OBJECTIVES:

The global prevalence of obesity has soared in the past 40 years, presenting a large morbidity and mortality burden. Lifestyle-based interventions have had limited success. In response, anti-obesity medications (AOMs) are of interest, with several drugs approved or in development and a growing volume of published research on AOM effectiveness and safety. This research aims to identify key trends in systematic literature reviews (SLRs) on AOMs in adults, published in the past five years.

METHODS:

Embase, Medline, and Cochrane databases were searched for SLRs published between 1/Jan/2018 and 3/Jan/2022 using a NICE-published search strategy for obesity, along with intervention and SLR terms. SLRs of adults with obesity treated with AOMs were included. SLRs exclusively on surgical, lifestyle, or herbal/supplement treatments were excluded. A single reviewer screened references in Endnote, followed by Covidence, with a 10% check by a second reviewer.

RESULTS:

After removing duplicates, 3702 publications were identified and screened, with 91 SLRs retained for assessment. The number of SLRs more than doubled over the five years, from 12 published in 2018 to 27 in 2022. More than two-thirds (64) included a meta-analysis. The most commonly assessed agents were GLP-1 receptor agonists (40.7%), followed by orlistat (18.7%), metformin (17.6%), and phentermine/topiramate (12.1%). SGLT-2 inhibitors and lorcaserin were reported in eight studies (8.8%) each. Other less common agents were also identified. Thirteen SLRs (14.3%) were in populations without diabetes. The most common subpopulations were diabetes (8.8%), polycystic ovary syndrome (7.7%) and schizophrenia (3.3%). The identified SLRs did not include some of the newest AOMs being investigated in early phase trials.

CONCLUSIONS:

Recent SLRs reflect a range of AOMs and highlight the need for efficacious and safe drug treatment for long-term weight loss to address the substantial burden of obesity. Subsequent SLRs are needed to synthesize evidence on new AOMs once data are published.