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FDA-approved weight loss drugs modestly improve cardiometabolic risk factors

17 Jan 2018

Weight loss medications that have received the Food and Drug Administration (FDA) approval appear to confer only modest positive benefits for cardiometabolic risk profile, according to a study.

Researchers conducted a systematic review and meta-analysis of randomized clinical trials investigating the effects of at least 1 year of treatment with FDA-approved weight loss medications (eg, orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate and liraglutide) in obese adults as compared with placebo or another active agent.

Outcomes investigated were changes in blood glucose (fasting blood glucose [FBG] and haemoglobin A1c [A1c]), cholesterol profile (low-density lipoprotein and high-density lipoproteins [HDL]), blood pressure (BP; systolic/diastolic) and waist circumference (WC). Quality of evidence was evaluated using GRADE.

Pooled data from 28 trials, including 29,018 participants (median body mass index, 36.1 kg/m2), showed that weight loss medications were associated with a modest reduction in FBG (weighted mean difference [WMD], –4.0 mg/dL; 95 percent CI, –4.4 to –3.6) and in WC (WMD, –3.3 cm;–3.5 to –3.1). The drugs did not produce clinically meaningful changes in systolic/diastolic BP or cholesterol profile compared with placebo (standardized mean difference, <0.2), with the effects varying among drugs.

In particular, treatment with phentermine-topiramate resulted in a substantial reduction in WC, as well as a modest decrease in FBG, A1c and BP, with a minimal effect on cholesterol. Liraglutide use led to a substantial decrease in FBG, A1c and WC, with a minimal effect on BP and cholesterol. Naltrexone-bupropion use, on the other hand, was associated with moderate increase in HDL cholesterol with a minimal effect on FBG and WC. Finally, orlistat treatment delivered a reduction in low-density lipoprotein and HDL-cholesterol. None of these drugs produced improvements in all cardiometabolic risk factors.

Researchers called for additional studies to investigate the long-term cardiometabolic benefits of these weight loss medications. 

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Most Read Articles
Tristan Manalac, 2 days ago
Switching insulin pumps on or off before exercise does not seem to affect blood glucose concentrations during physical activity in type 1 diabetes patients, according to a recent study.
06 Jun 2019
Having at least four pregnancies through childbearing age appears to increase the risk of diabetes in postmenopausal women without a history of gestational diabetes, a study has found.
Stephen Padilla, 07 Oct 2019
Almost half of Asian patients with dyslipidaemia and hypertension, as well as half of those on pharmacotherapy, have achieved their blood pressure (BP) treatment goals, a Singapore study has shown. Moreover, BP goal attainment is significantly associated with type 2 diabetes mellitus (T2DM) and low-density lipoprotein (LDL-C) control.
Roshini Claire Anthony, 30 Jul 2019

Individuals who adhere to a plant-based diet, particularly one consisting of healthy plant-based foods, may reduce their risk of developing type 2 diabetes (T2D), according to a recent meta-analysis.