Long-term health benefits of appetite suppressants remain unproven

Abstract

Because of the increasing prevalence of obesity, prevention and treatment of overweight has become a major public health concern. In addition to diet and exercise, drugs are needed for patients who failed to lose weight with behavioral treatment. The current article aimed to summarize recent concerns on the safety and effi cacy of appetite suppressants. Several appetite suppressants have been banned for safety reasons. In 2010, sibutramine was withdrawn from the market because a long-term study showed it increased the risks of cardiovascular events. So far no study with a suffi ciently large sample size has demonstrated that appetite suppressants can reduce morbidity and mortality associated with overweight. The withdrawal of sibutramine highlights that guidelines for the evaluation of weight control drugs must be more stringent, and studies on their long-term health benefi ts are needed prior to their marketing. RESUMOO aumento da prevalência da obesidade tornou a prevenção e tratamento do sobrepeso importante desafi o para a Saúde Pública. Além da dieta e exercício, os medicamentos são necessários para pacientes que não conseguem perder peso com as mudanças comportamentais. O objetivo do artigo foi sumarizar as preocupações atuais com a segurança e efetividade de medicamentos inibidores do apetite. Vários anorexígenos foram banidos por razões de segurança. Em 2010, a sibutramina foi retirada do mercado porque um estudo de longa duração mostrou que ela aumentava o risco de eventos cardiovasculares. Até agora nenhum estudo com número expressivo de pacientes demonstrou que anorexígenos reduzem a morbi-mortalidade associada ao sobrepeso. A retirada da sibutramina do mercado mostra que diretrizes para avaliação de medicamentos anorexígenos devem ser mais rigorosas, e que estudos de longa duração sobre os benefícios para a saúde devem ser realizados antes da comercialização. Rev Saúde Pública 2011;45(6):1192-6 During recent decades the prevalence of overweight (body mass index -BMI >25 kg/m 2 ) and obesity (BMI >30 kg/m 2 ) has steadily increased worldwide. It was recently reported that 33.8% of adults (≥20 years old) in the US, and 20% of adults in Europe are obese. DESCRITORES:1,a In Brazil, the prevalence of overweight and obesity have also soared, and a recent survey has estimated that nearly 50% of the population (all ages, males and females) are over the "ideal" weight and at least 13% are obese. Since overweight was shown to contribute to the development and aggravation of chronic conditions such as type 2 diabetes, hypertension, cardiovascular diseases, and several types of cancer, prevention and treatment of obesity is today a major public health concern.