Title: Anti-Obesity Medications: Evolution, Regulatory Challenges and Social Impact

Abstract

Obesity has been declared a 21st-century epidemic, and over the past 50 years notable advancements have been made in treating obesity-associated comorbidities, including hypertension, type 2 diabetes, and hypercholesterolemia. However, the management of obesity and its treatment is still a challenge to this day, primarily because all the past medications have been introduced in the market as therapeutic agents for weight loss and faced many obstacles. This review documents the regulatory framework under which past and recent anti-obesity medications (AOMs) have been approved. Moreover, it examines the regulatory decisions taken for these drugs, focusing on how they have been used and the significant side-effects incidents that led to remarkable withdrawals. New insights into the molecular signaling of the gut-brain axis have emerged as a driving force behind the creation of the next-generation therapeutics with potent effectiveness for obesity. Moreover, this paper delves into some of the ongoing challenges faced by this new class of medicines. In particular, while many individuals have embraced the glucagon-like peptide 1 receptor agonists (GLP-1Ras) for weight loss, concerns have been raised about possible adverse events and the associated risks with off-label use. Society must remain vigilant regarding GLP-1Ras rational use and long-term safety, particularly with the overwhelming amount of information shared on social media platforms.