Abstract
650 millions of adults are obese worldwide - in the US alone, forty percent of the adults are obese. Although the obesity pandemic is constantly expanding at very high costs for health care systems, the currently available options of pharmacotherapy for obesity are rather limited. Despite intensive research efforts, the vast majority of the anti-obesity drugs developed up to now have a rather limited efficacy and/or safety profile. In the last fifty years, various drugs reached advanced states of clinical development but were either never marketed or were initially approved but withdrawn later due to safety issues. However, the understanding of the pathophysiology of obesity has been steadily improving and new, promising drugs targeting various selective obesityassociated and energy-homeostasis-related pathways are now available. When lifestyle changes alone fail to combat, then additional pharmacotherapy with an acceptable efficacy and safety profile could provide a useful therapeutic option.
Keywords: Obesity, anti-obesity drugs, weight loss, body mass index, pharmacotherapy, energy-homeostasis-related pathways.
[http://dx.doi.org/10.1056/NEJMe1706095] [PMID: 28604226]
[http://dx.doi.org/10.1056/NEJMoa1614362] [PMID: 28604169]
[http://dx.doi.org/10.1016/j.metabol.2018.10.010] [PMID: 30391259]
[http://dx.doi.org/10.4337/9781849808620]
[http://dx.doi.org/10.1016/S0140-6736(11)60814-3] [PMID: 21872750]
[http://dx.doi.org/10.1136/bmj.e1011] [PMID: 22334541]
[http://dx.doi.org/10.1016/j.jacc.2013.11.004] [PMID: 24239920]
[http://dx.doi.org/10.1007/s13679-018-0300-4] [PMID: 29504049]
[http://dx.doi.org/10.1097/HJH.0000000000001730] [PMID: 29634663]
[http://dx.doi.org/10.1038/clpt.2011.82] [PMID: 21654742]
[http://dx.doi.org/10.1186/s12916-016-0735-y] [PMID: 27894343]
[http://dx.doi.org/10.1016/j.pcad.2018.06.001] [PMID: 29890171]
[http://dx.doi.org/10.1097/SAP.0000000000001478] [PMID: 30204622]
[http://dx.doi.org/10.1007/s40265-018-0946-y] [PMID: 30014268]
[http://dx.doi.org/10.1097/MJT.0b013e31817fde95] [PMID: 19092640]
[http://dx.doi.org/10.1002/1098-2396(20010101)39:1<32:AID-SYN5>3.0.CO;2-3] [PMID: 11071707]
[http://dx.doi.org/10.1111/nyas.13542] [PMID: 29377198]
[http://dx.doi.org/10.3349/ymj.2006.47.5.614] [PMID: 17066505]
[http://dx.doi.org/10.1136/bmj.1.5588.352] [PMID: 15508204]
[http://dx.doi.org/10.1111/j.1463-1326.2010.01242.x] [PMID: 20920040]
[http://dx.doi.org/10.1002/oby.21649] [PMID: 27664021]
[http://dx.doi.org/10.1592/phco.20.4.270.34882] [PMID: 10730683]
[http://dx.doi.org/10.2337/diacare.27.1.155] [PMID: 14693982]
[http://dx.doi.org/10.1001/archinternmed.2011.103] [PMID: 21482850]
[PMID: 24350530]
[http://dx.doi.org/10.4158/EP161365.GL]
[http://dx.doi.org/10.1080/00325481.2018.1435129] [PMID: 29388462]
[http://dx.doi.org/10.1080/14740338.2018.1437143] [PMID: 29411652]
[PMID: 18393108]
[http://dx.doi.org/10.1038/sj.ijo.0803446] [PMID: 16953261]
[http://dx.doi.org/10.1038/oby.2009.155] [PMID: 19461584]
[http://dx.doi.org/10.1517/14728214.2011.609168] [PMID: 21834735]
[http://dx.doi.org/10.1056/NEJMoa1603827] [PMID: 27295427]
[http://dx.doi.org/10.2337/diacare.28.5.1092] [PMID: 15855572]
[http://dx.doi.org/10.1016/S0140-6736(09)61375-1] [PMID: 19853906]
[http://dx.doi.org/10.1038/ijo.2011.158] [PMID: 21844879]
[http://dx.doi.org/10.1038/ijo.2013.120] [PMID: 23812094]
[http://dx.doi.org/10.1001/jama.2015.9676] [PMID: 26284720]
[http://dx.doi.org/10.1038/ijo.2016.52] [PMID: 27005405]
[http://dx.doi.org/10.1056/NEJMoa1411892] [PMID: 26132939]
[http://dx.doi.org/10.1016/S0140-6736(17)30069-7] [PMID: 28237263]
[http://dx.doi.org/10.1111/dom.12632] [PMID: 26744025]
[http://dx.doi.org/10.1111/dom.13125] [PMID: 28950422]
[http://dx.doi.org/10.1210/jc.2011-0599] [PMID: 21734003]
[http://dx.doi.org/10.1056/NEJMoa1607141] [PMID: 27633186]
[http://dx.doi.org/10.1016/S0140-6736(18)31773-2] [PMID: 30122305]
[http://dx.doi.org/10.1210/en.2007-1321] [PMID: 18039773]
[http://dx.doi.org/10.1021/jm0709034] [PMID: 18095642]
[http://dx.doi.org/10.1161/01.CIR.102.23.2836] [PMID: 11104741]
[http://dx.doi.org/10.1038/nm764] [PMID: 12244304]
[http://dx.doi.org/10.1038/oby.2008.537] [PMID: 19057523]
[http://dx.doi.org/10.1210/jc.2010-1848] [PMID: 21190985]
[http://dx.doi.org/10.1124/jpet.107.133348] [PMID: 18252809]
[http://dx.doi.org/10.1056/NEJMoa0909809] [PMID: 20647200]
[http://dx.doi.org/10.1210/jc.2011-1256] [PMID: 21795446]
[http://dx.doi.org/10.1038/oby.2012.66] [PMID: 22421927]
[http://dx.doi.org/10.1056/NEJMoa1808721] [PMID: 30145941]
[http://dx.doi.org/10.1016/S0140-6736(18)32328-6] [PMID: 30293771]
[http://dx.doi.org/10.1016/S0140-6736(18)32460-7] [PMID: 30293772]
[http://dx.doi.org/10.1210/jc.2009-1350] [PMID: 19846734]
[http://dx.doi.org/10.1016/S0140-6736(10)60888-4] [PMID: 20673995]
[http://dx.doi.org/10.1038/oby.2010.147] [PMID: 20559296]
[http://dx.doi.org/10.1002/oby.20309] [PMID: 23408728]
[http://dx.doi.org/10.2337/dc13-0234] [PMID: 24144653]
[PMID: 2500425]
[http://dx.doi.org/10.2165/00002018-200831110-00006] [PMID: 18840021]
[http://dx.doi.org/10.1097/JCP.0b013e318172424e] [PMID: 18480687]
[http://dx.doi.org/10.1016/S0140-6736(10)60999-3] [PMID: 20673996]
[http://dx.doi.org/10.1097/00006842-199803000-00020] [PMID: 9560874]
[http://dx.doi.org/10.3109/07853890.2010.541490] [PMID: 21254901]
[http://dx.doi.org/10.1517/14656566.2011.591382] [PMID: 21689063]
[http://dx.doi.org/10.1007/s11356-018-2730-7] [PMID: 30014368]
[http://dx.doi.org/10.1001/jama.2016.1558] [PMID: 26954408]
[http://dx.doi.org/10.1016/j.psc.2011.08.013] [PMID: 22098810]
[http://dx.doi.org/10.1124/pr.117.014803] [PMID: 30087160]
[http://dx.doi.org/10.1002/oby.20584] [PMID: 24136928]
[http://dx.doi.org/10.1038/oby.2003.102] [PMID: 12805393]
[http://dx.doi.org/10.1038/sj.ijo.0802783] [PMID: 15486569]
[http://dx.doi.org/10.1016/S0140-6736(11)60205-5] [PMID: 21481449]
[http://dx.doi.org/10.2337/dc13-1518] [PMID: 24103901]
[http://dx.doi.org/10.2337/dc14-0930] [PMID: 25249652]
[http://dx.doi.org/10.1038/oby.2011.330] [PMID: 22051941]
[http://dx.doi.org/10.3945/ajcn.111.024927] [PMID: 22158731]
[http://dx.doi.org/10.1016/S0140-6736(12)60379-1] [PMID: 22413140]
[http://dx.doi.org/10.1111/obr.12606] [PMID: 29024559]
[http://dx.doi.org/10.1001/jama.2016.7602] [PMID: 27299618]
[http://dx.doi.org/10.1136/bmj.i3330] [PMID: 27307315]