Pediatric obesity psychopharmacology: Quo vadis?

Obesity is a major risk factor for child, adolescent and adult health. Though diet and exercise are the cornerstone of obesity prevention and treatment, many pediatric persons do not adhere to a nutrition-exercise approach. This review reflects on concepts of pharmacology for the management of obesity in children and adolescents in the early 21st century. Medications considered in the management of obesity include sympathomimetics (with or without topiramate), serotonin agonists, fat blockers (gastrointestinal lipase inhibitors), glucagon-like peptide 1 (GLP-1) agonists, antidepressant/opioid antagonist combination and others. Medications that were used for obesity management and later pulled from the market are also discussed. There are two drugs, orlistat and liraglutide, approved by the United States Food and Drug Administration (US-FDA) for adolescents ≥ 12 years of age with obesity. In the pediatric population there remains limited evidence on the safety and efficacy of anti-obesity medications used in adults and close monitoring for adverse effects is needed. The use of medications to assist in the management of overweight and obesity in pediatric and adult persons will increase as the 21st century continues. Clinicians should be vigilant about the current state of the art with regard to pharmacology of obesity and to its future. [ABSTRACT FROM AUTHOR]