Pharmacotherapy of obesity
by
Finer N.
Wellcome Trust Clinical Research Facility
Honorary Consultant in Obesity Medicine,
Addenbrooke's Hospital, Cambridge, UK
Best Pract Res Clin Endocrinol Metab 2002 Dec;16(4):717-42


ABSTRACT

The growing recognition of the health risks of obesity coupled with the difficulties in treating it successfully by lifestyle modification predicates a need for effective drug treatment. The history of drug treatment in the second half of the 20th century is, however, one of disappointment and concern over drug toxicity. However, the advances in our understanding of the mechanism of weight control, together with improved ways of evaluating anti-obesity drugs, has resulted in two effective compounds, sibutramine and orlistat, becoming available for clinical use. Sibutramine has actions on both energy intake and expenditure and had been shown to enhance weight loss and weight maintenance achieved by diet, in simple obesity as well as when accompanied by complications of diabetes or hypertension. About 50-80% of patients can achieve a >5% loss, significantly more than if patients receive the same lifestyle intervention with placebo. Orlistat, which acts peripherally to block the absorption of dietary fat, has had similar results in clinical trials; a recent study (XENDOS) has just reported results which show that the enhanced, albeit modest, weight loss achieved with orlistat delays the development of diabetes over a 4-year period. A number of other compounds are expected to complete or enter clinical trials over the next decade. There is considerable optimism that we will soon have the pharmacological tools needed to make the treatment of obesity feasible.
Fen/Phen
Serotonin
Tesofensine
Sibutramine
Noradrenaline
Amphetamines
SSRIs and SNRIs
New slimming drugs
Beta-adrenoeceptors
Sibutramine compared
Sibutramine and obesity
Drug-induced weight gain
Sibutramine for binge-eaters
Sibutramine v dexfenfluramine
Sibutramine as an antidepressant
Sibutramine: clinical pharmacology
Body weight changes associated with psychopharmacology



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