Fast Five Quiz: Confronting Obesity

Romesh Khardori, MD, PhD; Elif A. Oral, MD


December 05, 2023

The use of certain weight loss medications is a recommended option for patients who are obese and seek pharmacologic treatment for weight loss in conjunction with other lifestyle modifications. The Obesity Society, the American Association of Clinical Endocrinologists, and the Endocrine Society have recommended anti-obesity medications for individuals with BMI ≥ 30 or BMI ≥ 27 with comorbidities.

Choice of treatment depends on the individual and their management plan. For example, glucagon-like peptide 1 (GLP-1) receptor agonists have shown to promote weight loss in patients with obesity, with or without type 2 diabetes, and are the Food and Drug Administration (FDA)-approved for chronic weight management. Semaglutide (2.4-mg/week subcutaneous dose) is approved by the US FDA for patients with an initial BMI of ≥ 30 and for those with a BMI of ≥ 27 in the presence of at least one weight-related comorbid condition. The approval was based on four phase 3 clinical trials involving approximately 4500 patients with overweight or obesity that showed a 15%-18% weight loss over 68 weeks. More recently, the FDA approved tirzepatide, a GLP-1 and glucose-dependent insulinotropic polypeptide antagonist injection for patients with overweight or obesity and at least one weight-related comorbidity. It is to be used in conjunction with a reduced calorie diet and increased physical activity.

Sympathomimetic agents phentermine and diethylpropion should be avoided in patients who have obesity with a history of cardiovascular disease or uncontrolled hypertension.

For patients with type 2 diabetes and obesity, guidelines recommend using antidiabetic medications that have additional actions to promote weight loss (eg, GLP-1 analogs or SGLT inhibitors) in addition to metformin.

Learn more about the pharmacologic treatment of obesity.

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