2
Medication and Supplement History
Key Points
1. Multiple medications are approved for obesity treatment and
are available in oral and injectable dosage forms. Several other
agents have been withdrawn or discontinued.
2. Patients presenting for obesity treatment should undergo a
thorough medication history to identify medications that may
potentially contribute to weight gain.
3. Patients frequently use supplements, herbal formulations, or
over-the-counter (OTC) products that are not subject to US Food
and Drug Administration (FDA) regulation or review. These agents
may interact with prescription obesity treatment.
4. Obesity medications are a treatment option for overweight and
obesity, rather than a cure.
5. Individual weight loss response to obesity medications is variable
based on physiologic response to medication, lifestyle changes,
and underlying health conditions.
6. Obesity is a chronic disease requiring long-term treatment. As
with other chronic diseases, cessation of therapy may negate
realized therapeutic benefits.
7. The following obesity medications have received approval for
long-term treatment: orlistat, naltrexone-bupropion extended-
release, phentermine hydrochloride (HCl)-topiramate extended-
release, liraglutide, semaglutide, tirzepatide, setmelanotide,
metrelpetin, and diazoxide choline extended-release.
8. All obesity medications have potential adverse effects and
contraindications that must be assessed before initiation. The use
of all obesity medications is either contraindicated or used with
caution in breastfeeding.
9. Setmelanotide acts in place of deficient α-melanocyte-
stimulating hormone (α-MSH) and is approved for monogenic
obesity due to proopiomelanocortin (POMC), proprotein
convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor
(LEPR) deficiency, as well as for Bardet-Biedl syndrome (BBS).
10. All obesity medications, except for orlistat, must be slowly
titrated to minimize adverse effects.
