A total of 28 randomized controlled trials with about 29,000 participants were included in the analysis.
The median body mass index (BMI) was about 36 kg/m2. Note: A person with a BMI of 30 and above is considered to be obese.
The weight loss medications were associated with:
- A modest but statistically significant decrease in fasting blood glucose (weighted mean difference, 4 mg/dL), and
- A statistically significant decrease in waist circumference (weighted mean difference 3.3 cm).
But, the medications were not associated with clinically meaningful changes in systolic/diastolic BP or lipid profile.
The changes in cardiometabolic factors varied from one of the medications to another.
Phentermine-topiramate use was associated with:
- A substantial decrease in waist circumference
- A modest decrease in fasting blood sugar, hemoglobin A1c, and blood pressure
- Minimal effect on lipid profile.
Liraglutide use was associated with:
- A substantial decrease in fasting blood sugar, hemoglobin A1c, and waist circumference, but,
- Minimal effect on blood pressure and lipid profile.
Naltrexone-bupropion use was associated with:
- A moderate increase in high-density lipoprotein cholesterol, but,
- Minimal effect on fasting blood sugar and waist circumference
Orlistat use was, not surprisingly, associated with:
- A decrease in low-density lipoprotein, but also with
- A decrease in high-density lipoprotein cholesterol, which is undesirable.
It is important to note that none of these medications improved all the cardiometabolic risk factors evaluated.