Pharmacological Support for the Treatment of Obesity—Present and Future

Abstract

Obesity is a growing civilization problem, associated with a number of negative health consequences affecting almost all tissues and organs. Currently, obesity treatment includes lifestyle modifications (including diet and exercise), pharmacologic therapies, and in some clinical situations, bariatric surgery. These treatments seem to be the most effective method supporting the treatment of obesity. However, they are many limitations to the options, both for the practitioners and patients. Often the comorbidities, cost, age of the patient, and even geographic locations may influence the choices. The pharmacotherapy of obesity is a fast-growing market. Currently, we have at our disposal drugs with various mechanisms of action (directly reducing the absorption of calories—orlistat, acting centrally—bupropion with naltrexone, phentermine with topiramate, or multidirectional—liraglutide, dulaglutide, semaglutide). The drugs whose weight-reducing effect is used in the course of the pharmacotherapy of other diseases (e.g., glucose-sodium cotransporter inhibitors, exenatide) are also worth mentioning. The obesity pharmacotherapy is focusing on novel therapeutic agents with improved safety and efficacy profiles. These trends also include an assessment of the usefulness of the weight-reducing properties of the drugs previously used for other diseases. The presented paper is an overview of the studies related to both drugs currently used in the pharmacotherapy of obesity and those undergoing clinical trials, taking into account the individual approach to the patient.

Obesity and Cardiovascular Risk: Systematic Intervention Is the Key for Prevention

“…Orlistat impairs fat absorption at the level of the gastrointestinal tract; in particular, it blocks the lipase enzyme that breaks down the triglycerides derived from food intake, in order to allow their absorption. It is indicated for obesity management, including weight loss and weight maintenance when coupled with a hypocaloric diet and for the risk reduction of weight regain after prior weight loss [ 55 ]. Four studies highlighted the role of Orlistat in promoting weight-loss maintenance over a placebo.…”

“…This treatment is indicated for chronic weight management in adults with an initial BMI ≥ 30 kg/m 2 or ≥27 kg/m 2 in the presence of ≥1 weight-related comorbidities (such as hypertension or dyslipidemia). The treatment should be discontinued after 4 weeks if at least 5% of the initial weight has not been lost [ 55 ]. In a multicenter, randomized, double-blind, placebo-controlled, phase 3 trial, Greenway et al assessed the effect of Naltrexone plus Bupropion on bodyweight in overweight and obese participants, concluding that a sustained-release combination of Naltrexone plus Bupropion could be a useful therapeutic option for treatment of obesity [ 60 ].…”

Resistance exercise training augments the immunomodulatory adaptations to aerobic high‐intensity interval training

“…To address this, numerous studies are being conducted to investigate the effects of various treatments, such as lifestyle interventions and weight loss medications, on inflammatory mediators in both animal and human models, thereby providing important insights into the complex interplay between obesity and inflammation (Fujisaka et al, 2013; Kosmalski et al, 2023; Kraakman et al, 2014; Wang et al, 2014; Wensveen et al, 2015). The skeletal muscle has been identified as an active secretory endocrine organ, which establishes a paradigm for linking the muscle secretome to organ cross‐talk, including the liver, brain, and immune cells (Pedersen & Febbraio, 2012; Sabaratnam et al, 2022).…”

360-Degree Perspectives on Obesity

“…Dulaglutide (registered for the treatment of T2D) but exhibiting weight reducing effects [294,317] Exendin-4 backbone:…”

“…• Exenatide (registered for the treatment of T2D) but exhibiting weight reducing effects [294] • Lixisenatide Pipeline drugs:…”