Weight Loss Drug Therapies: Current Evidence and Prospects for Use in Metabolic Clinics in Nigeria

Obesity is a major risk factor for cardiovascular diseases, type 2 diabetes, and other chronic illnesses. There are approximately 21 million overweight and obese people in Nigeria over the age of 15, with corresponding age-adjusted prevalence rates of 20.3% and 11.6% respectively. It is recommended that patients with a body mass index (BMI) of at least 30kg/m2 or those with comorbidities related to obesity and a BMI of at least 27kg/m2 will benefit from weight-loss medications. Although dietary and activity changes are still essential components of weight loss strategies, medications are seen as an additional treatment when lifestyle changes are not enough to reach weight loss objectives. Typically, pharmacotherapy for obesity focuses on pathways related to energy metabolism, appetite control, and fat storage. Recently, the dual glucose-dependent insulinotropic polypeptide receptor (GIPR) and GLP-1R agonist, (Tirzepatide) has shown improved weight loss compared to selective GLP-1R agonists in patients with T2DM. Glucagon, similar in structure to GLP-1 and GIP, was incorporated into the duos to form a single chimera peptide (Retatrudide) and the trio hormones are recognized by their three separate receptors. Given the benefits of the dual GIPR and GLP-1R agonist, tirzepatide, a triple agonist retatrudide, targeting all 3 receptors, has the potential to provide a therapeutic approach with superior glycemic control and weight loss than what has been achieved with single and dual receptor agonists. This report is a literature review of existing research or reports on obesity or overweight or anti-obesity drug or weight loss drugs, aim to explore the evolution of weight-loss drugs, revolutionary novel therapies, and the need for their general acceptability in developing countries like Nigeria. Databases of PubMed, Google Scholar, and ResearchGate were searched to identify relevant articles published up to recent. The search terms were obesity OR pharmacotherapy for obesity OR weight loss drugs OR novel weight management drugs. The use of medications for the management of obesity is a subject of continuing research and clinical interest. Despite breakthrough discoveries of novel medications with minimal side effects but have limited adoption in low- and middle-income countries.