Introduction
Obesity is a chronic and progressive disease with serious health consequences. Weight loss, even in small amounts, can significantly improve metabolic markers and overall health. Bariatric surgery, while effective, has limitations and risks, highlighting the need for effective and safe anti-obesity medications (AOMs).
Updated Obesity Pharmacotherapy Guidelines by KSSO
The KSSO recommends pharmacotherapy for Korean adults with a BMI of 25 kg/m2 or more who have failed to lose weight with non-medicinal treatment. The guidelines emphasize the use of medications approved based on large-scale clinical trials for long-term weight management.
Currently Available AOMs
Five AOMs have been approved for long-term weight management in Korea: orlistat, naltrexone/bupropion, phentermine/topiramate, liraglutide, and semaglutide. Tirzepatide is awaiting approval, and CagriSema and oral semaglutide are in phase 3 trials.
- Orlistat: Approved for long-term weight management, it inhibits dietary fat absorption and has been associated with reduced rates of major adverse cardiovascular events.
- Naltrexone/Bupropion: FDA-approved in 2014, this combination has shown significant weight loss in clinical trials but with common side effects like nausea and constipation.
- Phentermine/Topiramate: Approved in 2012, it has shown dose-related weight loss but with concerns over long-term cardiovascular effects.
- Liraglutide: A GLP-1 receptor agonist approved for weight management, showing significant weight loss and improvements in metabolic markers.
- Semaglutide: The newest GLP-1RA approved for chronic weight management, showing remarkable weight loss outcomes in clinical trials.
Future AOMs
- Tirzepatide: A dual GIP/GLP-1 receptor agonist showing promising weight loss results in clinical trials.
- CagriSema: A combination of an amylin analogue and a GLP-1 analogue, currently in phase 3 trials.
- LY3502970 (orforglipron), BI 456906, and LY3437943 (retartrutide): Drugs approaching phase 3 clinical trials, showing potential for effective obesity treatment.
Conclusion
The global obesity epidemic underscores the demand for effective and safe AOMs. With the advancement in pharmacotherapy, personalized obesity therapy becomes crucial, emphasizing the role of physicians in selecting appropriate AOMs based on individual patient characteristics.
