Hormonal
FDA-approved weight loss medications (liraglutide, lorcaserin, naltrexone-bupropion, orlistat, phentermine-topiramate) produce greater weight loss and diabetes risk reduction than placebo, but are associated with higher rates of adverse events and dropout.
If behavioral interventions alone are insufficient, FDA-approved weight loss medications can provide greater weight loss and diabetes risk reduction. However, be prepared for a higher likelihood of side effects and discontinuation. These medications should be used in conjunction with behavioral interventions.
Participants randomized to weight loss medications had more weight loss, were more likely to lose 5% of their weight, and experienced a greater decrease in waist circumference than those on placebo... Weight loss medications were associated with more adverse events than placebo, which was associated with higher dropout rates for AEs in the medication than placebo groups.
Why this rating
Multiple RCTs but limited by high attrition, short follow-up in some trials, and variability in reporting.
Source
Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults
Erin S. LeBlanc et al. · JAMA · 2018
DOI 10.1001/jama.2018.7777
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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