Pharmacotherapy in Obesity

May 19, 2020


Pharmacotherapy is indicated as an adjunct to caloric restriction and increased physical activity in adults with a BMI >30 kg/m2or between 27 and 29.9 kg/m2 with at least 1 weight-related comorbidity. The rationale for pharmacologic treatment of obesity is that weight loss and weight-loss maintenance are difficult for most patients because caloric restriction is counteracted by adaptive biologic responses of increased appetite and decreased basal metabolic rate, which promote weight regain. Antiobesity medications have a checkered past that make many clinicians uncomfortable with their use.Specifically, the experience with fenfluramine, a serotonin-releasing agent, that was found to cause valvular heart disease and pulmonary hypertension resulting in its removal from the US market in 1997,gives many clinicians and patients pause about the use of antiobesity medications. Fortunately, over the past several years, a number of pharmacologic options for the treatment of obesity have become available and approvals have been granted supporting their long-term use and safety. Barriers exist to prescribing these medications and they are underutilized in relation to patients’ desires to try antiobesity medications and to lose weight with the support of their healthcare providers. Endocrinologists can improve their patients’ weight loss success by incorporating FDA-approved antiobesity medications into their clinical practices.


Marc-Andre, Cornier, MD
University of Colorado School of Medicine

David Saxon, MD, MSc 
University of Colorado

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