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Systematic review
Obesity medications reduce total body weight by 3–9% compared with placebo, when combined with lifestyle changes
  1. Kishore M Gadde1,
  2. William S Yancy Jr1,2
  1. 1Duke University Medical Center, Durham, North Carolina, USA
  2. 2Veterans Affairs Medical Center, Durham, North Carolina, USA
  1. Correspondence to : Dr Kishore M Gadde, Duke University Medical Center, Box 3292, Durham, NC 27710, USA; kishore.gadde{at}

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Implications for practice and research

  • Unless delivered in an intensive manner, lifestyle therapies generally do not yield significant and sustainable weight loss for most obese patients.

  • Pharmacotherapy aimed at weight loss, when used prudently and in consideration of individual benefit-to-risk balance, could be a useful addition to lifestyle interventions.


Obesity is associated with numerous complications, notably type 2 diabetes, hypertension, coronary artery disease and obstructive sleep apnoea. Weight loss of 5–10%, if maintained for 2 years or more, can lead to significant improvements in these comorbidities, especially type 2 diabetes.1 Mild-to-moderate-intensity lifestyle interventions often do not achieve clinically significant and sustained weight loss for obese patients. Pharmacotherapy is recommended as an adjunct to lifestyle therapies for achieving weight loss in patients with a body mass index (BMI) of ≥30 kg/m2, and in patients with weight-related comorbidities and a BMI of ≥27 kg/m2.


Yanovski and Yanovski conducted …

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  • Competing interests In the past 3 years, KMG has received research funding from Amylin, Eisai, Medical University of South Carolina and Vivus, and held equity (not currently) in Orexigen.