scholarly journals Drugs in the treatment of obesity: sibutramine, orlistat and rimonabant

2007 ◽  
Vol 10 (10A) ◽  
pp. 1200-1205 ◽  
Author(s):  
Miguel A Rubio ◽  
Manuel Gargallo ◽  
Ana Isabel Millán ◽  
Basilio Moreno
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Cardiometabolic Risk ◽  
The Body ◽  
Cardiometabolic Risk Factors ◽  
Phase Iii ◽  
Diabetic Patients ◽  
Long Term Treatment ◽  
Treatment Of Obesity

AbstractBackgroundModification of lifestyle is the main therapeutical approach in the treatment of obesity, but use to fail on long terms of time. Addition of anti-obesity drugs allows keeping the weight loss during years and improving obesity-related comorbidities.MethodsThis review is an actualisation on efficacy, safety and tolerability of the approved drugs on the long-term treatment of obesity (orlistat and sibutramine). New indications and effects of their use far beyond the weight loss are as well commented. Finally, potential benefits of the administration of CB1 antagonist rimonabant on the weight loss and cardiometabolic risk factors are analysed in detail.DiscussionA decade of experience on the use of orlistat and sibutramine has demonstrated their higher efficacy on the weight loss when compared to placebo either on adult or teenage population as well as safety and tolerability on long-term administration. Beneficial effects on the lipid profile, glycosilated haemoglobin on diabetic patients, blood pressure and levels of inflammatory cytokines, contribute to decrease the cardiovascular risk on obese patients. Phase III clinical trials using rimonabant show additional benefits to the expected weight loss, mainly reducing visceral fat and cardiometabolic risk factors.ConclusionPharmacological treatment of obesity must be considered as a therapeutical tool that has to be used together with long-term lifestyle changes, contributing to the body weight reduction as well as to the improvement of the cardiometabolic risk related to obesity.

scholarly journals Effects of Extreme Weight Loss on Cardiometabolic Health in Children With Metabolic Syndrome: A Metabolomic Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jingxin Liu ◽  
Lin Zhu ◽  
Jing Liao ◽  
Xiaoguang Liu
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Body Composition ◽  
Organic Acids ◽  
Cardiometabolic Risk ◽  
The Body ◽  
Cardiometabolic Risk Factors ◽  
Plasma Metabolites ◽  
Cardiometabolic Health

Objectives: To evaluate the effect of extreme weight loss programs on circulating metabolites and their relationship with cardiometabolic health in children with metabolic syndrome.Methods: This study was a quasi-experimental design with a pretest and post-test. Thirty children with metabolic syndrome and aged 10–17years were recruited to an extreme weight loss program (i.e., exercise combined with diet control). The primary outcomes included plasma metabolites, body composition, and cardiometabolic risk factors. A total of 324 metabolites were quantitatively detected by an ultra-performance liquid chromatography coupled to tandem mass spectrometry system, and the variable importance in the projection (VIP) value of each metabolite was calculated by the orthogonal projection to latent structures discriminant analysis. The fold change (FC) and p value of each metabolite were used to screen differential metabolites with the following values: VIP>1, p value<0.05, and |log2FC|>0.25. Pathway enrichment and correlation analyses between metabolites and cardiometabolic risk factors were also performed.Result: A large effect size was observed, presenting a weight loss of −8.9kg (Cohen’s d=1.00, p<0.001), body mass index reduction of −3.3kg/m2 (Cohen’s d=1.47, p<0.001), and body fat percent reduction of −4.1 (%) (Cohen’s d=1.22, p<0.001) after the intervention. Similar improvements were found in total cholesterol (Cohen’s d=2.65, p<0.001), triglycerides (Cohen’s d=2.59, p<0.001), low-density lipoprotein cholesterol (Cohen’s d=2.81, p<0.001), glucose metabolism, and blood pressure. A total of 59 metabolites were changed after the intervention (e.g., aminoacyl-tRNA biosynthesis, glycine, serine, and threonine metabolism; nitrogen metabolism, tricarboxylic acid cycle, and phenylalanine, tyrosine, and tryptophan biosynthesis). The changes in metabolites (e.g., amino acids, fatty acids, organic acids, and carnitine) were related to lipid metabolism improvement (p<0.05). Organic acids and carnitines were associated with changes in the body composition (p<0.05).Conclusion: Exercise combined with dietary control improved the body composition and cardiometabolic health in children with metabolic syndrome, and these changes may be related to plasma metabolites.

scholarly journals The adolescent with obesity: what perspectives for treatment?

2022 ◽  
Vol 48 (1) ◽  
Author(s):  
Antonio Nicolucci ◽  
Claudio Maffeis
Keyword(s):  
Risk Factors ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Cardiometabolic Risk ◽  
Public Health Problem ◽  
Overweight And Obesity ◽  
Cardiometabolic Risk Factors ◽  
Major Public Health Problem ◽  
Lifestyle Interventions

AbstractThe dramatic increase in overweight and obesity among children and adolescents has become a major public health problem. Obesity in children and young adults is associated with an increased prevalence of cardiometabolic risk factors. Obesity during adolescence represents a strong predictor of obesity and higher mortality in adulthood. Due to the serious implications of obesity in adolescents, effective treatments are urgently needed. Lifestyle interventions represent the recommended therapy. Nevertheless, real world data show that the majority of adolescents do not achieve weight loss in the long term, and are reluctant to participate in lifestyle interventions. Pharmacological treatment is recommended if a formal lifestyle modification program fails to limit weight gain or to improve comorbidities. However, until 2020 the European Medicines Agency (EMA) had not approved any pharmacotherapeutic agents for obesity in pediatric patients. On April 2021, EMA has authorized the use of Liraglutide, a glucagon-like peptide (GLP)-1 analog, for the treatment of obesity in adolescents (12–17 years). The efficacy and safety of Liraglutide were demonstrated in a randomized, double-blind trial, enrolling 251 adolescents. After 56 weeks, a reduction in BMI of at least 5% was observed in 43.3% of participants in the liraglutide group vs. 18.7% in the placebo group, and a reduction in BMI of at least 10% was observed in 26.1 and 8.1%, respectively. Gastrointestinal events were the events most frequently reported with liraglutide. Bariatric surgery represents another effective treatment for adolescents with severe obesity, with sustained benefits on weight loss and cardiometabolic risk factors. However, long-term safety and effectiveness data in adolescents are still scarce. Risks of bariatric surgery include the need for additional abdominal surgical procedures and specific micronutrient deficiencies. Hopefully, new pharmacological treatments in addition to lifestyle interventions will offer more chances of success.

scholarly journals Glucocorticoid receptor polymorphisms modulate cardiometabolic risk factors in patients in long-term remission of Cushing’s syndrome

Endocrine ◽  
2016 ◽  
Vol 53 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Sean H. P. P. Roerink ◽  
M. A. E. M. Wagenmakers ◽  
J. W. A. Smit ◽  
E. F. C. van Rossum ◽  
R. T. Netea-Maier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Glucocorticoid Receptor ◽  
Cushing’S Syndrome ◽  
Cardiometabolic Risk ◽  
Cushing's Syndrome ◽  
Cardiometabolic Risk Factors ◽  
Glucocorticoid Receptor Polymorphisms

scholarly journals Effects of whole and refined grains on cardiometabolic risk factors in a controlled‐feeding, weight loss study: Preliminary findings

2012 ◽  
Vol 26 (S1) ◽  
Author(s):  
Kristina Arline Harris ◽  
Shiela West ◽  
Jack Vanden Heuvel ◽  
Satya Jonnalagadda ◽  
Penny Kris-Etherton
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Refined Grains ◽  
Weight Loss Study

scholarly journals Late eating is associated with cardiometabolic risk traits, obesogenic behaviors, and impaired weight loss

2020 ◽  
Vol 113 (1) ◽  
pp. 154-161 ◽  
Author(s):  
Hassan S Dashti ◽  
Puri Gómez-Abellán ◽  
Jingyi Qian ◽  
Alberto Esteban ◽  
Eva Morales ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Cardiometabolic Health ◽  
Activity Levels ◽  
Weight Loss Intervention ◽  
Meal Intake ◽  
Intervention Protocol ◽  
Obesogenic Behaviors

ABSTRACT Background There is a paucity of evidence regarding the role of food timing on cardiometabolic health and weight loss in adults. Objectives To determine whether late eating is cross-sectionally associated with obesity and cardiometabolic risk factors at baseline; and whether late eating is associated with weight loss rate and success following a weight loss intervention protocol. Also, to identify obesogenic behaviors and weight loss barriers associated with late eating. Methods Participants were recruited from a weight-loss program in Spain. Upon recruitment, the midpoint of meal intake was determined by calculating the midway point between breakfast and dinner times, and dietary composition was determined from diet recall. Population median for the midpoint of meal intake was used to stratify participants into early (before 14:54) and late (after 14:54) eaters. Cardiometabolic and satiety hormonal profiles were determined from fasting blood samples collected prior to intervention. Weekly weight loss and barriers were evaluated during the ∼19-wk program. Linear and logistic regression models were used to assess differences between late and early eaters in cardiometabolic traits, satiety hormones, obesogenic behaviors, and weight loss, adjusted for age, sex, clinic site, year of recruitment, and baseline BMI. Results A total of 3362 adults [mean (SD): age: 41 (14) y; 79.2% women, BMI: 31.05 (5.58) kg/m2] were enrolled. At baseline, no differences were observed in energy intake or physical activity levels between early and late eaters (P >0.05). Late eaters had higher BMI, higher concentrations of triglycerides, and lower insulin sensitivity compared with early eaters (all P <0.05) prior to intervention. In addition, late eaters had higher concentrations of the satiety hormone leptin in the morning (P = 0.001). On average, late eaters had an average 80 g lower weekly rate of weight loss [early, 585 (667) g/wk; late, 505 (467) g/wk; P = 0.008], higher odds of having weight-loss barriers [OR (95% CI): 1.22 (1.03, 1.46); P = 0.025], and lower odds of motivation for weight loss [0.81 (0.66, 0.99); P = 0.044] compared with early eaters. Conclusion Our results suggest that late eating is associated with cardiometabolic risk factors and reduced efficacy of a weight-loss intervention. Insights into the characteristics and behaviors related to late eating may be useful in the development of future interventions aimed at advancing the timing of food intake.

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