New medications for obesity management: changing the landscape of obesity treatment.

PURPOSE OF REVIEW: Despite being one of the most prevalent chronic diseases, obesity was not recognized as such until very recently. Although linked to ubiquitous diseases like diabetes, hypertension, coronary artery disease, obstructive sleep apnea, and many others, targeted treatments are few. Diet, exercise, and behavior modification are the pillars of weight loss. When they alone do not achieve the required weight reduction, medications may be used for patients with a BMI above 30 or above 27 if obesity-related comorbidities are present. The spectrum of pharmacologic agents aimed at obesity treatment will be reviewed.

RECENT FINDINGS: Two medications, phentermine and orlistat, have been the only agents approved many years ago and now still standing. Others have come and gone, removed from the market by the Food and Drug Administration (FDA) because of harmful side-effects. However, in the last few years, new drugs have started to emerge. Since 2012, two new medications phentermine-topiramate extended-release combination and lorcaserin have been FDA approved, while at least one more, naltrexone SR/bupropion SR combination is expected to be re-evaluated by the FDA in 2014.

SUMMARY: Treating obesity is crucial as it will ultimately result in the prevention of many related chronic diseases and will decrease morbidity and mortality. Weight loss medications are a valuable part of the clinician's toolbox in the treatment of obesity and should be used when appropriate. Having a variety of medications would be a great asset to accommodate various patients' needs and pre-existing medical conditions.