In addition to lifestyle modifications, pharmacotherapy can be considered for weight management in patients who have limited treatment response to lifestyle modifications alone and have a BMI ≥ 30 or a BMI ≥ 27 in the presence of weight-related comorbidities, such as hypertension. When antiobesity pharmacotherapy is prescribed for individuals with or at risk for hypertension, it is important to consider the mechanism of action when selecting a treatment option. There is a potential risk for increased blood pressure with sympathomimetic amines related to their mechanism of action, which includes increasing catecholamine levels; however, clinically significant increases in blood pressure have not been observed in randomized controlled trials of these drugs, which may be attributable to concomitant weight loss.
Orlistat, a lipase inhibitor, has a generally favorable safety profile attributable to its peripheral mechanism of action. However, it is often poorly tolerated because of a high occurrence of loose stools, fecal urgency, and flatus when patients do not strictly adhere to a low-fat diet while taking this drug.
Learn more about weight loss strategies for patients with hypertension.
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Cite this: Elif A. Oral. Fast Five Quiz: Obesity Comorbidities - Medscape - Jan 31, 2022.