Obesity management: An update on the available pharmacotherapy

Obesity is a complex condition characterized by excessive fat accumulation, leading to significant health risks, including cardiovascular diseases, diabetes, and certain cancers. Its multifactorial etiology encompasses genetic predispositions, behavioral factors, like poor eating habits and sedentary lifestyles, and hormonal imbalances involving leptin and insulin resistance. In addition to lifestyle interventions, such as balanced diets and regular physical activity, pharmacological therapies play a pivotal role in managing obesity. Approved medications include orlistat, which inhibits fat absorption by blocking gastrointestinal lipases; liraglutide and semaglutide, which are glucagon-like peptide (GLP)-1 receptor agonists that regulate appetite and glucose metabolism; phentermine/topiramate, which combines appetite suppression and satiety enhancement; and naltrexone/bupropion, which modulates the brain’s reward pathways to reduce food cravings. Advanced therapies, such as setmelanotide, target genetic deficiencies affecting appetite regulation, while tirzepatide, a dual gastric inhibitory polypeptide, and GLP-1 receptor agonist, enhances satiety and metabolic control. Bariatric surgery remains a viable option for severe cases. With the inception of individualized treatment plans and the ongoing research into genetic and metabolic factors, the development of targeted, effective therapies, devoid of serious adverse effects, continues to evolve, offering hope for improved obesity management.