Witkiewitz K, Litten RZ, Leggio L
If youve lost 5% of your initial weight at that assessment, you are likely to be able to continue using it for up to two years with clinical guidance
Semaglutide, with its robust clinical evidence, has also made waves in the treatment landscape
FDA-approved pharmacotherapy alternatives include several options with established safety profiles: Semaglutide (Wegovy): A GLP-1 receptor agonist producing 12-15% weight loss, with cardiovascular benefits demonstrated in the SELECT trial and FDA-approved indication for reducing cardiovascular risk Liraglutide (Saxenda): A GLP-1 receptor agonist producing 5-8% weight loss [4] Phentermine-topiramate (Qsymia): FDA-approved combination producing 7-10% weight loss with established safety data Naltrexone-bupropion (Contrave): Combination targeting reward pathways and appetite, producing 5-9% weight loss [4] Orlistat (Xenical, Alli): Lipase inhibitor producing 3-5% weight loss with gastrointestinal side effects [4] Setmelanotide (Imcivree): For rare genetic obesity disorders (POMC, PCSK1, LEPR deficiency) [4] Metabolic and bariatric surgery should be considered for patients with BMI 40 kg/m or 35 kg/m with obesity-related comorbidities who have not achieved adequate weight loss with nonsurgical interventions
LDL cholesterol decreases by 3-7%, total cholesterol reduces by 3-8%, and HDL cholesterol modestly increases by 2-5%, with additional reductions in non-HDL cholesterol of 5-10%
