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The limits and challenges of antiobesity pharmacotherapy.
Expert Opin Pharmacother. 2020 Aug; 21(11):1319-1328.EO

Abstract

INTRODUCTION

Pharmacotherapy is a useful adjunct when patients with obesity are unable to achieve adequate benefit from lifestyle interventions.

AREAS COVERED

This review covers the history of antiobesity drugs, efficacy, and risks of currently approved drugs, limits of their usefulness in clinical practice, gaps in knowledge, methodological limitations of clinical trials, and reasons for underutilization.

EXPERT OPINION

In randomized controlled trials, currently approved antiobesity drugs have yielded an average weight loss ranging from approximately 3% to 9% relative to placebo at 1 year. Inadequate inclusion of racial and ethnic minorities and men, and high dropout rates in clinical trials limit generalizability of these findings to clinical practice. Weight loss achieved with antiobesity drugs is generally associated with lowered glycemia, but improvements in blood pressure and lipid measures tend to be marginal. There is limited evidence for sustained weight loss beyond 1 year and for safety and efficacy of antiobesity drugs in children and adolescents, and in post-bariatric surgery patients. None have demonstrated reduction in major adverse cardiovascular events or other significant disease outcomes. Limited health insurance coverage and negative perceptions of physicians have hindered the utilization of antiobesity drugs.

Authors+Show Affiliations

Pennington Biomedical Research Center , Baton Rouge, LA, USA.Pennington Biomedical Research Center , Baton Rouge, LA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32292094

Citation

Gadde, Kishore M., and Katelyn D. Atkins. "The Limits and Challenges of Antiobesity Pharmacotherapy." Expert Opinion On Pharmacotherapy, vol. 21, no. 11, 2020, pp. 1319-1328.
Gadde KM, Atkins KD. The limits and challenges of antiobesity pharmacotherapy. Expert Opin Pharmacother. 2020;21(11):1319-1328.
Gadde, K. M., & Atkins, K. D. (2020). The limits and challenges of antiobesity pharmacotherapy. Expert Opinion On Pharmacotherapy, 21(11), 1319-1328. https://doi.org/10.1080/14656566.2020.1748599
Gadde KM, Atkins KD. The Limits and Challenges of Antiobesity Pharmacotherapy. Expert Opin Pharmacother. 2020;21(11):1319-1328. PubMed PMID: 32292094.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The limits and challenges of antiobesity pharmacotherapy. AU - Gadde,Kishore M, AU - Atkins,Katelyn D, Y1 - 2020/04/15/ PY - 2020/4/16/pubmed PY - 2020/4/16/medline PY - 2020/4/16/entrez KW - Obesity KW - antiobesity drugs KW - bupropion KW - liraglutide KW - lorcaserin KW - naltrexone KW - pharmacotherapy KW - phentermine KW - topiramate KW - weight loss SP - 1319 EP - 1328 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 21 IS - 11 N2 - INTRODUCTION: Pharmacotherapy is a useful adjunct when patients with obesity are unable to achieve adequate benefit from lifestyle interventions. AREAS COVERED: This review covers the history of antiobesity drugs, efficacy, and risks of currently approved drugs, limits of their usefulness in clinical practice, gaps in knowledge, methodological limitations of clinical trials, and reasons for underutilization. EXPERT OPINION: In randomized controlled trials, currently approved antiobesity drugs have yielded an average weight loss ranging from approximately 3% to 9% relative to placebo at 1 year. Inadequate inclusion of racial and ethnic minorities and men, and high dropout rates in clinical trials limit generalizability of these findings to clinical practice. Weight loss achieved with antiobesity drugs is generally associated with lowered glycemia, but improvements in blood pressure and lipid measures tend to be marginal. There is limited evidence for sustained weight loss beyond 1 year and for safety and efficacy of antiobesity drugs in children and adolescents, and in post-bariatric surgery patients. None have demonstrated reduction in major adverse cardiovascular events or other significant disease outcomes. Limited health insurance coverage and negative perceptions of physicians have hindered the utilization of antiobesity drugs. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/32292094/The_limits_and_challenges_of_antiobesity_pharmacotherapy L2 - http://www.tandfonline.com/doi/full/10.1080/14656566.2020.1748599 DB - PRIME DP - Unbound Medicine ER -
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