Pharmacotherapy of
obesity should be an integral part of the comprehensive
obesity management program which includes diet, exercise and cognitive behavioural intervention. Currently available
antiobesity drugs result in only modest
weight loss, however it is still accompanied by reduction of cardiometabolic health risks. In the past several
antiobesity drugs were removed from the market because of serious adverse effects (psychostimulatory, cardiovascular,
pulmonary hypertension, valvular disease, depression, addiction etc.). Such situations led some investigators and clinicians to nihilistic approaches to the drug treatment of
obesity. This paper aims to review the data on clinical efficiency and safety of currently available
antiobesity drugs and to summarize our knowledge on the recently discovered
antiobesity agents which underwent clinical trials (such as
lorcaserin,
tesofensine,
cetilistat, combination drugs, gut
hormone analogues etc.). Approaches with two
drug combination of decreased doses were recommended to increase both safety and efficacy of antiobesity treatment. However, previous experiences that
antiobesity drug combinations (e.g.
fenfluramine/
phentermine) may also potentiate adverse events should be carefully considered in the evaluation of recently tested compounds. Administration of physiological doses of gut
hormones - derived appetite regulating agents seems to be a promising, efficient, specific and thus, low side-effect approach in the treatment of
obesity. To confirm the strong role of
antiobesity drugs in the treatment of
obesity and its complications further long-term studies evaluating their effect on morbidity and mortality end points in appropriate target populations are needed.