Systematic Review Maps GI Side Effects of Anti-Obesity Drugs in Non-Diabetics

Obesity is a global health crisis, significantly increasing the risk of numerous chronic conditions like cardiovascular disease, type 2 diabetes, and certain cancers. While lifestyle interventions are foundational, anti-obesity medications (AOMs) have become increasingly vital tools in managing weight. However, these medications are frequently associated with gastrointestinal (GI) adverse effects, which can impact patient adherence and quality of life. This systematic review addresses a critical knowledge gap by comprehensively synthesizing the evidence on the prevalence and nature of GI adverse effects specifically in non-diabetic adults using AOMs.

The systematic review revealed that nausea was consistently the most frequently reported gastrointestinal adverse effect across nearly all classes of AOMs, affecting up to 45% of patients. This was closely followed by diarrhea, reported in approximately 30% of individuals, and constipation, observed in around 25%. > GLP-1 receptor agonists were particularly associated with a 3.1-fold higher incidence of nausea compared to placebo (p<0.001), and a 2.8-fold increased risk of vomiting (p<0.001). Lipase inhibitors showed a distinct profile, with steatorrhea (fatty stools) and fecal urgency occurring in up to 50% of users, leading to a 4.5-fold increase in these specific symptoms compared to control groups. While most GI effects were mild to moderate, approximately 12% of patients discontinued AOMs due to intolerable GI adverse events.