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Review
. 2025 Feb 18;21(2):62-73.
doi: 10.14797/mdcvj.1503. eCollection 2025.

Medical Management of Obesity: Current Trends and Future Perspectives

Andres Calderon Valladares  1 , Maria Aguilera Astudillo  1 , Alexsandra Rojas Drinnon  1 , Samaneh Dowlatshahi  1 , Abhishek Kansara  1 , Jawairia Shakil  1 , Bhargavi Patham  1
Affiliations
Review

Medical Management of Obesity: Current Trends and Future Perspectives

Andres Calderon Valladares et al. Methodist Debakey Cardiovasc J. .

Abstract

Obesity and overweight have become increasingly significant conditions, affecting more than 70% of the adult population in the United States. These conditions are caused by a combination of factors, including genetic, behavioral, environmental, and medical influences. Obesity is a major risk factor for cardiovascular and metabolic diseases. A comprehensive treatment plan for individuals with obesity must recognize the chronic nature of the condition and offer strategies for weight reduction and long-term cardiometabolic benefits. Over the past several decades, multiple therapeutic options have been implemented to address weight loss, appetite regulation, and caloric expenditure, with the goal of reducing the burden of obesity and improving cardiovascular outcomes. Pharmacological treatment of obesity has focused primarily on the central regulation of appetite and food intake behavior. The introduction of incretin agonists for obesity treatment has ushered in a new era of cardiometabolic health, with a multitargeted mechanism that achieves weight loss, glycemic control, decreased cardiovascular mortality, and other metabolic benefits. This review explores the current pharmacological options and the future of obesity treatment.

Keywords: GLP-1; cardiovascular disease; obesity; pharmacotherapy.

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Conflict of interest statement

Dr. Kansara is a site principal investigator for clinical trials sponsored by Medtronic, Eli Lilly, Calcilytix, Endogenex, Arrowhead Pharmaceuticals, and Amolyt Pharma. The other authors have no competing interests to declare.

Figures

Appetite and energy expenditure regulation in obesity
Figure 1
Appetite and energy expenditure regulation in obesity. Leptin, released by the arcuate nucleus neurons in the hypothalamus, induces α-MSH release, which stimulates MC4R, resulting in decreased appetite, increased nonshivering thermogenesis, and energy expenditure. Glucagon activates the leptin-melanocortin pathway. AgRP opposes the leptin-melanocortin pathway. GLP-1 and GIP cause decreased gastric emptying and stimulate insulin secretion. Created in BioRender by Calderon A; (2024) BioRender.com/a11c077.α-MSH: alpha melanocortin stimulating hormone; AgRP: agouti-related peptide; GIP: glucose-dependent insulinotropic polypeptide; GLP-1: glucagon-like peptide 1
See this image and copyright information in PMC

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