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54 Drugs with Weight Changes

Feb 20, 2015

Researchers examined data from 257 randomized trials to find out which drugs cause weight loss…

Researchers conducted a systematic review and meta-analysis to summarize the evidence about commonly prescribed drugs and their association with weight change.

MEDLINE, DARE, and the Cochrane Database of Systematic Reviews were searched to identify published systematic reviews as a source for trials. They included randomized trials that compared an a priori selected list of drugs to placebo and measured weight change and extracted data in duplicate and assessed the methodological quality using the Cochrane risk of bias tool.

They included 257 randomized trials (54 different drugs; 84,696 patients enrolled). Weight gain was associated with the use of: amitriptyline (1.8 kg), mirtazapine (1.5 kg), olanzapine (2.4 kg), quetiapine (1.1 kg), risperidone (0.8 kg), gabapentin ( 2.2 kg), tolbutamide (2.8 kg), pioglitazone (2.6 kg), glimepiride (2.1 kg), gliclazide (1.8 kg), glyburide (2.6 kg), glipizide (2.2 kg), sitagliptin (0.55 kg), and nateglinide (0.3 kg).

Weight loss was associated with the use of: metformin (1.1 kg), acarbose (0.4 kg), miglitol (0.7 kg), bupropion (1.3 kg), and fluoxetine (1.3 kg).

For many other remaining drugs (including antihypertensives and antihistamines), the weight change was either statistically nonsignificant or supported by very low-quality evidence.

In conclusion, several drugs are associated with weight change of varying magnitude. Data are provided to guide the choice of drug when several options exist and institute preemptive weight loss strategies when obesogenic drugs are prescribed.

Practice Pearls:

  • The authors of this study summarized data from 257 randomized trials (84,696 patients) to examine associations between 54 different drugs commonly associated with weight change and actual weight change. Classes of drugs examined included atypical antipsychotics, hormones, antihypertensive agents, antihistamines, antidepressants, hypoglycemic agents, anticonvulsants, and mood stabilizers. Weight gain was associated with the use of 14 different drugs, and weight loss with 10 different drugs.
  • These findings could be used to guide drug selection when several options exist and to suggest preemptive strategies for weight management during treatment.

JP Domecq. The Journal of Clinical Endocrinology and Metabolism Drugs Commonly Associated With Weight Change: J. Clin. Endocrinol. Metab. 2015 Jan 15;100(2)363–370, From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.