Table 1. A summary of anti-obesity drugs for long-term use.

Drug	Product name	Application	Mechanism of action	Main adverse effect	Contraindication	FDA approval	EMA approval	Korea approval
Orlistat	Xenical®, Alli®	60 or 120 mg TID during or within 1 hour of a fatcontaining meal	Gastrointestinal and pancreatic lipase inhibitor; decrease lipid absorption	Oily stools, oily spotting, fecal urgency, fecal incontinence, hyperdefecation, flatus with discharge, deficiency in vitamins A, D, E, and K	Pregnancy, cholestasis, malabsorption	Yes 1999	Yes 2012	Yes 2000
Phentermine/topiramate	Qsymia®	3.75/23 mg QD for 14 days and then 7.5/46 mg QD; If <3% weight loss is achieved at 12 weeks, increase to 11.25/69 mg QD for 14 days, followed by 15/92 mg QD; discontinue gradually if <5% weight loss is achieved at 12 weeks with the highest dose	NE agonist/GABA agonist, glutamate antagonist; suppress appetite	Paresthesia, dry mouth, constipation, insomnia, dysgeusia, anxiety, depression	Pregnancy, uncontrolled HTN, CVD, CKD, glaucoma, hyperthyroidism patients on MAOIs	Yes 2012	No	Yes 2019
Naltrexon/bupropion	Contrave®,Mysimba®	8/90 mg for 7 days; BID for 7 days; 2 tablets in the morning and 1 tablet in the evening for 7 days; and 2 tablets BID thereafter	Opioid receptor antagonist/dopamine agonist and NE reuptake inhibitor; increase satiety, uppress appetite	Nausea, headache, constipation, dizziness, vomiting, dry mouth	Pregnancy, uncontrolled HTN, seizure, anorexia or bulimia nervosa, abrupt discontinuation of alcohol, benzodiazepines, barbiturates or antiepileptic drugs, other bupropion-containing drugs, opioids or opiate agonists, MAOIs	Yes 2014	Yes 2015	Yes 2016
Liraglutide	Saxenda®	0.6 mg subcutaneous injection QD, increase by 0.6 mg weekly to a daily target dose of 3 mg	Glucagon-like peptide-1 agonist; slow gastric emptying, increase satiety, decrease food reward	Nausea, diarrhea, constipation, vomiting, dyspepsia	Pregnancy, personal or family history of medullary thyroid carcinoma or type 2 MEN	Yes 2014	Yes 2015	Yes 2017
Lorcaserin	Belviq®, Belviq XR®	10 mg BID 20 mg extended release QD	Serotonin 2C receptor agonist; reduce food intake	Headache, dizziness, fatigue, nausea, constipation, dry mouth	Pregnancy, severe renal disease	Yes 2012 Withdrawn from the market in February 2020	No	Yes 2015 Withdrawn from the market in February 2020

DA: Food and Drug Administration, EMA: European Medicines Agency, XR: extended release, TID: three times per day, QD: once daily, BID: twice daily, NE: norepinephrine, GABA: gamma-aminobutyric acid, HTN: hypertension, CVD: cardiovascular disease, CKD: chronic kidney disease, MAOIs: monoamine oxidase inhibitors, MEN: multiple endocrine neoplasia.