Idrees Zarwa, Cancarevic Ivan, Huang Li
Internal Medicine, Icahn School of Medicine at Mount Sinai/NYC Health+Hospitals Queens, New York City, USA.
Endocrinology, Icahn School of Medicine at Mount Sinai/NYC Health+Hospitals Queens, New York City, USA.
Cureus. 2022 Sep 17;14(9):e29262. doi: 10.7759/cureus.29262. eCollection 2022 Sep.
Obesity is a recently defined illness whose diagnosis and treatment continue to be stigmatized. Currently, due to lifestyle changes brought on by technological advancements and the wide availability and affordability of high-calorie foods, millions of people around the world suffer from obesity and/or its sequelae. Finding adequate prevention and treatment options would therefore lead to massive improvements in the duration and quality of life of affected individuals. In this review, we searched the PubMed database for studies exploring the safety and efficacy of the five medications currently approved by the FDA for the treatment of obesity. We included only studies pertaining to adult patients that have been published between 2012 and 2022. We found evidence that all the drugs analyzed such as orlistat, phentermine/topiramate, naltrexone/bupropion, liraglutide, and semaglutide appear to be effective in inducing weight loss, with the suggestion that semaglutide may have superior efficacy. However, a massive obstacle in developing treatment guidelines remains the lack of prolonged studies monitoring the long-term safety and efficacy of obesity medications. Nevertheless, in patients at risk of complications from obesity, the benefits of losing fat mass may outweigh the potential side effects associated with these medications and clinicians should prescribe whichever of the FDA-approved pharmacotherapy they deem most appropriate for the patient's specific set of circumstances.
肥胖是一种最近才被定义的疾病,其诊断和治疗仍然受到污名化。目前,由于技术进步带来的生活方式改变以及高热量食物的广泛可得性和可承受性,全球数百万人患有肥胖症和/或其后遗症。因此,找到适当的预防和治疗方法将极大地改善受影响个体的寿命和生活质量。在本综述中,我们在PubMed数据库中搜索了探索美国食品药品监督管理局(FDA)目前批准用于治疗肥胖症的五种药物的安全性和有效性的研究。我们仅纳入了2012年至2022年间发表的与成年患者相关的研究。我们发现有证据表明,所分析的所有药物,如奥利司他、苯丁胺/托吡酯、纳曲酮/安非他酮、利拉鲁肽和司美格鲁肽,似乎都能有效诱导体重减轻,提示司美格鲁肽可能具有更高的疗效。然而,制定治疗指南的一个巨大障碍仍然是缺乏监测肥胖症药物长期安全性和有效性的长期研究。尽管如此,对于有肥胖并发症风险的患者,减少脂肪量的益处可能超过这些药物相关的潜在副作用,临床医生应根据患者的具体情况开出他们认为最合适的FDA批准的药物治疗方案。