Which weight-loss medication class would be most beneficial to add to the regimen in a patient who failed previous therapy, as described in the case?

Which weight-loss medication class would be most beneficial to add to the regimen in a patient who failed previous therapy, as described in the case?

• A. Orlistat
• B. Lorcaserin
• C. Liraglutide
• D. Phentermine

Answer: (C)

The main idea here is that after previous weight-loss therapies have failed, choosing a medication with a different mechanism and proven, durable weight loss is most effective. Liraglutide is a GLP-1 receptor agonist that reduces appetite and slows gastric emptying, leading to meaningful, sustained weight loss when used long-term. In weight-management trials, liraglutide at the approved dose for obesity produces greater weight loss and metabolic benefits than many older agents, with typical losses in the range of several percent of body weight over a year and added improvements in glycemic control and cardiovascular risk factors. It provides a robust option for ongoing therapy, which is important after failure of previous regimens. In contrast, the other options have limitations: orlistat yields modest weight loss and causes gastrointestinal side effects; lorcaserin (withdrawn in many places) carries cancer risk concerns; phentermine is generally used short-term due to stimulant-related side effects and potential misuse. Thus, liraglutide offers the strongest, most durable benefit for a patient not responding to prior pharmacotherapy.

The main idea here is that after previous weight-loss therapies have failed, choosing a medication with a different mechanism and proven, durable weight loss is most effective. Liraglutide is a GLP-1 receptor agonist that reduces appetite and slows gastric emptying, leading to meaningful, sustained weight loss when used long-term. In weight-management trials, liraglutide at the approved dose for obesity produces greater weight loss and metabolic benefits than many older agents, with typical losses in the range of several percent of body weight over a year and added improvements in glycemic control and cardiovascular risk factors. It provides a robust option for ongoing therapy, which is important after failure of previous regimens.

In contrast, the other options have limitations: orlistat yields modest weight loss and causes gastrointestinal side effects; lorcaserin (withdrawn in many places) carries cancer risk concerns; phentermine is generally used short-term due to stimulant-related side effects and potential misuse. Thus, liraglutide offers the strongest, most durable benefit for a patient not responding to prior pharmacotherapy.