Obesity Drugs

Obesity is an epidemic in western countries.   This section reviews several medications that have been used for weight loss.  GLP-1 agonists have shown increased use recently for their weight loss properties. GLP-1 agonists are reviewed briefly here, but full review is available in the GLP-1 agonists module.  Drugs outside of GLP-1 agonists are rarely used due to side effects and/or abuse potential.  

Class Drugs

• Diethylpropion

• Phentermine

• Orlistat

• Lorcaserin

Class Mechanism of Action

• Varies by drug.

Class Applications

• Treatment of obesity

Class Adverse Effects

• Varies by drug

Drug Table

Drug Name	Application	Comments	Image
Diethylpropion		Mechanism; -Appetite suppression by decreasing norepinephrine reuptake in nerve terminals; -Stimulates fight or flight response; Adverse Effects; -Controlled substance due to abuse potential; -Tachycardia, hypertension; -Avoid in patients with arrhythmia, CAD, stroke, etc.; -Insomnia, dry mouth, headache	"Dye" "Ethel" "Prop"
Phentermine		Mechanism; -Appetite suppression by decreasing norepinephrine and dopamine reuptake in nerve terminals; -Stimulates fight or flight response; Adverse Effects; -Controlled substance due to abuse potential; -Tachycardia, hypertension; -Avoid in patients with arrhythmia, CAD, stroke, etc.; -Insomnia, dry mouth, headache	"Fence" "Termite"
Orlistat		Mechanism; -Lipase inhibitor; -Decreases breakdown of fat in the stomach and small intestine leading to decreased absorption of fat; Adverse Effects; -Diarrhea, flatulence, oil spotting, urgency; -Limiting side effects; -Pancreatitis/liver injury; -Decreases absorption of fat soluble vitamins (D,E,A,K); -Decreases absorption of some other medications	"OR" "STAT"
Lorcaserin		Mechanism; -Serotonin Agonist (5-HT2c receptors); -Acts centrally causing activation of melanocortin receptors, which decreases appetite; Adverse Effects; -Nausea, headache, dry mouth, dizziness; -Suicidal ideation; -Caution with MAOis and other serotonergic drugs due to risk of NMS and serotonin syndrome	"Lorax" "Case"