American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the first-line pharmacologic therapy for weight loss?

1. Metformin

2. Orlistat

3. Phentermine

4. Topiramate

The correct answer is: Orlistat

The first-line pharmacologic therapy for weight loss is orlistat. Orlistat works by inhibiting the absorption of dietary fats in the intestines, leading to reduced caloric intake and weight loss. It has been studied extensively and is considered effective in aiding weight loss when combined with lifestyle modifications, including diet and exercise. The use of orlistat is supported by clinical guidelines and its approval by regulatory authorities for weight management. It may be particularly beneficial for individuals who are overweight or obese and have not achieved sufficient weight loss through dietary changes alone. In contrast, metformin is primarily used for type 2 diabetes management but may have modest weight loss effects in some patients. Phentermine is a stimulant that suppresses appetite but is typically considered a short-term option due to its potential for side effects and addiction. Topiramate is an anticonvulsant that has also been used for weight loss but is not as commonly cited as a first-line treatment. Overall, orlistat stands out as a well-established option for those seeking pharmacologic assistance in their weight loss journey.