Hormonal
Orlistat is the only currently available anti-obesity drug for long-term management due to its favorable cardiovascular safety profile compared to withdrawn agents like sibutramine and rimonabant.
Orlistat is the only long-term anti-obesity drug currently available because it does not carry the cardiovascular risks of older drugs. It works by blocking fat absorption. You must take 120mg with meals. Expect gastrointestinal side effects if you eat fat; managing your fat intake can reduce these side effects. It provides modest weight loss (~3kg over a year) but improves metabolic markers.
Even if orlistat is not as effective as other drugs in reducing body weight, orlistat is presently the only available choice for the treatment of obesity because of its safety for cardiovascular events and positive effects on diabetic control.
Why this rating
Supported by multiple meta-analyses and RCTs cited in the review.
Source
Anti-Obesity Drugs: A Review about Their Effects and Safety
Jun Goo Kang et al. · Diabetes & Metabolism Journal · 2012
DOI 10.4093/dmj.2012.36.1.13
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- Sibutramine was withdrawn from the market because long-term use increases the risk of non-fatal myocardial infarction and stroke in patients with cardiovascular risk factors.Strong
- Rimonabant, a CB1 receptor antagonist, was withdrawn due to an increased risk of serious psychiatric adverse events, including depression and suicidal ideation.Good
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