Pharmakotherapie der Adipositas

Recent years have seen a revolution in pharmacological approaches to obesity therapy in direct response to the increasing prevalence of overweight and obesity worldwide. Approved agents of recent years have focused primarily on incretin-mediated effects that regulate appetite and satiety as well as having gastrointestinal effects such as reduction of gastric emptying. The introduction of new selective and dual co-agonists such as semaglutide and tirzepatide has opened up new perspectives, particularly because of their pleiotropic cardiometabolic effects. These agents are not only used for weight loss but also play a key role in the treatment of diseases such as type 2 diabetes mellitus, metabolic dysfunction-associated fatty liver disease/metabolic dysfunction-associated steatohepatitis (MAFLD/MASH), and in the reduction of cardiovascular risk factors in patients suffering from obesity. The introduction of setmelanotide marks a significant milestone, offering a treatment option for rare, monogenic forms of obesity. A new chapter in modern obesity therapy has begun, and it is likely to become even more important in the coming years as scientific evidence continues to accumulate, particularly with regard to the pleiotropic effects of new pharmacotherapeutic agents in the treatment of obesity.