Drugs for slimming: Orlistat, Liraglutide, Bupropion, Naltrexone are the active ingredients of approved drugs used in cases of overweight and obesity, but always under medical supervision

Do you need to lose a lot of weight? Today it is possible to combine diet and physical activity with additional support, which in this case can come from specific slimming drugs.

But beware: the drugs approved in Italy for the treatment of obesity and overweight are few and selected.

For this reason, if you want to embark on a pharmacological pathway, in association with lifestyle changes, it is essential to turn to specialised centres with proven experience in this area. But what are these drugs? And what mechanism of action are they based on?

Slimming down, the importance of seeing a specialist

Obesity and overweight are now a major public health problem in every western country.

It is a growing problem, which is associated with a constant search for new strategies to reduce body weight, including through the use of drugs.

The use of drugs can be an additional weapon in the treatment of people suffering from overweight and obesity.

It is important, however, that the use of these drugs is accompanied by a correct lifestyle and an adequate dietary prescription and, above all, that they are carefully evaluated and monitored by the medical specialist.

In fact, it is essential to consider whether there are any concomitant pathologies and other therapies in progress with which these drugs may interfere.

Active ingredients currently authorised for overweight and obesity

To date, the active ingredients approved in Italy for the treatment of obesity and overweight in adults are 3:

• orlistat;
• liraglutide;
• bupropion/naltrexone.

Weight loss is also often achieved by using food supplements, food products that have no therapeutic indication.

The use of these types of products to treat overweight and obesity is not supported by scientific evidence of clinical efficacy and safety.

Need to lose weight: let’s take a closer look at how approved drugs work

Orlistat

Orlistat is an inhibitor of gastrointestinal lipases, i.e. enzymes that metabolise fat.

Inhibition of these enzymes prevents the metabolism of certain fats in the diet.

This means that a proportion of the fat ingested during meals passes through the intestine undigested and therefore assimilated and is eliminated.

The drug is taken in tablet form, the number of tablets varying daily depending on the individual case.

The limitation of this drug is the possible reduction in intestinal absorption of other drugs taken at the same time.

Undesirable effects include intestinal discomfort and diarrhoea (steatorrhoea).

Liraglutide

Liraglutide is a ‘GLP-1 (glucagon-like peptide-1) receptor agonist’, which has been authorised for years in the European Union at lower doses (up to 1.8 mg daily) for the treatment of type 2 diabetes.

The drug acts as a regulator of appetite and hunger, acting both in the intestine by slowing down the digestive process, resulting in a greater sense of satiety even when small amounts of food are eaten, and centrally in certain brain nuclei, by increasing feelings of fullness and satiety and simultaneously reducing feelings of hunger and desire to eat.

Clinical studies show that the drug in combination with dietary treatment and physical activity can lead to a weight loss of around 10%.

The drug is taken through an injectable solution with one subcutaneous puncture per day, with the dosage increasing from week to week.

Side effects of the drug include nausea, reflux, tachycardia and headache.

Response to treatment and tolerability of the drug should therefore be carefully monitored during specialist dietary visits.

Naltrexone/ Bupropion

These two active ingredients reduce appetite and thus food intake and increase energy expenditure.

They act on the systems in the brain that link food and emotion, which are often responsible for nervous hunger, by trying to inhibit ‘food addiction’ and generally the centres responsible for controlling feelings of pleasure related to food intake.

Formulated as sustained-release tablets, they are contraindicated if there have been episodes of convulsions in the past, in the presence of severe depression or uncontrolled hypertension.

Slimming and Semaglutide: the latest weight-loss novelty on the way

A new prospect in the treatment of overweight and obesity may soon be Semaglutide, a molecule which has been in use for some years in the treatment of type 2 diabetes but which is not yet prescribed for patients suffering from obesity.

This drug belongs to the same category of molecules as Liraglutide, namely ‘GLP-1 (glucagon like peptide-1) receptor agonists’, and the mechanism of action is also the same.

Clinical studies to date have shown very encouraging results in terms of weight loss: up to 15-20% weight loss when combined with appropriate nutritional treatment and physical activity.

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Source:

GSD