Professor Xu Danyan, from the Department of Metabolic Cardiology at the Second Xiangya Hospital of Central South University, believes that if a healthy lifestyle is the foundation for fighting obesity, then weight-loss medications are the lever. With advances in medicine, the options for weight-loss medications have become more diverse, and they are currently categorized into three main classes:
- Amplifiers of the Body’s Protective SignalsGLP-1 Receptor Agonists (GLP-1 RAs) and GLP-1/GIP Dual Receptor Agonists GLP-1 RAs: Include liraglutide and semaglutide.
Dual agonists: Include tirzepatide.
They primarily work by suppressing the appetite center, reducing food intake, and improving metabolism, making them currently popular weight-loss medications. - Intestinal Fat GatekeeperOrlistatThe only currently available over-the-counter oral medication. It acts by blocking the absorption of approximately 30% of dietary fat. However, it may cause gastrointestinal discomfort, and long-term use could potentially affect the absorption of fat-soluble vitamins. Therefore, it should be used under the guidance of a doctor and pharmacist, with close attention to long-term cardiovascular safety.
- Brain Appetite CoordinatorNaltrexone/Bupropion CombinationA fixed-dose combination drug that acts on the central nervous system. It helps rebalance the neural signals that regulate appetite, particularly reducing food cravings and impulsive eating. It is contraindicated in individuals with uncontrolled hypertension, epilepsy, eating disorders, or a history of drug abuse.
Additional MedicationsFurthermore, drugs such as phentermine suppress appetite through different mechanisms. They have specific target populations and potential side effects, including dry mouth, paresthesia, and increased heart rate. These require close monitoring by a specialist and are not considered first-line, universal options.
ConclusionOverall, modern weight-loss medications have evolved from 单纯 appetite suppression to precise, multi-targeted physiological regulation. However, clinical selection must be tailored to the individual, based on a comprehensive assessment of the patient’s obesity level, health status, comorbidities, and lifestyle, to achieve safe and effective personalized treatment.