Advancements in the management of obesity: a review of current evidence and emerging therapies

ABSTRACT

Introduction

Obesity is the modern world’s current epidemic, with substantial health and economic impact. This study aimed to provide a narrative overview of the past, currently available, and future treatment options that offer therapeutic and preventive advantages for obesity management.

Areas covered

Historically, rimonabant, and lorcaserin, were approved and used for managing non-syndromic obesity. Currently, orlistat, naltrexone/bupropion, glucagon-like peptide-1 receptor agonist (GLP-1 RA), and a few promising therapeutic agents are under investigation, including retatrutide, cagrilintide and orforglipron, which show promising weight reduction effects. We have developed a search string of the Medical Subject Headings (MeSH), including the terms GLP-1 RAs, obesity, and weight loss. This string was then used to perform a systematic literature search in the database including PubMed, EMBASE, MEDLINE, and Scopus up to January 31^st, 2024.

Expert opinion

Managing obesity often requires medical interventions, particularly in cases of severe obesity or obesity-related comorbidities. Thus, it is important to approach obesity management holistically, considering individual needs and circumstances. In our opinion, consulting with healthcare professionals is crucial to developing a personalized plan that addresses both weight loss and overall health improvement.

KEYWORDS:

• Obesity
• diabesity
• GLP-1 RA
• overweight
• pharmacotherapy

Article highlights

• Obesity is a global pandemic that imposes a substantial burden on the world’s economy.

• GLP-RAs have shown remarkable efficacy in promoting significant weight reductions and preventing obesity-related comorbidities.

• Setmelanotide and metreleptin have demonstrated effectiveness in managing syndromic obesity.

• Newer therapeutic agents such as methylphenidate, diazoxide choline, taste receptor agonists, and leptin sensitizers are on the horizon and hold great potential in the future of obesity management.

• There is great future therapeutic potential in using precision medicine to personalize obesity management.

Declaration of interest

T Sathyapalan has received research grants for clinical trials from Novo Nordisk, Eli Lilly, and Abbott UK. T Sathyapalan has received a travel grant from Novo Nordisk and Rhythm Pharmaceuticals but none of the other authors have any affiliation, conflict of interest or financial interest with any organization or entity.

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

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.