History, Challenges, Pharmacology and Safety Perspectives of Anti-Obesity Medications

Abstract

Obesity is a complex, chronic condition that has grown pandemic in most developed nations and poses a threat to spread globally. Body weight over a body mass index (BMI) of 27 and an increase in waist circumference both increase the risk of illness and death (as an index of visceral localization of fat). Patients who are obese are more likely to develop coronary artery disease, hypertension, hyperlipidemia, diabetes mellitus, certain malignancies, cerebrovascular accidents, osteoarthritis, restrictive pulmonary disease, and sleep apnea. Improvements have been made in the last half-century in the treatment of diseases including high blood pressure, diabetes in adults, and high cholesterol that are associated to obesity. The realization that obesity is a chronic, complex condition that responds poorly to existing therapy modalities (diet, exercise, and behavior) has sparked resurgence in interest in medication usage. Obesity treatment, however, has proven challenging, with anti-obesity medications (AOMs) often falling short of their promises and creating safety concerns. In this post, we provide a high-level overview of AOM's development, outlining significant steps along the way and describing some of the obstacles that still need to be solved. Recent advances, such a better understanding of the molecular gut-brain interface, have fueled the quest for next-generation AOMs that show promise in generating significant and long-lasting weight loss without sacrificing patient safety.