비만 약물치료의 최신지견

초록

Purpose: Obesity is a chronic disease associated with substantial health consequences, including cardiovascular disease, type 2 diabetes, and certain cancers. Although lifestyle modifications remain foundational to treatment, pharmacotherapy has become a crucial strategy, particularly for patients unable to achieve sustained weight loss. This review aims to provide an updated overview of long-term anti-obesity medications, discussing their mechanisms of action, efficacy, safety profiles, clinical applicability, and future perspectives on emerging therapeutic agents. Current Concepts: Recent pharmacological advancements have substantially transformed obesity management. Glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide (2.4 mg) and the dual glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonist tirzepatide (15 mg) have demonstrated significant weight loss effects (15–21%) and have shown benefits across various obesity-related comorbidities, including type 2 diabetes, cardiovascular disease, and heart failure with preserved ejection fraction. Additionally, investigational agents such as CagriSema, retatrutide, and oral GLP-1 receptor agonists hold promise for enhanced efficacy and improved patient convenience. These developments underscore a shift toward personalized, mechanism-based pharmacotherapy. Discussion and Conclusion: Despite encouraging outcomes, significant challenges remain. Issues such as weight regain after discontinuation, limited long-term safety data, and access barriers due to high treatment costs continue to present obstacles. In Korea, the absence of insurance reimbursement for most anti-obesity medications severely restricts patient access, even among high-risk populations. Given the recognition of obesity as a chronic, relapsing disease, treatment strategies should incorporate the individual patient's comorbidity profile and personal needs. Alongside pharmacologic advancements, healthcare policies must evolve to ensure equitable medication access and optimize clinical outcomes. © Korean Medical Association.

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