Weight Loss Drugs: What Works?

Laura A. Stokowski, RN, MS

Disclosures

December 13, 2010

In This Article

Potential Future Therapies

ZGN-433, a methionine aminopeptidase inhibitor, targets the adipose tissue rather than the central nervous system. This class of medication essentially works by restoring control of adipose tissue lipolysis, ketogenesis, food intake, and fat synthesis. ZGN-433 is believed to stimulate adipose tissue to convert stored triglycerides into free fatty acids that can be used for energy.[32]

ZGN-433 is still in the early stages of development but has shown promise in rodent studies. A safety and tolerability study in humans is in progress.

Another novel therapy that may have a role in weight loss is ezlopitant, a neurokinin receptor-1 (NK1R) antagonist. The NK1R system has been implicated in both learned appetitive behaviors and addiction to alcohol and opioids; recent evidence from rodent studies suggests that ezlopitant reduces the appetite for sucrose as well, thus decreasing the consumption of sweetened foods and drinks.[33] It has been suggested that sweet foods and drinks can be addictive in the same way as alcohol, explaining the suppressant effects of ezlopitant.

The antidiabetes drugs represent another possible drug class to mine for potential weight-loss effects and for possible development as dual diabetes/obesity agents. Metformin, a biguanide approved for the treatment of type 2 diabetes, causes weight loss by reducing hepatic glucose production and intestinal absorption from the gastrointestinal tract, and enhancing insulin sensitivity.[34]

Liraglutide (Victoza®), another drug that is already approved for the treatment of type 2 diabetes, induces moderate weight loss of approximately 2-3 kg.[35] The glucagon-like peptide-1 (GLP-1) receptor agonists exenatide and liraglutide are newer medications for diabetes that have favorable effects not only on glycemic control but also on weight loss.[3]Although some of these agents might not induce enough weight loss to qualify as anti-obesity agents, they could prove useful for overweight individuals who have diabetes.[34]

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