American Gastroenterological Association (AGA) guidelines are the first to make priority recommendations for antiobesity medication selection on the basis of available evidence from individual agent trials explicitly recommending the use of
(a) semaglutide 2.4 mg because of the magnitude of clinical benefit
(b) next prioritize liraglutide 3.0 mg, followed by
(c) phentermine-topiramate, and then
(d) naltrexone-bupropion.
Like the Endocrine Society, the American Gastroenterological Association guidelines also allow for off-label long term phentermine prescribing, while acknowledging the low quality of evidence in this space.
Importantly, they advise against the use of orlistat as an antiobesity medication, given the modern available options that are superior and better tolerated.
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