Anorectics

Anorectics, also called anorexiants, are medications that suppress appetite and are used as part of obesity treatment when diet, exercise, and behavioral changes alone have not achieved sufficient weight loss. They are usually prescribed for short-term use due to limited efficacy and safety concerns.

Most act on the central nervous system, increasing monoamines such as norepinephrine and serotonin to reduce hunger signals in the hypothalamus. Some agents have peripheral effects, such as inhibiting fat absorption or altering gut hormones. The intended outcome is lower caloric intake and enhanced weight loss when combined with lifestyle measures.

Historically available agents include stimulant-type drugs such as phentermine and diethylpropion. Others, such as sibutramine and the earlier fenfluramine/dexfenfluramine, were withdrawn from many markets because of cardiovascular risks and other safety concerns. Orlistat and GLP-1–based therapies are related approaches but not classic anorectics; they act by fat absorption inhibition or by appetite suppression via gut-brain signaling, respectively.

Safety and monitoring focus on cardiovascular risk, hypertension, tachycardia, insomnia, dependence potential, and interactions with other stimulants or antidepressants. Contraindications include cardiovascular disease, uncontrolled hypertension, arrhythmias, hyperthyroidism, glaucoma, pregnancy, and substance use disorders. Given safety issues and modest long-term efficacy, current practice emphasizes short-term use as part of a broader weight-management plan.