4.4.0.0 Ap­proved Weight-‍Loss Med­i­ca­tions

The U.S. Food and Drug Ad­min­is­tra­tion (FDA) has ap­proved med­i­ca­tions for both short-‍term and long-‍term weight man­age­ment as ad­juncts to diet, ex­er­cise, and be­hav­ioral ther­a­py. Near­ly all FDA- ap­proved med­i­ca­tions for weight loss have been shown to im­prove glycemic con­trol in pa­tients with type 2 di­a­betes and delay pro­gres­sion to type 2 di­a­betes in pa­tients at risk (41). Phen­ter­mine is in­di­cat­ed as short-‍term (≤12 weeks) treat­ment (42). Five weight-‍loss med­i­ca­tions (or com­bi­na­tion med­i­ca­tions) are FDA-‍ap­proved for long-‍term use (more than a few weeks) by pa­tients with BMI ≥27 kg/m2 with one or more obe­si­ty-‍as­so­ci­at­ed co­mor­bid con­di­tions (e.g., type 2 di­a­betes, hy­per­ten­sion, and dys­lipi­demia) who are mo­ti­vat­ed to lose weight (41). Med­i­ca­tions ap­proved by the FDA for the treat­ment of obe­si­ty and their ad­van­tages and disad­van­tages are sum­ma­rized in Table 8.2. The ra­tio­nale for weight-‍loss med­i­ca­tions is to help pa­tients to more con­sis­tently ad­here to low-‍calo­rie diets and to rein­force lifestyle changes. Providers should be knowl­edge­able about the prod­uct label and should bal­ance the po­ten­tial benefits of suc­cess­ful weight loss against the po­ten­tial risks of the med­i­ca­tion for each pa­tient. These med­i­ca­tions are contrain­di­cat­ed in women who are preg­nant or ac­tive­ly try­ing to con­ceive. Women of reprod­uctive po­ten­tial must be coun­seled re­gard­ing the use of re­li­able meth­ods of con­tra­cep­tion.

Table 8.2—Med­i­ca­tions ap­proved by the FDA for the treat­ment of obe­si­ty