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Phentermine in the Modern Era of Obesity Pharmacotherapy: Does It Still Have a Role in Treatment?

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Abstract

Purpose of Review

This review provides an overview of the history, mechanism of action, and expected treatment effects of the anti-obesity medication (AOM), phentermine. It also includes a summary of recent research and practical guidance for prescribing clinicians.

Recent Findings

Recent research on phentermine is sparse and consists primarily of observational studies with methodologic limitations. These studies suggest that phentermine use is associated with clinically significant weight loss in adults and that the medication is generally well tolerated. Large-scale observational studies evaluating phentermine’s safety have not identified an increased risk of cardiovascular events or elevations in blood pressure. There is no data to support the notion that phentermine is addictive.

Summary

Although it remains the most commonly prescribed AOM in the USA, phentermine has little rigorous research to support its efficacy and safety in long-term treatment, which creates a dilemma with guideline-recommended chronic use of AOMs. While we await forthcoming conclusive data on this front, clinicians may consider using phentermine long-term in selected patients, if such prescribing is consistent with local regulatory statutes.

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Authors and Affiliations

  1. Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27101, USA

    Kristina H. Lewis & Jamy D. Ard

  2. Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Kimberly A. Gudzune

  3. Department of Health Policy & Management, Johns Hopkins University School of Public Health, Baltimore, MD, USA

    Kimberly A. Gudzune

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  1. Kristina H. Lewis
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KHL, KG and JDA all contributed equally to the development and writing of the manuscript. All authors reviewed the manuscript.

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Correspondence to Kristina H. Lewis.

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Conflict of Interest

Dr. Lewis reports non-financial support from KVK Tech, and personal fees from American Board of Obesity Medicine, outside the submitted work; Dr. Gudzune reports grants and personal fees from Novo Nordisk, personal fees from Eli Lilly, personal fees from American Board of Obesity Medicine, and personal fees from Johns Hopkins ACG System, outside the submitted work; Dr. Ard reports personal fees and non-financial support from Nestle Healthcare Nutrition, grants and personal fees from Eli Lilly, grants from Epitomee, grants and personal fees from UnitedHealth Group, personal fees from Novo Nordisk, non-financial support from KVKTech, personal fees and non-financial support from Weight Watchers, personal fees from Regeneron, personal fees from Brightseed, grants and personal fees from Boehringer Ingelheim, and personal fees from Intuitive, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by any of the authors. This article does reference a previously published observational study in humans by Drs. Lewis and Ard and an ongoing clinical trial in humans on which all authors are Investigators. All clinical trials reported were overseen by Institutional Review Boards and included appropriate informed consent.

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Lewis, K.H., Gudzune, K.A. & Ard, J.D. Phentermine in the Modern Era of Obesity Pharmacotherapy: Does It Still Have a Role in Treatment?. Curr Obes Rep 13, 132–140 (2024). https://doi.org/10.1007/s13679-023-00546-9

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