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. 2025;18(5):481-488.
doi: 10.1159/000545967. Epub 2025 Apr 21.

The Effectivity and Safety of Naltrexone/Bupropion in Patients Suffering from Overweight and Obesity in a Real-World Setting

Marijn Jense, Marijn T F Jense  1   2   3 , Lars Knibbeler  2 , Roel P L M Hoogma  4 , Inge H Palm-Meinders  2 , Jan Willem M Greve  1   2   3 , Evert-Jan G Boerma  1   2
Affiliations

The Effectivity and Safety of Naltrexone/Bupropion in Patients Suffering from Overweight and Obesity in a Real-World Setting

Marijn Jense et al. Obes Facts. 2025.

Abstract

<p>Introduction: Bariatric and metabolic surgery carries risks of complications and may affect food tolerance. For patients who are overweight or do not meet surgical criteria, alternative weight loss strategies must be explored. One such option is naltrexone/bupropion (NB) treatment. This study evaluates the impact of NB treatment combined with lifestyle intervention on weight loss over 12 months in a real-world setting.

Methods: A retrospective cohort study included all patients initiating NB treatment at the Dutch Obesity Clinic from February 2021 to October 2022.

Results: Among 98 patients (17.5% male; median age 49 [43-53]; median BMI 35.4 [33.0-39.1]), mean percentage total weight loss (SD) was 7.9% (4.2) at 3 months, 10.3% (6.5) at 6 months, and 11.5% (8.3) at 12 months. During the buildup phase, 23.5% of patients experienced nausea/vomiting, 19.4% reported headaches, and 28.6% had constipation. At optimal dosage, 39.8% experienced side effects, with 33% reporting multiple symptoms. Treatment discontinuation within 12 months occurred in 52.7% of patients.

Conclusion: NB treatment combined with lifestyle intervention results in significant weight loss after 6 and 12 months. Despite high discontinuation rates due to multiple reasons including side effects, NB treatment in combination with lifestyle intervention may be of interest for a specific population. </p>.

Keywords: Naltrexone/bupropion; Obesity; Obesity management medication; Overweight.

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Conflict of interest statement

Author J.W.M. Greve is on the scientific advisory board of Morphic Medical and is executive board member of the IFSO. Author I.H. Palm-Meinders received a payment for a presentation on weight loss drugs for primary health care practitioners. All other authors declare that they have no conflict of interest.

Figures

Fig. 1.
Fig. 1.
TWL over 12 months. Mean (±SE) %TWL at 3, 6, and 12 months after the start of the treatment with NB. *Significantly different in TWL between 3 and 6 and 3 and 12 months.
Fig. 2.
Fig. 2.
Scatterplot of TWL at 3 months by TWL at 12 months. Mean (±SE) %TWL at 3 months (TWL_3M) plotted against the mean (±SE) %TWL at 12 months (TWL_12M).
Fig. 3.
Fig. 3.
a All types of symptoms for the total study group who experienced any or multiple symptoms. b Occurence of one, multiple, and no symptoms for subjects at multiple optimum dosages (1dd1, 1dd2, 1dd2 + 1dd1, and 2dd2) of N/B. c Occurrence of symptoms for subjects at multiple optimum dosages (1dd1, 1dd2, 1dd2 + 1dd1, and 2dd2) of N/B.
Fig. 4.
Fig. 4.
Overview of the reasons why certain subjects stopped the treatment with N/B.
See this image and copyright information in PMC

References

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