Effect of Obesity Pharmacotherapy on anthropometrics, metabolic parameters and blood pressure in patients with obesity or overweight: An umbrella review of systematic reviews and meta-analyses of randomized clinical trials

The effects of obesity pharmacotherapy on anthropometric and cardiometabolic indicators have been a discrepancy in the reviewed studies. This umbrella review aimed to evaluate the effect of obesity pharmacotherapy on anthropometric and metabolic parameters in patients with obesity or overweight. Methods: The Cochrane Library, PubMed, Scopus, Cochrane, Google Scholar, and Web of Science databases were searched by two independent researchers using mesh terms until November 2023. Exposure consisted of pharmacotherapy for obesity with one of the (orlistat, sibutramine, phentermine, lorcaserin, liraglutide, and naltrexone for at least six months). Changes in anthropometric indicators (weight loss, body mass index, and waist circumference), metabolic changes (triglycerides, cholesterol, and hemoglobin A1C (HbA1c)), and systolic and diastolic blood pressure were investigated as outcomes of the study. The AMSTAR2 checklist was used to assess the quality of the studies, and Cochran’s tests were used to assess heterogeneity between studies. In total, 28 meta-analyses were included. Results: The pooled estimate showed that obesity pharmacotherapy was significantly associated with weight reduction (standardized mean difference [SMD]: -5.02, 95% confidence interval [CI]: -6.13, -3.91), BMI (SMD: -1.60, 95% CI: -1.84, -1.35), and waist circumference (SMD: -3.11, 95%CI: -4.78, -1.45). In addition, Obesity Pharmacotherapy significantly reduced cholesterol, triglyceride, and HbA1C, systolic and diastolic blood pressure. Conclusion: This umbrella showed that Obesity pharmacotherapy, regardless of the type of drug, was associated with a decrease in anthropometric, metabolic, systolic, and diastolic blood pressure indicators. Sibutramine, orlistat, and liraglutide had the greatest effect on reducing the anthropometric indices. Orlistat had the greatest effect in reducing mean HbA1C. According to the Amstar2 checklist, most studies included in this umbrella were of high and moderate quality.