Table 2.

Antiobesity medications approved by the Food and Drug Administration for chronic weight management.

Antiobesity medication	Mechanism of action	Reported total body weight loss percentage	Potential interactions with cancer risk
Orlistat [[183], [184], [185], [186], [187], [188], [189], [190]]	Lipase inhibitor.	10.2%	In vitro study suggested that orlistat induced caspase-dependent apoptosis and protective autophagy in ovarian cancer cells.
			In vitro and in vivo studies suggest that orlistat led to decreased colonic inflammation and cancer cell proliferation.
			Orlistat is a fatty acid synthase inhibitor, potentially having antiproliferative effects.
Phentermine –Topiramate [191,192]	Appetite suppressant.	6.7%–14.4%	An in vitro study suggested that topiramate inhibited proliferation and promoted apoptosis in ovarian cancer cells.
Naltrexone – bupropion [[193], [194], [195], [196]]	Appetite suppressant.	6.7%–11.5%	In vitro and in vivo studies have suggested that low-dose naltrexone might promote apoptosis and inhibit proliferation of colorectal cancer cells and cervical cancer cells.
Setmelanotidea [197]	Melanocortin 4 receptor (MC4R) agonist.	12.5%–25.6%	Half of patients treated with setmelanotide develop skin hyperpigmentation disorders. Melanoma has been proposed as a potential risk and is actively being monitored. Subjects with a history or close family history of melanoma were excluded from clinical trials. To date, no evidence exists of an increased risk of melanoma in patients treated with setmelanotide.
Liraglutide [79,198,199]	Glucagon-like peptide 1 (GLP-1) receptor agonist.	6.2%–8.0%	Concerns have been raised about the possibility of increased risk of medullary thyroid cancer (MTC) and pancreatic cancer with the use of GLP-1 receptor agonists.
Semaglutide [77,88,89,200]		9.6%–14.9%	While data from animal models have suggested a possible connection between the use of GLP-1 receptor agonists and MTC, the risk of MTC in humans with the use of these medications has not been established clinically. Currently, GLP-1 receptor agonists are contraindicated in patients with a personal or family history of MTC or multiple endocrine neoplasia type 2 syndrome (MEN2).
Tirzepatide [78,201]	GLP-1 and Glucose-dependent insulinotropic polypeptide (GIP) dual agonist.	14.7%–20.9%	Evidence suggests that the risk of pancreatic and thyroid cancer, and overall neoplasias are not increased in patients using GLP-1 receptor agonists.

^aSetmelanotide has been approved for chronic weight loss management in patients with select genetic variants in the leptin-melanocortin pathway.