ABSTRACT
This chapter reviews the data supporting the safety and efficacy of appetite suppressants, lipase inhibitors, anticonvulsants, antidepressants, and other agents in the treatment of obesity. Medicating for treatment of obesity can be a useful adjunct to diet and exercise and can help selected patients achieve and maintain meaningful weight loss. Surgeries for obesity such as gastric bypass and gastric banding have been demonstrated in one large registry study to produce >16% weight loss from baseline that is sustained for up to 10 years from baseline. There are only two agents currently available with food and drug administration approval and an obesity indication for long term use—orlistat and sibutramine. Topiramate is a neuropsychiatric agent approved for treatment of certain forms of epilepsy, either as monotherapy and in combination with other antiepileptic drugs. Central nervous system symptoms are the most worrisome aspect of developing topiramate for an obesity indication.
