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Table 1 Approved medications for obesity in adolescents

From: The adolescent with obesity: what perspectives for treatment?

Medication Indication Dosage Mechanism of action Side effects Contraindications/warnings Weight loss in adolescents Approved
by FDA
Approved
by EMA
Orlistat Long-term management of obesity in adolescents 12 years of age and older 120 mg three times a day with meals Reduction of the absorption of the fatty acids consumed by food through inhibition of gastrointestinal lipases Mostly gastrointestinal (flatulence; fecal urgency/incontinence; fatty, oily stools), generally of mild-to-moderate intensity.
Mineral deficiency.
Rare but serious associations of hepatic and renal illness with orlistat use have been described in the product brochure.
Chronic malabsorption syndrome, cholestasis BMI decreased by 0.55 kg/m2 at 12 months.
A reduction in BMI of at least 5% was observed in 26.5% of participants in the orlistat group and 15.7% participants in the placebo group [52]
Yes No
Phentermine Short-term management of obesity in individuals > 16 years of age From 15 mg to 37.5 mg daily Increase in catecholamines and serotonin activity in the central nervous system resulting in appetite suppression Increases in heart rate and blood pressure, dry mouth, insomnia, constipation, worsening anxiety, irritability Cardiovascular disease hyperthyroidism, active drug use, glaucoma, agitated states, pregnancy BMI reduction of 4.1% at 6 months [53] Yes No
Liraglutide Treatment of obesity in adolescence (12–17 years) Starting dose: 0,6 mg; titration up to 3 mg daily Glucagon-like peptide (GLP)-1 analog inducing weight loss through increased insulin secretion and counteraction of glucagon secretion depending on blood glucose levels, induction of satiety by slowing gastric emptying, and suppression of appetite by acting on the parts of the central nervous system affecting food consumption Gastrointestinal events including nausea, vomiting, and diarrhea Reports of pancreatitis, cholelithiasis, cholecystitis.
It should be used with caution in patients with thyroid diseases.
Clinically significant episodes of hypoglycemia have been reported in adolescents treated with liraglutide
Liraglutide superior to placebo with regard to the change from baseline in the BMI SDS at week 56 (estimated difference, −0.22). A reduction in BMI of at least 5% was observed in 43.3% of participants in the liraglutide group and 18.7% participants in the placebo group [54] Yes Yes