Table 2.
Approved medications for weight management.
| Medication (full dose & adminstration) | Main Mechanism of Action | Approval Status | Mean Weight Loss (% from Baseline) | Effects on MHO Diagnostic Parameters | |
|---|---|---|---|---|---|
| Placebo | Medication | ||||
| Orlistat (120 mg TID, oral) | Pancreatic lipase inhibitor | USA, EU | -2.6% | -6.1% | HbA1c lowering; lowers risk of developing type 2 diabetes in individuals with prediabetes; HDL-C decrease; lowers BP; LDL-C lowering |
| Phentermine (15–30 mg, QD, oral) | Sympatho-mimetic | USA, only for short-term use | No data available for monotherapy treatment of ≥52 weeks | ||
| Lorcaserin (10 mg, BID, oral) | 5-HTac serotonin agonist | USA | -2.5% | -5.8% | HbA1c lowering; HDL-C increase; lowers BP |
| Phentermine/topiramate ER (titration) (15 mg/92 mg, QD, oral) | Sympatho-mimetic/ anticonvulsant | USA | -1.2% | -7.8% to -9.8% (dose dependent) | HbA1c lowering; HDL-C increase; lowers BP |
| Naltrexone SR/ bupropion SR (titration) (32 mg/360 mg, BID, oral) | Opiod receptor antagonist/ dopamine and noradrenaline reuptake inhibitor | USA, EU | -1.3% | -5.4% | HbA1c lowering; BP increase; HDL-C increase |
| Liraglutid (titration) (3.0 mg, QD, subcutaneous injection) | GLP-1 receptor agonist | USA, EU | -3.0% | -7.4% | HbA1c lowering; lowers risk of developing type 2 diabetes in individuals with prediabetes; lowers BP; HDL-C increase reduces cardiovascular outcomes in type 2 diabetes patients treated with up to 1.8 mg daily dose (109) |
Status of approval in the U.S. and the European Union (EU), main mechanism of action, reported mean weight loss outcomes, and impact on parameters of metabolic health. Data are only included from randomized controlled trials with a duration of ≥52 weeks.
Abbreviations: BID, bis in die, twice a day; BP, blood pressure; ER, extended release; GLP-1, glucagon-like peptide-1; MHO, metabolically healthy obesity; QD, quaque die, once daily; SR, short release; TID, ter in die, three times a day. Adapted from references (102, 103); data on mean percentage of weight loss are from reference (102).