec 26.

Efficacy of antiobesity medications for weight reduction in older adults: a systematic review

Alissa S Chen  1 , Alexandra M Hajduk  2 , Alyssa A Grimshaw  3 , Terri R Fried  2 , Ania M Jastreboff  4   5 , Kasia J Lipska  5   6
Affiliations

Efficacy of antiobesity medications for weight reduction in older adults: a systematic review

Alissa S Chen et al. Obesity (Silver Spring). 2025 Nov.

Abstract

Objective: The objective of this study was to examine weight reduction and adverse events associated with use of antiobesity medications (AOMs) in older adults ages ≥65 years.

Methods: Seven databases were searched for studies evaluating weight reduction of Food and Drug Administration (FDA)-approved AOMs. Studies had to include adults ages ≥65 years with obesity (BMI ≥ 30 kg/m2 or ≥27 kg/m2 with one weight-related condition), with independent analysis of weight reduction for adults ages ≥65 years. Two coauthors extracted and evaluated studies for risk of bias using standardized forms.

Results: Six experimental studies (five secondary analyses of randomized clinical trial data and one single-arm trial) and two observational studies met inclusion criteria. Seven medications were studied. Sample size of older adults ranged from 13 to 6728. Experimental studies predominantly included patients with concurrent prediabetes or cardiovascular disease. All studies found statistically significant weight reduction between intervention and placebo groups or compared with baseline weight. Few studies reported on adverse events.

Conclusions: Limited evidence suggests weight reduction of AOMs in older adults, with the best current evidence for the use of semaglutide in older adults with obesity and cardiovascular disease. Larger, more inclusive studies of older adults are needed to guide clinical care and determine the tolerability of AOMs for older adults.

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Conflict of interest statement

Conflict of Interest Disclosures:

Dr. Jastreboff conducts multi-center trials with Boehringer Ingelheim, Eli Lilly, Novo Nordisk, and Rhythm Pharmaceuticals; serves on scientific advisory boards for Amgen, AstraZeneca, Boehringer Ingelheim, Biohaven, Eli Lilly, Intellihealth, Novo Nordisk, Pfizer, Regeneron, Scholar Rock, Structure Therapeutics, Terms Pharmaceutical, WeightWatchers, Zealand Pharmaceuticals; and receives institutional grant funding from the NIH/NIDDK.

Figures

Figure 1:
Figure 1:
PRISMA flow chart Adapted from: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372: n71. doi: 10.1136/bmj.n71. For more information, visit: http://www.prisma-statement.org/
Figure 2:
Figure 2:
Representation of medications in studies of anti-obesity medications inclusive of and reporting on outcomes in older adults
Figure 3:
Figure 3:
Cochrane Risk of Bias ratings for Experimental Studies
See this image and copyright information in PMC

References

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