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Obesity medications should only be used in conjunction with lifestyle modifications. Further, it is important to recognize that obesity medications are a tool for the treatment of overweight and obesity, and are not a cure (OMA, 2025).
Several obesity medications are approved by the FDA, including phentermine (approved for short-term use), phentermine HCl-topiramate extended release, naltrexone-bupropion sustained release, orlistat, and the glucagon-like peptide receptor agonists (GLP-1s) semaglutide and liraglutide, as well as tirzepatide (which also is a glucose-dependent insulinotropic polypeptide [GIP] receptor agonist) (OMA, 2025). (Although tirzepatide is both a GLP-1 and GIP receptor agonist, it will be referred to as a GLP-1 in this program.)
Although there is some variability among individual agents, indications for prescription weight-loss medications generally include (OMA, 2025):
These medications should be used in conjunction with a reduced-calorie diet and increased physical activity for chronic weight management.
Obesity medications approved for short-term use include (OMA, 2025):
Although not approved for long-term use, the use of these medications (particularly phentermine) for longer than 12 weeks is supported by other data and opinion leaders in patients at low risk for cardiovascular disease.
Obesity medications approved for long-term use include (OMA, 2025):
Older adults are more likely to recognize obesity as a disease and believe insurance should cover obesity care. However, many are hesitant about advanced treatments like anti-obesity medications, likely due to past negative experiences, such as the fen-phen era. It's crucial they seek healthcare provider guidance rather than attempting weight loss alone.
Older adults often use several medications to manage multiple chronic health conditions. The entire medication regimen, including risks for drug interactions and adverse effects, should be considered when selecting among available obesity medications.
After initiating treatment with an obesity medication, patients should monitor for effectiveness and side effects during the first 3 months and contact the prescriber as needed.
Providers should work with patients to support adherence and ensure patients are prepared to manage potential adverse events.
If the patient has not lost 5% or more of baseline weight by 3 months, the medication should be discontinued and alternatives considered.
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