J Korean Med Assoc.  2022 Jul;65(7):408-416. 10.5124/jkma.2022.65.7.408.

Pharmacologic treatment of obesity

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 2Asan Diabetes Center, Asan Medical Center, Seoul, Korea

Abstract

Background
Obesity and obesity-related comorbidities are increasingly being recognized as significant threats to global health. Pharmacological treatments are required in patients in whom lifestyle modifications fail to achieve an individual’s target body weight.
Current Concepts
Currently available short-term anti-obesity drugs, including phentermine, diethylpropion, and mazindol (all sympathetic nerve agents) serve as appetite suppressants. Prescription anti-obesity drugs currently approved for long-term use in Korea include orlistat, phentermine/topiramate, naltrexone/bupropion, and liraglutide. Semaglutide (2.4 mg) has recently been authorized by the United States Food and Drug Administration for treatment of obesity. Research is underway to introduce novel drugs that are likely to revolutionize the global anti-obesity drug market. Representative examples include tirzepatide, a dual agonist of glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide and cagrilintide, an amylin analogue. These drugs have shown excellent weight-loss effects with tolerable adverse effects in phase II or III clinical trials, with significantly greater effectiveness than that of currently available medications.
Discussion and Conclusion
Despite the introduction of a variety of anti-obesity drugs, these agents are not currently widely used in all patients with obesity owing to high costs, adverse effects, and unsatisfactory effectiveness. Further research is warranted to determine the effects and adverse effects of combinations of available drugs, including tirzepatide and cagrilintide, along with the development of newer agents that may show a different mechanism of action.

Keyword

Obesity; Drug therapy; Anti-obesity agents; 비만; 약물치료; 항비만제
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