Efficacy and risks of obesity pharmacotherapy: implications of the inappropriate use of anti-obesity medications
DOI:
https://doi.org/10.69849/ymmvct50Keywords:
Obesity, Pharmacological treatment, Semaglutide, Rational use of drugs, Pharmaceutical careAbstract
Obesity is a chronic and multifactorial pathology that requires complex therapeutic strategies, with pharmacological treatment being an essential ally when associated with lifestyle changes. This study aimed to analyze the efficacy, risks, and consequences of the inappropriate use of anti-obesity drugs, such as Orlistat, Sibutramine, and modern GLP-1 analogs (Liraglutide and Semaglutide). The methodology adopted was an integrative literature review, searching databases such as PubMed and SciELO, covering the period from 2010 to 2024. The results and discussion reveal that although drugs like Semaglutide show superior efficacy in weight loss and metabolic control, indiscriminate use by non-obese individuals, driven by aesthetic motivations, increases the risk of serious adverse reactions, including gastrointestinal disorders, pancreatitis, and biliary imbalances. It was found that Sibutramine, despite being accessible, has severe restrictions due to cardiovascular risk, while Orlistat remains a safe option, albeit with modest efficacy. The discussion emphasizes that discontinuing pharmacotherapy without follow-up often results in weight regain (rebound effect). The conclusion highlights that treatment success depends on ethical prescription and multidisciplinary monitoring. The fundamental role of the pharmacist in promoting rational use is emphasized, aiming to mitigate the trivialization of these drugs and ensure patient safety.
References
LINCOFF, Michael A. et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. The New England Journal of Medicine, [S. l.], v. 389, n. 24, 2023. DOI: https://doi.org/10.1056/nejmoa2307563. Disponível em: https://www.nejm.org/doi/10.1056/NEJMoa2307563.
APOVIAN, Caroline M. et al. A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR-II). Obesity, [S. l.], v. 21, n. 5, p. 935–943, 2013. DOI: 10.1002/oby.20309.
CHIAPPINI, Stefania et al. Is There a Risk for Semaglutide Misuse? Focus on the Food and Drug Administration’s FDA Adverse Events Reporting System (FAERS) Pharmacovigilance Dataset. Pharmaceuticals, [S. l.], v. 16, n. 7, p. 994–994, 2023. DOI: https://doi.org/10.3390/ph16070994. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384093/.
FDA. FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss. 2024. Disponível em: https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss.
GAO, Zhao et al. Efficacy and safety of orlistat in controlling the progression of prediabetes to diabetes: A meta-analysis and systematic review. Medicine, [S. l.], v. 103, n. 21, p. e38354–e38354, 2024. DOI: https://doi.org/10.1097/md.0000000000038354. Disponível em: https://journals.lww.com/md-journal/fulltext/2024/05240/efficacy_and_safety_of_orlistat_in_controlling_the.5.aspx. Acesso em: 9 set. 2025.
MAHASE, Elisabeth. Weight loss pill praised as “holy grail” is withdrawn from US market over cancer link. BMJ, [S. l.], p. m705, 2020. DOI: https://doi.org/10.1136/bmj.m705. Acesso em: 15 set. 2025.
PI-SUNYER, Xavier et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. New England Journal of Medicine, [S. l.], v. 373, n. 1, p. 11–22, 2015. DOI: https://doi.org/10.1056/nejmoa1411892. Disponível em: https://pubmed.ncbi.nlm.nih.gov/26132939/.
QI, Q. Y. D. et al. Obesity medications: a narrative review of current and emerging agents. Osteoarthritis and cartilage open, [S. l.], v. 6, n. 2, p. 100472–100472, 2024. DOI: https://doi.org/10.1016/j.ocarto.2024.100472.
UWAIFO, Gabriel et al. Phentermine and topiramate for the management of obesity: a review. Drug Design, Development and Therapy, [S. l.], p. 267, 2013. DOI: https://doi.org/10.2147/dddt.s31443. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623549/pdf/dddt-7-267.pdf.
WILDING, John P. H. et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England Journal of Medicine, [S. l.], v. 384, n. 11, p. 989–1002, 2021. DOI: https://doi.org/10.1056/NEJMoa2032183. Disponível em: https://www.nejm.org/doi/full/10.1056/NEJMoa2032183.
GREENWAY, Frank L. et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet, v. 376, n. 9741, p. 595–605, 2010.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Maria Fernanda dos Santos Souza (Autor)
This work is licensed under a Creative Commons Attribution 4.0 International License.
"Os Autores que publicam nesta revista concordam com os seguintes termos:
-
Os Autores mantêm os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a licença Creative Commons Attribution 4.0 International (CC BY 4.0). Esta licença permite que o trabalho seja compartilhado, copiado e adaptado em qualquer suporte ou formato, para qualquer fim, inclusive comercial, desde que seja atribuído o devido crédito de autoria e de publicação inicial nesta revista.
-
Os Autores têm autorização para assumir compromissos contratuais adicionais separadamente, para a distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
-
A revista permite e incentiva os autores a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) após o processo de edição e publicação, pois isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado."
