The Effectivity and Safety of Naltrexone/Bupropion in Patients Suffering from Overweight and Obesity in a Real-World Setting

INTRODUCTION: Bariatric and metabolic surgery carries risks of complications and may affect food tolerance. For patients who are overweight or do not meet surgical criteria, alternative weight loss strategies must be explored. One such option is naltrexone/bupropion (NB) treatment. This study evaluates the impact of NB treatment combined with lifestyle intervention on weight loss over 12 months in a real-world setting. METHODS: A retrospective cohort study included all patients initiating NB treatment at the Dutch Obesity Clinic from February 2021 to October 2022. RESULTS: Among 98 patients (17.5% male; median age 49 [43-53]; median BMI 35.4 [33.0-39.1]), mean percentage total weight loss (SD) was 7.9% (4.2) at 3 months, 10.3% (6.5) at 6 months, and 11.5% (8.3) at 12 months. During the buildup phase, 23.5% of patients experienced nausea/vomiting, 19.4% reported headaches, and 28.6% had constipation. At optimal dosage, 39.8% experienced side effects, with 33% reporting multiple symptoms. Treatment discontinuation within 12 months occurred in 52.7% of patients. CONCLUSION: NB treatment combined with lifestyle intervention results in significant weight loss after 6 and 12 months. Despite high discontinuation rates due to multiple reasons including side effects, NB treatment in combination with lifestyle intervention may be of interest for a specific population.