Recent progress in obesity pharmacotherapy

Interest in obesity pharmacotherapy is intense, sparked by the public healt h threat of increases in obesity rates, as well as by increased knowledge o f the biology underlying food intake and energy balance. After a hiatus of more than 20 years, three new medications approved by the US Food and Drug Administration for obesity treatment recently reached the marketplace. One of these, dexfenfluramine, has been withdrawn because of fenfluramine's and its isomer's association with valvular regurgitation. Sibutramine, a centr ally acting reuptake inhibitor of monoamines, and orlistat, a pancreatic li pase inhibitor, have been approved for long-term obesity treatment. This re view covers recent publications documenting clinical trial experience with these two agents and updates the evidence associating dexfenfluramine and f enfluramine with valvulopathy. As obesity rates increase throughout the wor ld and as knowledge expands regarding the biology of obesity, an expansion of pharmacologic options for obesity treatment is certain. (C) 2000 Lippinc ott Williams & Wilkins, Inc.