Long-term pharmacotherapy for obesity and overweight

Padwal, Raj; Rucker, Diana; Li, Stephanie K; Curioni, Cíntia Chaves; Lau, David C.W.

doi:10.1002/14651858.cd004094.pub2

Cited by 217 publications

(177 citation statements)

References 109 publications

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“…Treatment in adults using sibutramine or orlistat has shown a significant weight reduction although it is required to be combined with other approaches. 51 These approaches are not well-defined, instead the medical product agencies usually give a weight goal for the patient to achieve a weight reduction before the treatment starts followed by a further weight reduction in the beginning of the drug treatment.…”

Section: Treatment Based On Psychotherapy Techniquesmentioning

confidence: 99%

New insights into the field of children and adolescents’ obesity: the European perspective

et al. 2004

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EDITOR'S NOTE:The problem of childhood obesity is accelerating throughout the world. The following is a position paper from The European Childhood Obesity Group (ECOG) that outlines the nature of the problem of childhood obesity along with treatment and prevention methods available today. The paucity of literature on prevention and treatment of obesity in children as documented in this paper points out the need for much additional research on obesity in children. OBJECTIVES: The awareness of childhood obesity as a major health problem and an uncontrolled worldwide epidemic has to be increased in the society. DESIGN: In order to improve the quality of the health care and to minimize the cost it is important to investigate and standardize pediatric obesity prevention and treatment and to adapt to social and cultural aspects. RESULTS: Obesity is the result of excess body fat. The different norms and definitions in Europe and the US is described and clarified. However, the available methods for the direct measurement of body fat are not easily used in daily practice. For this reason, obesity is often assessed by means of indirect estimates of body fat, that is, anthropometrics. There are essentially six relevant levels, which could be involved in prevention of child and adolescent obesity: family (child, parents, siblings, etc), schools, health professionals, government, industry and media. Evidence-based health promotion programs has to be given a high priority. Government should encourage media increase information about healthy nutrition and to avoid the marketing of unhealthy foods including sweet drinks, for example, in TV. Many different approaches of treatments of obesity have been investigated, including diet, exercise, behavioral therapy, surgery, and medication. None have been found to be effective enough as sole tools in children. This has led to focus on multidisciplinary programs especially involving families. Behavioral cognitive therapy is effective in treating childhood obesity as is family therapy. Surgery and drug treatment cannot be recommended without additional research. Clinicians should consider the various factors that can influence body composition. CONCLUSION: It is important to know and to follow nutritional factors, energy intake and composition of the diet, nutrition and hormonal status, food preferences and behavior, and the influence of non-nutritional factors. We recommend that obesity should be the major priority both in the health care system, on the scientific level and for future political actions.

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Section: Treatment Based On Psychotherapy Techniquesmentioning

confidence: 99%

New insights into the field of children and adolescents’ obesity: the European perspective

et al. 2004

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“…A recent meta-analysis was performed on 11 orlistat trials and 5 sibutramine trials lasting 1 year or longer by the Cochrane database system (25). Compared with placebo, orlistat-treated patients lost 2.7 kg (95% CI, 2.3 to 3.1 kg) or 2.9% (95% CI, 2.3% to 3.4%) more weight, and patients on sibutramine experienced 4.3 kg (95% CI, 3.6 to 4.9 kg) or 4.6% (95% CI, 3.8% to 5.4%) greater weight loss.…”

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Trials of the D1/D5 Antagonist Ecopipam for Weight Loss in Obese Subjects

Astrup

Greenway

Ling

et al. 2007

Obesity

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“…This publication concentrates on weight loss studies and represents a condensed version of a larger review published within the Cochrane Collaboration, which also contains information on weight maintenance trials. 29 …”

Section: Objectivementioning

confidence: 99%

Long-term pharmacotherapy for overweight and obesity: a systematic review and meta-analysis of randomized controlled trials

2003

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CONTEXT: Safe and effective strategies to curb rising obesity prevalence rates are urgently needed and medications may play a more prominent role in future therapeutic regimens. OBJECTIVE: To review systematically the long-term efficacy and safety of approved antiobesity medications. DATA SOURCES: MEDLINE, EMBASE, the Cochrane Controlled Trials Register, Current Science Meta-register of Controlled Trials, and reference lists of original studies and reviews were searched. Drug manufacturers and two obesity experts were contacted. No language restrictions were imposed. STUDY SELECTION: Double-blind, randomized controlled studies of approved antiobesity medications with follow-up periods of 1 y or greater were eligible for inclusion. DATA EXTRACTION: Two reviewers independently assessed all potentially relevant studies for inclusion and methodological quality using standardized abstraction forms. RESULTS: A total of 11orlistat (n ¼ 6021) and three sibutramine (n ¼ 929) studies met inclusion criteria. Attrition rates averaged 33% in orlistat studies and 48% in sibutramine studies. A random effects model was used for meta-analysis. Compared to placebo, orlistat-treated patients displayed a 2.7 kg (95% CI: 2.3-3.1 kg) or 2.9% (95% CI: 2.3-3.4%) greater reduction in weight and patients on sibutramine displayed a 4.3 kg (95% CI: 3.6-4.9 kg) or 4.6% (95% CI: 3.8-5.4%) greater weight reduction after 1 y of follow-up. The number of patients achieving 10% or greater weight loss was 12% (95% CI: 8-16%) higher with orlistat and 15% (95% CI: 4-27%) higher with sibutramine compared to placebo. Orlistat caused gastrointestinal side effects and sibutramine increased blood pressure and pulse rate. CONCLUSION: There is a relative paucity of long-term studies of antiobesity agents. In weight loss trials of 1-y duration, orlistat and sibutramine appear modestly effective in promoting weight loss. Longer, more methodologically rigourous studies that are powered to examine end points such as mortality and cardiovascular morbidity are required.

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Long-term pharmacotherapy for obesity and overweight

Cited by 217 publications

References 109 publications

New insights into the field of children and adolescents’ obesity: the European perspective

New insights into the field of children and adolescents’ obesity: the European perspective

Randomized Controlled Trials of the D1/D5 Antagonist Ecopipam for Weight Loss in Obese Subjects

Long-term pharmacotherapy for overweight and obesity: a systematic review and meta-analysis of randomized controlled trials

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