Lorcaserin vs. Phentermine among non-surgical and surgical obese patients: Anthropometric, glycemic, lipid, safety and cost outcomes

Background: To evaluate effectiveness, safety, and costs of Lorcaserin vs. phentermine among obese non-surgical and surgical patients (post bariatric surgery). Methods: This retrospective study retrieved charts of all patients (January 2013-June 2016) who received Lorcaserin or phentermine for 3 months. The study assessed anthropometric, glycemic, and lipid changes, as well as side effects and cost of medications among overweight and obese non-surgical (n=83) and surgical patients (n=46). These two patient groups were compared using Chi-square (chi(2)) and unpaired't' test for qualitative and quantitative variables respectively. Results: At 3 months, among the non-surgical group, Phentermine patients had greater percentage of total weight loss (TWL%) (7.65 +/- 8.26 vs. 2.99 +/- 3.72%, P=0.003), and greater BMI reduction (-3.16 +/- 3.63 vs. -1.15 +/- 1.53 kg/m(2), P=0.003) than Lorcaserin. Within the surgical group, Lorcaserin patients had significantly smaller TWL% (1.86 +/- 5.06 vs. 7.62 +/- 9.80%, P=0.012), and smaller BMI reduction (-0.74 +/- 1.80 vs. -3.06 +/- 4.08 kg/m(2), P=0.012) than Phentermine. Lorcaserin exhibited significant total cholesterol and LDL improvements only among surgical patients with significant weight reduction (>= 5% TW). Both medications were not associated with glycemic improvements among non-surgical and surgical groups. Phentermine had slightly more side effects but was less expensive. Conclusions: Among both patient groups, phentermine was more effective in achieving weight loss. Lorcaserin showed dyslipidemia improvements only among surgical patients who achieved significant weight reduction. Anti-obesity medications as part of weight management programs can result in weight loss among non-surgical and surgical patients, or halt weight regain among surgical patients. This is the first study to evaluate the effectiveness and safety of two anti-obesity medications (lorcaserin vs. phentermine) among two distinct obese patient groups, non-surgical and surgical patients.