Abstract
Introduction: The rise of the obesity pandemic has been underestimated since most assessments do not include perhaps up to 2.7 billion patients with excessive stores of adipose tissue and calories. A variety of classes of anti-obesity drugs approved for other indications have been used off-label in attempts to promote weight loss. Objective: It was to discuss the main off-label drugs for treating excess fatty tissue and obesity through clinical studies and consensus among world societies. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from September to October 2023 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 115 articles were found, 30 articles were evaluated in full, and 22 were included and developed in the present systematic review study, out of a total of 24 (2 references are on the website and were not included) Considering the Cochrane tool for risk of bias, the overall evaluation resulted in 18 studies with high risk of bias and 27 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=58.6%>50%. It was concluded that the current paradigm for the diagnosis and treatment of obesity is for those with high BMI, however, the paradigm is flawed for patients with lower BMI in the early stages of abnormal adipose tissue accumulation, who are often ignored and left without treatment. This promotes the continuation of obesity worldwide, allowing early-stage patients to accumulate increasingly greater amounts of adipose tissue. Thus, the use of off-label antiobesity drugs has accumulated scientific evidence for a safe and effective treatment. However, it is still necessary to promote more observational studies and medical reports to corroborate the findings so far present in randomized studies.