Obesity Therapy: How and Why?

2020 ◽  
Vol 27 (2) ◽  
pp. 174-186 ◽  
Author(s):  
Sara Paccosi ◽  
Barbara Cresci ◽  
Laura Pala ◽  
Carlo Maria Rotella ◽  
Astrid Parenti
Keyword(s):  
Weight Loss ◽  
Lifestyle Modification ◽  
Herbal Medicines ◽  
The Internet ◽  
Obese Patients ◽  
Self Medication ◽  
Pharmacological Management ◽  
Regulatory Standards ◽  
Meta Analyses ◽  
Obesity Drugs

Background: Obesity represents the second preventable mortality cause worldwide, and is very often associated with type 2 Diabetes Mellitus (T2DM). The first line treatment is lifestyle modification to weight-loss, but for those who fail to achieve the goal or have difficulty in maintaining achieved results, pharmacological treatment is needed. Few drugs are available today, because of their side effects. Objective: We aim to review actual pharmacological management of obese patients, highlighting differences between Food and Drug Administration - and European Medicine Agency-approved molecules, and pointing out self-medications readily obtainable and widely distributed. Methods: Papers on obesity, weight loss, pharmacotherapy, self- medication and diet-aid products were selected using Medline. Research articles, systematic reviews, clinical trials and meta-analyses were screened. Results: Anti-obesity drugs with central mechanisms, such as phentermine and lorcaserin, are available in USA, but not in Europe. Phentermine/topiramate and naltrexone/bupropion combinations are now available, even though the former is still under investigation from EMA. Orlistat, with peripheral mechanisms, represents the only drug approved for weight reduction in adolescents. Liraglutide has been approved at higher dose for obesity. Anti-obesity drugs, readily obtainable from the internet, include crude-drug products and supplements for which there is often a lack of compliance to national regulatory standards. Conclusion: Mechanisms of weight loss drugs include the reduction of energy intake or the increase in energy expenditure and sense of satiety as well as the decrease of hunger or the reduction in calories absorption. Few drugs are approved, and differences exist between USA and Europe. Moreover, herbal medicines and supplements often sold on the internet and widely used by obese patients, present a risk of adverse effects.

Leptin Receptor Lys656Asn Polymorphism Is Associated with Decreased Leptin Response and Weight Loss Secondary to a Lifestyle Modification in Obese Patients

2006 ◽  
Vol 37 (7) ◽  
pp. 854-859 ◽  
Author(s):  
Daniel de Luis Roman ◽  
Rocio Aller de la Fuente ◽  
Manuel Gonzalez Sagrado ◽  
Olatz Izaola ◽  
Rosa Conde Vicente
Keyword(s):  
Weight Loss ◽  
Leptin Receptor ◽  
Lifestyle Modification ◽  
Obese Patients

scholarly journals A Global Review of Obesity

2021 ◽  
Vol 68 (1) ◽  
Author(s):  
Vijay. J ◽  
Natarajan. P ◽  
Gokul. V ◽  
Janani. A.M ◽  
Mumthaj. P
Keyword(s):  
Weight Loss ◽  
Causes Of Death ◽  
Obese Patients ◽  
Weight Regulation ◽  
Pharmacological Agents ◽  
Major Health Problem ◽  
Major Health ◽  
Sustained Weight Loss ◽  
Control Body ◽  
Obesity Drugs

Obesity is major health problem and are defined as abnormal or excessive amount of fat accumulation that presents a risk to health. A body mass index (BMI) over 24 is considered overweight, and over 30 is obese. obesity are main risk factors for a number of chronic diseases, like cardiovascular diseases such as heart disease and stroke, which are the leading causes of death worldwide. Over 800 million people around the world are living with obesity. The medical consequences of obesity will cost over $1 trillion by 2025. People living with obesity are twice as likely to be hospitalized if tested positive for COVID-19. The weight loss segments are one of the major contributors to the overall revenue of the dietary supplements in market. Anti-obesity drugs are used as pharmacological agents which reduce or control body weight. These drugs can change one of the fundamental processes of the human body or weight regulation by altering either appetite or absorption of calories. The treatment for obese patients is dieting and physical exercise. An anti-obesity drug have produce sustained weight loss with minimal side effects.

Comparative efficacy of bariatric endoscopic procedures in the treatment of morbid obesity: a systematic review and network meta-analysis

Endoscopy ◽  
2020 ◽  
Vol 52 (11) ◽  
pp. 940-954
Author(s):  
Sung Hoon Jung ◽  
Jai Hoon Yoon ◽  
Hyuk Soon Choi ◽  
Seung-Joo Nam ◽  
Kyoung Oh Kim ◽  
...  
Keyword(s):  
Weight Loss ◽  
Botulinum Toxin ◽  
Lifestyle Modification ◽  
Meta Analysis ◽  
Botulinum Toxin Injection ◽  
Comparative Efficacy ◽  
Endoscopic Procedures ◽  
Significant Difference ◽  
Meta Analyses ◽  
Jejunal Bypass

Abstract Background The comparative efficacy of bariatric endoscopic procedures has not been completely elucidated. We aimed to comprehensively evaluate the efficacy of bariatric endoscopic procedures. Methods We searched for randomized controlled trials investigating the efficacy of bariatric endoscopic procedures, including the use of an intragastric balloon, duodenal-jejunal bypass liner (DJBL), aspiration therapy, primary obesity surgery endoluminal (POSE) procedure, and botulinum toxin injection to the stomach. Network meta-analyses were performed to determine the percentage of weight loss (%weight loss) and percentage of excess weight loss (%EWL). Results 22 studies with 2141 patients were included in the meta-analysis. Most endoscopic procedures showed superior efficacy in terms of %weight loss compared with the control (mean difference [MD] [95 % confidence interval (CI)]: aspiration therapy 10.4 % [7.0 % to 13.7 %]; fluid-filled balloon 5.3 % [3.4 % to 7.2 %]; POSE 4.9 % [1.7 % to 8.2 %]; and DJBL 4.5 % [1.4 % to 7.7 %]). In terms of %EWL, aspiration therapy, fluid-filled balloon, POSE, and DJBL were superior to the control (MD [95 %CI]: 27.3 % [15.3 % to 39.3 %]; 22.4 % [15.4 % to 29.4 %]; 15.3 % [2.5 % to 28.0 %]; and 13.0 % [4.9 % to 21.2], respectively). The gas-filled balloon and botulinum toxin injection did not show a significant difference in %weight loss or %EWL compared with the control. For the fluid-filled balloon, the %EWL and %weight loss tended to decrease after balloon removal at 6 months after the procedure. Conclusion All bariatric endoscopic procedures, except for gas-filled balloon and botulinum toxin injection to the stomach, showed superior short-term efficacy in terms of %weight loss or %EWL compared with lifestyle modification.

scholarly journals A contemporary view on obesity treatment in adults

2021 ◽  
pp. 45-50
Author(s):  
V.I. Velychko ◽  
B.M. Mankovskyi ◽  
T.F. Tatarchuk ◽  
D.O. Lahoda ◽  
I.M. Todurov ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Fat ◽  
Lifestyle Modification ◽  
Obesity Treatment ◽  
Pharmacological Therapy ◽  
Overweight And Obesity ◽  
Evidence Based ◽  
Obese Patients ◽  
Lifestyle Modifications

Today, the prevalence of overweight and obesity is pandemic. This disorder is defined as “a complex chronic disease in which abnormal or excess body fat impairs health, increases the risk of long-term medical complications, and decreases life expectancy”.This article presents evidence-based clinical guidelines for the management of obese patients, as well as excerpts comments on pharmacological treatment.Treatment approaches for overweight and obese patients include behavioral interventions, lifestyle adjustments, etc. One of the methods is pharmacological therapy, based on the following principles: therapy for weight loss can be used starting already at a body mass index ≥ 27 kg/m2 or ≥ 30 kg/m2 with complications associated with excess body fat. As drugs can be used liraglutide, combination of naltrexone + bupropion, orlistat. Pharmacotherapy must be accompanied by lifestyle modification, including if necessary therapeutic diet, increased physical activity on ongoing basis with its mandatory control, and behavioral or cognitive-behavioral therapy. Pharmacotherapy can be used to support the weight loss achieved through lifestyle modifications and to prevent weight gain. It is forbidden to use over-the-counter drugs unless they are approved for weight control. Patients with metabolic obesity should be consulted by specialists to assess the feasibility of bariatric surgery, followed by treatment with this specialist.Every clinician must have sufficient knowledge to diagnose obesity and offer their patients an individualized, long-term, evidence-based weight loss regimen. The success of obesity treatment depends on the patient's trust the doctor and on the doctor's knowledge in this area.

scholarly journals Acute liver failure and self-medication

2014 ◽  
Vol 27 (4) ◽  
pp. 294-297 ◽  
Author(s):  
André Vitorio Câmara de OLIVEIRA ◽  
Frederico Theobaldo Ramos ROCHA ◽  
Sílvio Romero de Oliveira ABREU
Keyword(s):  
Weight Loss ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Green Tea ◽  
Liver Damage ◽  
Herbal Medicines ◽  
Cochrane Library ◽  
Self Medication ◽  
Additional Information ◽  
High Doses

INTRODUCTION: Not responsible self-medication refers to drug use in high doses without rational indication and often associated with alcohol abuse. It can lead to liver damage and drug interactions, and may cause liver failure. AIM: To warn about how the practice of self-medication can be responsible for acute liver failure. METHOD: Were used the Medline via PubMed, Cochrane Library, SciELO and Lilacs, and additional information on institutional sites of interest crossing the headings acute liver failure [tiab] AND acetaminophen [tiab]; self-medication [tiab] AND acetaminophen [tiab]; acute liver failure [tiab] AND dietary supplements [tiab]; self-medication [tiab] AND liver failure [tiab] and self-medication [tiab] AND green tea [tiab]. In Lilacs and SciELO used the descriptor self medication in Portuguese and Spanish. From total surveyed were selected 27 articles and five sites specifically related to the purpose of this review. CONCLUSIONS: Legislation and supervision disabled and information inaccessible to people, favors the emergence of cases of liver failure drug in many countries. In the list of released drugs that deserve more attention and care, are some herbal medicines used for the purpose of weight loss, and acetaminophen. It is recommended that institutes of health intensify supervision and better orient their populations on drug seemingly harmless, limiting the sale of products or requiring a prescription for release them.

scholarly journals Weight Loss at First Month and Development of Tolerance as Possible Predictors of 30 mg Phentermine Efficacy at 6 Months

2021 ◽  
Vol 11 (12) ◽  
pp. 1354
Author(s):  
Héctor Isaac Rocha-González ◽  
Lidia Elizabeth De la Cruz-Álvarez ◽  
Ashuin Kammar-García ◽  
Samuel Canizales-Quinteros ◽  
Juan Carlos Huerta-Cruz ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Interindividual Variability ◽  
Body Weight Loss ◽  
Obese Patients ◽  
High Degree ◽  
Obesity Drugs ◽  
Continue Therapy ◽  
Development Of Tolerance

The efficacy of anti-obesity drugs usually does not consider the high degree of interindividual variability in responses to the drug which could affect the decision to withdraw the drug early due to ineffectiveness or to continue therapy according to specific expectations of success. The aim of this study was to analyze body weight loss in kilograms during the first month (1 mo-BWLkg) of treatment with 30 mg phentermine and development of tolerance to phentermine, on its 6-month efficacy. One hundred sixty-six subjects with obesity were individually or jointly analyzed in the study. Subjects with 1 mo-BWLkg of <1 kg, 1–3 kg, 3–5 kg, and ≥5 kg reached 6-month mean percentage body weight reductions (BWR%) of approximately 3%, 5%, 10%, and 15%, respectively. Development of late tolerance (4–6 months) to phentermine had a lower impact than early tolerance (2–3 months). Subjects with 1 mo-BWLkg <3 kg who developed early tolerance did not achieve relevant BWR% (≥5%) at month 6, while the rest of the subgroups achieved increasing and progressive BWR%, according to their 1 mo-BWLkg range and time of onset of tolerance. The 1 mo-BWLkg and development of tolerance to phentermine could be useful to predict the expected 6-month efficacy trends in obese patients treated with 30 mg phentermine.

Sign in / Sign up

Export Citation Format

Share Document