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These include: Orlistat : A lipase inhibitor that reduces fat absorption, with a different mechanism and side effect profile than appetite suppressants Naltrexone-bupropion : A combination medication affecting reward pathways and appetite regulation Phentermine-topiramate ER (Qsymia) : An FDA-approved combination that has been studied more extensively than phentermine-semaglutide and is approved for long-term use Tirzepatide (Zepbound) : A dual GIP/GLP-1 receptor agonist that has demonstrated greater weight loss than semaglutide in head-to-head clinical trials (SURMOUNT-5) Intensive lifestyle interventions remain foundational to successful weight management
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It was demonstrated, that metabolic disturbances in hypothalamic astrocytes, caused either by selective knock-out of insulin receptors or decreased generation of reactive oxygen species (ROS) modulated glucose transport via BBB and also led to modification in behavioral responses in experimental animals [95, 96]
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