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Reduces appetite aids weight loss Common Drugs (Examples) Exenatide Liraglutide Dulaglutide Semaglutide Lixisenatide Clinical Uses Type 2 Diabetes Mellitus (as monotherapy or combination) Obesity / weight management (especially semaglutide, liraglutide) Cardiovascular benefit: reduces major adverse CV events in T2DM with CVD Administration Subcutaneous injection (daily or weekly depending on formulation) Oral semaglutide available for some patients Adverse Effects Gastrointestinal: nausea, vomiting, diarrhea Risk of pancreatitis (rare but serious) Mild hypoglycemia if combined with sulfonylureas or insulin Injection site reactions Contraindications / Precautions Personal/family history of medullary thyroid carcinoma History of multiple endocrine neoplasia syndrome type 2 (MEN2) Severe gastrointestinal disease (gastroparesis) GLP-1 agonists = incretin mimetics

Despite this being prominent in the news, the first medication mentioned by GPs and IMs when asked Which drugs for managing of patients living with obesity are you aware of, even if you have not prescribed them? was, in 54% of responses, the much older and less effective orlistat and its brand names Xenical and Alli (figure 1)