Adults with a body mass index (BMI) between 25 and 29.9 kg/m² are considered overweight. Those with a BMI ≥30 are considered obese. The initial recommendation for any weight loss effort is to achieve a 5-10% reduction in weight, which has been associated with a reduction in the risk of developing type 2 diabetes, hypertension, and dyslipidemia. Diet, exercise, and behavior modification are the preferred methods for losing weight, but long-term weight maintenance can be difficult. Several drugs and devices are FDA-approved for weight reduction and maintenance of weight loss.

View the Comparison Table: Some FDA-Approved Drugs for Weight Management

Adults with a body mass index (BMI) between 25 and 29.9 kg/m2 are considered overweight. Those with a BMI ≥30 are considered obese. The initial recommendation for any weight loss effort is to achieve a 5-10% reduction in weight, which has been associated with a reduction in the risk of developing type 2 diabetes, hypertension, and dyslipidemia. Diet, exercise, and behavior modification are the preferred methods for losing weight, but long-term weight maintenance can be difficult. Several drugs are FDA-approved for weight reduction and maintenance (see Table 1), and procedures such as endoscopic placement of dilated balloons have produced beneficial short-term results (see Table 2), but bariatric surgery has been the most effective intervention for sustainable long-term weight loss and reduction of obesity-related comorbidities.

View the Comparison Table: Some FDA-Approved Drugs for Weight Management

The FDA has approved Lomaira (KVK Tech), an 8-mg tablet formulation of phentermine that can be taken up to three times daily before meals, as an adjunct to lifestyle modifications for weight loss. It is only approved for short-term use (a few weeks) in adults with a body mass index (BMI) ≥30 kg/m², or with a BMI ≥27 kg/m² in addition to a weight-related comorbidity such as hypertension, dyslipidemia, or diabetes. Phentermine has been available alone and in combination with topiramate for years.1

Lomaira was approved by the FDA under an abbreviated new drug application (ANDA) and is considered a generic drug. Its approval was based on the results of earlier phentermine trials. No studies are available comparing the efficacy and safety of Lomaira to standard doses of phentermine or to any other drug approved for weight loss.

Like other sympathomimetic amines approved for weight loss, Lomaira is classified as a schedule IV controlled substance. All sympathomimetics can increase heart rate, raise blood pressure, and cause nervousness and insomnia.2 Phentermine is contraindicated for use in patients with cardiovascular disease, hyperthyroidism, glaucoma, or a history of drug abuse, and in pregnant women. It should not be used while taking, and for 14 days after stopping, a monoamine oxidase (MAO) inhibitor because of the risk of hypertensive crisis.

1. Diet, drugs, and surgery for weight loss. Med Lett Drugs Ther 2015; 57:21.
2. SZ Yanovski and JA Yanovski. Long-term drug treatment for obesity: a systematic and clinical review. JAMA 2014; 311:74.

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