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REFLECTIONS
Hypertension
Hypertension Global Newsletter #7 2024

SPECIAL POPULATIONS Hypertension

Medications for obesity: A review.
Gudzune KA, Kushner RF. JAMA. 2024 Aug 20;332(7):571-584.

Obesity is associated with increased morbidity and affects up to 19% of women and 14% of men worldwide. In developed
countries, like the United States, it has risen to 42% and is projected to affect nearly one in two adults by 2030. Antiobesity
medications (AOMs) are effective adjunctive therapies that affect appetite dysregulation associated with obesity, thereby
achieving and sustaining more significant weight loss than lifestyle modification alone. This review summarises the efficacy and
safety of currently available AOMs, including their effects on comorbidities such as hypertension and dyslipidaemia.

There are three main
groups of AOMs
based on their general
mechanism of action;
1) intragastrointestinal
medications, such as
orlistat, which blocks
digestion and absorption
of up to 30% of dietary
fats; 2) centrally
acting medications,
such as phentermine,
phentermine-topiramate,
and naltrexone-
bupropion, which affect
neurotransmitters and
receptors in the brain
such as norepinephrine,
GABA, and AMPA/
kainite receptors, and
3) nutrient-stimulated
hormone-based
medications, such as
liraglutide, semaglutide,
and tirzepatide,
which stimulate
metabolic effects
of enteropancreatic
hormones via the gut-
brain axis.

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