Long-Term Efficacy and Safety of Nutritional and Pharmacological Strategies for Obesity

Curr Obes Rep. 2025 Jan 3;14(1):1. doi: 10.1007/s13679-024-00602-y.

Abstract

Purpose of review: This review examines the long-term efficacy and safety of various nutritional and pharmacological strategies for managing obesity. The focus is on the Mediterranean diet (MedDiet), very low-energy ketogenic therapy (VLEKT), and pharmacological interventions such as naltrexone/bupropion and liraglutide. Given the chronic nature of obesity, understanding the sustainability and impact of these treatments over time is critical.

Recent findings: The MedDiet has shown significant benefits for cardiovascular health and moderate long-term weight loss, though it does not always outperform other diets in terms of weight reduction. VLEKT is highly effective for rapid weight loss, but concerns remain about its long-term sustainability. Pharmacological treatments, including naltrexone/bupropion and liraglutide, have shown promise in promoting significant weight loss and improving metabolic markers. However, issues related to long-term adherence and potential side effects need further exploration. Both nutritional and pharmacological strategies offer valuable tools in obesity management. While treatments like VLEKT and pharmacological options provide significant short-term benefits, the MedDiet remains a sustainable long-term approach. The long-term efficacy and safety of naltrexone/bupropion and liraglutide require more investigation to address challenges in weight maintenance and side effects. Further studies are needed to establish the optimal duration and combination of these therapies for sustained obesity management.

Keywords: Anti-obesity Drugs; GLP1-analogues; Ketogenic diet; Liraglutide; Long-term; Mediterranean diet; Naltrexone/bupropion; Nutrition; Obesity; Weight loss.

Publication types

  • Review

MeSH terms

  • Anti-Obesity Agents* / therapeutic use
  • Bupropion* / therapeutic use
  • Diet, Ketogenic*
  • Diet, Mediterranean*
  • Drug Combinations
  • Humans
  • Liraglutide* / therapeutic use
  • Naltrexone* / therapeutic use
  • Obesity* / drug therapy
  • Treatment Outcome
  • Weight Loss* / drug effects

Substances

  • Naltrexone
  • Bupropion
  • Anti-Obesity Agents
  • Liraglutide
  • Naltrexone-Bupropion combination
  • Drug Combinations