ADVANCES IN OBESITY PHARMACOTHERAPY: CURRENT STATE AND FUTURE PERSPECTIVES

Introduction: Excessive body weight is a growing problem in Poland and worldwide. Adverse epidemiological trends necessitate the search for effective pharmacological therapies to support behavioral interventions in achieving sustainable therapeutic goals and reducing the risk of metabolic complications of obesity. Material and Methodology: We reviewed the current medical literature and the results of phase 2 and 3 clinical trials (including the STEP, SURMOUNT, TRIUMPH, REDEFINE and ATTAIN programmes) regarding approved and experimental anti-obesity medications as part of this narrative review. Results: The analysis shows the evolution of incretin-based therapies. In addition to approved GLP-1 receptor agonists (semaglutide) and dual GLP-1/GIP agonists (tirzepatide), the high efficacy of new molecules has been demonstrated: retatrutide (triple GLP-1/GIP/GCG agonist), survodutide, and cagrilintide/semaglutide combination therapy. Studies prove that new molecules enable significant weight reduction while offering beneficial cardiometabolic effects, including improved glycemic parameters, lipid profiles, and reduction of cardiovascular risk factors. New developmental directions include oral administration routes (orforglipron) and muscle-sparing drugs (bimagrumab). Conclusions: Modern pharmacotherapy for obesity aims to achieve greater efficacy in weight reduction and maximize benefits in treating comorbidities. One of the developmental directions is improving adherence by introducing patient-friendly drug delivery forms. Overcoming therapeutic barriers, such as loss of lean body mass and preventing weight regain after treatment discontinuation, also remains a challenge.