Background: The increase in global obesity rates over the past three decades has been
remarkable, a true epidemic, both in developed and in developing countries. The projections, based on
current trends, suggest an increase in the prevalence of obesity at 60% in adult men, 40% in adult
women and 25% in children in 2050. Given the limitations of lifestyle and surgery interventions
bariatric, drug therapy approaches for the treatment of obesity, therefore become important options.
Aim: The purpose of this review is a review of the literature, based on research on MEDLINE until
2019, on the possible pharmacological options in the treatment of obesity.
Results: Currently, the FDA has approved several molecules for the treatment of obesity, both in
monotherapy and in combination. Pharmacological monotherapies focus mainly on a single protein
target and include orlistat, lorcaserin and liraglutide while the combination molecules propose a multitarget
approach and include phentermine/topiramate and naltrexone/bupropion. All the approved drugs
showed, in the different studies, a weight reduction of at least 5%, compared to placebo, in 52 weeks of
observation. Phentermine-topiramate and liraglutide have been associated with the highest probability
of at least 5% weight loss. Liraglutide and naltrexone-bupropion had the lowest rates of therapy
discontinuation due to adverse events.
Conclusion: The drugs, associated with the standard diet and/or exercise protocols, represent a good
therapeutic opportunity to allow not only weight loss but also to reduce the risk of developing diseases
caused by obesity, particularly cardiovascular diseases, and to maintain the set objectives over time.
However, future research on the pharmacological treatment of obesity should encourage greater
personalization of therapy, given the differences in safety, efficacy and response to therapy, in the
different subpopulations of patients with obesity.