Pharmacological Treatment

Pharmacological Treatment²

Pharmacological treatment should be considered as part of a comprehensive strategy of the obesity disease management (diet and physical activity are prerequisites).

Individuals that could be eligible to receive a drug therapy are those with a BMI ≥ 30 kg/m² or a BMI ≥ 27 kg/m² with an obesity-related disease (e.g. hypertension, type 2 diabetes mellitus, sleep apnea)

The check point of 3 months is important, meaning that, if an individual, under drug therapy, has not achieved a weight reduction of >5%, within this period, then there is no advantage of continuing the pharmacotherapy and treatment should be discontinued. Especially, if the individual has type 2 diabetes, then the >3% weight loss is the target so as to evaluate if she/he is responding to the treatment or not.

Pharmacotherapy of obesity in Europe²

Drugs	Status	Mechanism	Dosing	Response evaluation	For more information please visit EMA website
Orlistat	FDA & EMA approved	pancreatic, gastric lipase inhibitor	120mg tid 60mg tid (OTC)	2.9-3.4% 1 year	See more for Orlistat OTC See more for Orlistat Rx
Bupropion/ Naltrexone	FDA & EMA approved	DA/NE reuptake inhibitor (B) opioid antagonist (N)	8/90 mg tb 2tb bid	4.8% 1 year stop if <%5 weight loss at 12 weeks	See more for Bupropion/Naltrexone
Liraglutide	FDA & EMA approved	GLP-1 agonist	3mg sc once a day	5.8kg 1 year stop if <4% weight loss at 14 weeks	See more for Liraglutide

OTC=over the counter, MAOI=monoaminoxidase ınhibitor, NE=norepinephrine, DA=dopamine, GLP-1=glucagon-like peptide-1,
MEN=multiple endocrine neoplasia,
N=Naltrexone, B=Bupropion,
bid=twice a day,
tid=three times a day,
tb=tablets,
sc=subcutaneous injection,
Wks=Weeks

References

2. Yumuk V. et al. Obes Facts 2015;8:402–424.