Unit 4: Comparison of Anti-Obesity Agents
Comparison of Anti-Obesity Agents
Obesity is a long-term, complex health problem that affects millions of people around the world and leads to a lot of illness and death. It is affected by genetic, environmental, social, and metabolic factors, so treatment usually needs to include more than one method. Changing one’s way of life is still the most important part of therapy. However, pharmacologic treatments are also essential for people who do not lose weight or keep it off after making lifestyle changes alone. This paper will look at four popular weight loss drugs—Orlistat, Semaglutide, Phentermine/Topiramate, and Naltrexone/Bupropion—and compare them based on how they work, when they should not be used, any side effects, the amount of weight loss that is expected, and how much they are expected to cost.
Anti-obesity Medications Summary Table
| Medications | Mechanism of Action | Indications for Use | Contraindications | Potential Side Effects | Expected Weight Loss | Estimated Cost |
| 1. Orlistat | Inhibits gastric and pancreatic lipases, blocking the hydrolysis and absorption of approximately 30% of dietary fat. Undigested fats are excreted in feces, reducing caloric intake (Valladales-Restrepo et al., 2023). | It has been approved for long-term weight control in adults and teens (ages 12 and up) who are overweight or obese (BMI ≥30 kg/m² or ≥27 kg/m² with other health problems like diabetes, dyslipidemia, or high blood pressure). In overweight people, it can also help slow the development of type 2 diabetes (Valladales-Restrepo et al., 2023). | Chronic malabsorption syndrome, cholestasis, pregnancy, or hypersensitivity to the drug (Valladales-Restrepo et al., 2023). | Oily spotting, flatulence with discharge, fecal urgency, and fat-soluble vitamin deficiency (A, D, E, K) (Valladales-Restrepo et al., 2023). | Approximately 5–10% of baseline body weight after one year when combined with a calorie-restricted diet (Valladales-Restrepo et al., 2023). | Around $100–$150 per month (generic OTC versions available as Alli). |
| 2. Semaglutide (Wegovy) | A glucagon-like peptide-1 (GLP-1) receptor agonist that mimics the effects of natural GLP-1. It increases insulin secretion, delays gastric emptying, and acts on appetite centers in the brain to reduce hunger and caloric intake (Singh et al., 2021). | For long-term weight management in people who are obese (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) and have at least one condition related to their weight, like high blood pressure, type 2 diabetes, or dyslipidemia. It is also used to help people with diabetes better control their blood sugar (Singh et al., 2021). | Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN2), pregnancy, or hypersensitivity (Singh et al., 2021). | Nausea, vomiting, diarrhea, constipation, abdominal pain, and the potential risk of pancreatitis (Singh et al., 2021). | Up to 15–20% of body weight after 68 weeks in clinical trials (Singh et al., 2021). | Approximately $1,000–$1,400 per month without insurance. |
| 3. Phentermine/Topiramate (Qsymia) | Combines phentermine, a sympathomimetic amine that suppresses appetite by increasing norepinephrine release, with topiramate, an anticonvulsant that promotes satiety through modulation of GABA and glutamate activity (Ryan, 2021). | Used to help people who are obese (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) and also have other health problems like high blood pressure, diabetes, or dyslipidemia keep their weight under control. It works exceptionally well for people who need to control their hunger and feel fuller faster (Ryan, 2021). | Pregnancy (risk of fetal harm), glaucoma, hyperthyroidism, recent or unstable cardiovascular disease, and MAOI use within 14 days (Ryan, 2021). | Paresthesia, dizziness, insomnia, dry mouth, constipation, and mood changes (Ryan, 2021). | Produces an average weight loss of 8–10% over 12 months when combined with lifestyle modifications (Ryan, 2021). | Approximately $180–$220 per month (Ryan, 2021). |
| 4. Naltrexone/Bupropion (Contrave) | A combination of naltrexone, an opioid receptor antagonist that reduces cravings, and bupropion, a norepinephrine-dopamine reuptake inhibitor that suppresses appetite and increases energy expenditure through hypothalamic and mesolimbic pathways (Grabowska et al., 2025). | Allow for people with a BMI of 30 kg/m² or more, or a BMI of 27 kg/m² or more and at least one health problem related to obesity, such as high blood pressure, high cholesterol, or type 2 diabetes. People who have food urges or eat when they are upset may benefit the most from it (Grabowska et al., 2025). | Uncontrolled hypertension, seizure disorders, chronic opioid use, bulimia or anorexia nervosa, and use of MAOIs within 14 days (Grabowska et al., 2025). | Nausea, constipation, headache, insomnia, dizziness, and increased blood pressure (Grabowska et al., 2025). | Approximately 5–8% of body weight after one year (Grabowska et al., 2025). | About $200–$250 per month. |
Conclusion
Adding pharmacologic therapy to lifestyle changes is an effective way to manage obesity, especially for people who have trouble losing weight with food and exercise alone. Every weight loss drug has its own mechanisms, advantages, and disadvantages that need to be carefully weighed based on the patient’s traits and other health problems. When healthcare providers know about these differences, they can tailor treatment to each patient, get better results, and help people stick to their plans and keep off the weight.
References
Grabowska, M., Grabowska, K., Kubicka, J., Wiśniewska, A., Balik, D., Kwaśniewska, A., Kaszyńska, K., Dąbek, J., Kosucka, W., & Lara, J. (2025). The role of Naltrexone-Bupropion in Obesity Management: Current State of Knowledge. Quality in Sport, 40, 59421. https://doi.org/10.12775/qs.2025.40.59421
Ryan, D. H. (2021). Drugs for treating obesity. Handbook of Experimental Pharmacology, 274, 387–414. https://doi.org/10.1007/164_2021_560
Singh, G., Krauthamer, M., & Bjalme-Evans, M. (2021). Wegovy (Semaglutide): a new weight loss drug for chronic weight management. Journal of Investigative Medicine, 70(1), 5–13. https://doi.org/10.1136/jim-2021-001952
Valladales-Restrepo, L. F., Sánchez-Ramírez, N., Usma-Valencia, A. F., Gaviria-Mendoza, A., Machado-Duque, M. E., & Machado-Alba, J. E. (2023). Effectiveness, persistence of use, and safety of orlistat and liraglutide in a group of patients with obesity. Expert Opinion on Pharmacotherapy, 24(4), 535–543. https://doi.org/10.1080/14656566.2023.2178900
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Instructions
Obesity is a disease process which has reached epidemic proportions in the United States and impacts millions of adults around the world. The causes of obesity are complex and include an interplay between genetics, environment, psychologic factors and chronic diseases. As such, we must look at obesity as a chronic disease and consider management with a variety of modalities including lifestyle, medications and possible surgical approaches based upon the patient’s health needs and goals.
The use of medications in the management of obesity has continued to grow and develop. We commonly see patients utilize lipase inhibitors, glucagon-like peptide-1 receptor agonists and other combination medications to manage their obesity and in an attempt to lower weight and improve health under the supervision of their healthcare provider.
- For this assignment, create a table that summarizes the following anti-obesity medications that you can save and utilize later in practice:
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- Orlistat
- Semaglutide
- Phentermine/Topiramate
- Naltrexone/Bupropion
- For each of the medications provided above include a summary of the following information in your table:
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- Mechanism of Action
- Indications for use
- Contraindications for use
- Potential Side Effects
- Expected weight loss
- Estimated cost of medication
- A minimum of two supporting references
Requirements
- Prepare and submit a table in MS Word or PDF format for this assignment.
- Utilize a minimum of two references to support the information summarized in your table.
- Include a cover page consistent with APA format and a reference page with full citations for each source.
- Address all the prompts for each of the four medications listed above.
- Please review the rubric to ensure that your assignment meets the criteria.