Obesity is a chronic disease with a continuously rising prevalence that currently affects more than half a billion people worldwide. Energy balance and appetite are highly regulated via central and peripheral mechanisms, and weight loss triggers a homeostatic response leading to weight regain. Lifestyle and behavioral modifications are the cornerstones of obesity management; however, they often fail to achieve or sustain long-term weight loss. Pharmacotherapy added onto lifestyle modifications results in an additional, albeit limited, weight reduction. Regardless, this weight reduction of 5-10% conveys multiple cardiovascular and metabolic benefits. In this review, evidence on the food and drug administration (FDA)-approved medications, i.e., orlistat, lorcaserin, phentermine/topiramate, liraglutide and naltrexone/bupropion, is summarized. Furthermore, anti-obesity agents in the pipeline for potential future therapeutic use are presented.

Obesity, which affects about 13% of the world population, results in significant deterioration of health and serious clinical, mainly meta-bolic and cardiovascular complications. Although the basis of therapeutic treatment is behavioural treatment, often non-pharmacological effects do not produce the desired effect. Currently there are several drugs with a safe action profile that improve the effect of treatment (5-10% weight reduction). The aim of the paper is to present the potential of modern pharmacotherapy in the treatment of obesity, in terms of mechanism of action, efficacy, and side effects, in order to individualise therapy. The drugs already registered include substances with a variety of mechanisms of action, including phentermine, orlistat, lorcaserin, and liraglutide. Compounded preparations (phenter-mine/topiramate, naltrexone SR/bupropion SR) are also available, which, by using low doses of active substances, have beneficial effects while reducing side effects. In addition, several drugs used to treat diabetes, such as metformin, SGLT2 inhibitors, GLP-1 agonists, and pramlintide, promote weight loss, although their use is reserved for diabetics, especially type 2 patients. Regarding the current alarm-ing epidemiological data there is a need for intensive prevention and treatment of obesity as well as the development of a new form of pharmacotherapy (new substances and treatment regimens) to develop effective, safe, and, above all, long-term effective therapy for the treatment of obesity.