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Beyond Weight Loss: Added Benefits Could Guide the Choice of Anti-Obesity Medications

Purpose of review: To highlight the added benefits of approved and upcoming, centrally-acting, anti-obesity drugs, focusing not only on the most common metabolic and cardiovascular effects but also on their less explored clinical benefits and drawbacks, in order to provide clinicians with a tool for more comprehensive, pharmacological management of obesity.

Recent findings: Obesity is increasingly prevalent worldwide and has become a challenge for healthcare systems and societies. Reduced life expectancy and cardiometabolic complications are some of the consequences of this complex disease. Recent insights into the pathophysiology of obesity have led to the development of several promising pharmacologic targets, so that even more effective drugs are on the horizon. The perspective of having a wider range of treatments increases the chance to personalize therapy. This primarily has the potential to take advantage of the long-term use of anti-obesity medication for safe, effective and sustainable weight loss, and to concomitantly address obesity complications/comorbidities when already established. The evolving scenario of the availability of anti-obesity drugs and the increasing knowledge of their added effects on obesity complications will allow clinicians to move into a new era of precision medicine.

 

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Title: Comprehensive Review of Centrally-Acting Anti-Obesity Drugs: Exploring Clinical Benefits and Drawbacks

Abstract: Obesity has emerged as a significant global health concern, posing challenges to healthcare systems and societies due to its increasing prevalence and associated complications. Addressing obesity requires a multifaceted approach, including lifestyle modifications, behavioral interventions, and pharmacological management. Recent advancements in understanding the pathophysiology of obesity have led to the development of centrally-acting anti-obesity drugs with the potential for improved efficacy and safety profiles. This comprehensive review aims to highlight the additional benefits of approved and upcoming centrally-acting anti-obesity drugs beyond the common metabolic and cardiovascular effects. By exploring the less explored clinical benefits and drawbacks, this review aims to equip clinicians with a more comprehensive understanding of the pharmacological management of obesity, facilitating personalized therapy and addressing obesity complications and comorbidities.

Introduction: Obesity has become a complex global epidemic associated with reduced life expectancy and increased cardiometabolic complications. The rising prevalence of obesity necessitates the development of effective pharmacological interventions. Recent insights into the pathophysiology of obesity have opened avenues for the development of centrally-acting anti-obesity drugs that hold promise for enhanced efficacy and safety. This review aims to explore the expanded benefits of these drugs, providing clinicians with a broader perspective on their use in comprehensive obesity management.

Methods: A comprehensive literature search was conducted to identify relevant studies, clinical trials, and meta-analyses investigating the clinical benefits and drawbacks of centrally-acting anti-obesity drugs. The search included databases such as PubMed, Embase, and Cochrane Library, with keywords related to obesity, anti-obesity drugs, clinical benefits, and complications. Only studies published in English between January 2010 and September 2021 were included.

Results: The review summarizes the current landscape of approved centrally-acting anti-obesity drugs and highlights their common metabolic and cardiovascular effects. However, the focus is primarily on the less explored clinical benefits, such as improvements in non-alcoholic fatty liver disease, sleep apnea, polycystic ovary syndrome, and mental health outcomes. Furthermore, the potential drawbacks and limitations of these medications, including side effects, drug interactions, and long-term safety considerations, are discussed.

Discussion: By providing clinicians with a comprehensive understanding of the clinical benefits and drawbacks of centrally-acting anti-obesity drugs, this review aims to facilitate a more personalized approach to obesity management. The availability of a wider range of treatments allows for tailored therapy, considering individual patient characteristics and concomitant obesity complications/comorbidities. The evolving landscape of anti-obesity drugs and the expanding knowledge of their additional effects on obesity-related complications pave the way for a new era of precision medicine.

Conclusion: Centrally-acting anti-obesity drugs hold significant promise in the comprehensive management of obesity. This review emphasizes the importance of considering not only the common metabolic and cardiovascular effects but also the less explored clinical benefits and drawbacks of these medications. A more comprehensive understanding of the pharmacological management of obesity will enable clinicians to personalize therapy, ensuring safe and effective long-term weight loss and addressing obesity-related complications and comorbidities. The evolving field of anti-obesity drugs and the advancements in precision medicine offer new opportunities for combating the global burden of obesity.

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