Anorectic state of obesity medications in the United States. Are leaner times ahead?

ABSTRACT

Introduction: Obesity is considered to be a chronic disease. Currently there are five prescription-only medications on the US market for the long-term management of obesity. However, these medications are underutilized by obese or overweight individuals seeking medical assistance for weight management.

Areas covered: This special report provides an overview of the emerging obesity pharmacotherapies based on the data available from recruiting and active phase II/III trials from a registry of clinical trials. The authors also give their expert opinion and provide their future perspectives on the treatment of obesity based on what is known.

Expert opinion: Despite obesity being a chronic condition affecting 40% of the US population, there is a low demand for obesity medications in the US market. Although the potential obesity medications that are currently being investigated in phase II/III clinical trials are promising, it is unclear whether the future pharmacotherapies will be enough to meet the health care need.

KEYWORDS:

• Orlistat
• phentermine/topiramate
• naltrexone/bupropion
• lorcaserin
• liraglutide
• setmelanotide
• semaglutide
• dapagliflozin
• MEDI0382
• tesofensine

Acknowledgment

The authors would like to thank Dr. Kathy Manger for editorial assistance.

Article highlights

• Several safe and effective obesity medications are on the US market and these medications have failed to stem the rising obesity epidemic.

• There are five potential new pharmacotherapies under phase II/III clinical trials.

• Currently approved for type II diabetes mellitus, semaglutide is a long-acting GLP-1 receptor agonist being investigated for the management of obesity.

• Setmelanotide and tesofensine/metoprolol are being investigating in rare genetic and hypothalamic-injured obese populations, respectively.

• Two other potential pharmacotherapies, dapagliflozin/metformin and MEDI0382, for the management of weight loss in obese/overweight patients with type II diabetes mellitus.

This box summarizes key points contained in the article.

Declaration of interest

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

One referee has served on the scientific advisory board for Novo Nordisk while another referee declares they are employed by Novo Nordisk. Another referee declares that they have been part of a Medical Advisory Committee for Saxenda in Australia for Novo Nordisk. They have also given lectures for iNova (marketers of Duromine and Contrave) on the management of obesity. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

The authors are supported by the National Institutes of Health through the National Center for Complementary and Integrative Health via grant R01AT008933.