Pharmacotherapy for Weight Loss

Pharmacotherapy weight loss may be useful for:

• assisting with the initial weight loss
• maintaining weight loss at the end of a very low-calorie diet
• preventing weight regain

Over the years, numerous pharmacological strategies targeting either peripheral or central components of the energy balance regulatory system have been designed to reduce body mass but only some have had sufficient safety and efficacy. Furthermore, weight loss pharmacotherapy will usually be required on a long-term basis, and data on the long-term effectiveness and safety of weight loss medication are limited.

In Australia in 2020, only four drugs have been approved by the Therapeutic Goods Association (TGA) for the treatment of obesity:

• Phentermine – helps suppress appetite by stimulating the release of neurotransmitters in the brain
• Orlistat – works in the stomach and intestine by preventing the body from absorbing fat
• Liraglutide – helps suppress appetite by mimicking an intestinal hormone that signals to the brain the stomach is full
• Contrave – helps suppress appetite by stimulating the release of neurotransmitters in the brain

Other medications not approved by the TGA for weight loss therapy are being used off-label in Australia for the management of obesity by health professionals experienced in obesity care. There is also much research in this area and as evidence emerges, different drugs may be approved for more widespread use.⁴⁶