Medications as Adjunct Therapy for Weight Loss: Approved and Off-Label Agents in Use

Moyers, Susan

doi:10.1016/j.jada.2005.03.010

Cited by 37 publications

(26 citation statements)

References 60 publications

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“…[252][253][254][255] The most-recent examples are the withdrawal of the prescription medication fenfluramine, which was banned in the United States in 1997, because of associated cardiac valve abnormalities [254][255] and the removal of ephedra from the herbal market 256 and phenylpropanolamine from the over-the-counter market because of cardiovascular concerns. [254][255] These experiences underscore the need to use weight loss medications conservatively for all obese patients. Particular care must be taken when the use of weight loss medications is considered for children, because the long-term effects of these substances on growth and development have not been studied.…”

Section: Weight Loss Medications In the Treatment Of Pediatric Obesitymentioning

confidence: 99%

“…Pharmacotherapy alone has not proved to be an effective obesity treatment. 252,254,255 Medication used as part of a structured lifestyle modification produces an average weight loss of 5% to 10%, which typically plateaus at 4 to 6 months of therapy, after which weight regain may occur. Weight regain is common if the drug is withdrawn.…”

Section: Weight Loss Medications In the Treatment Of Pediatric Obesitymentioning

confidence: 99%

“…Weight regain is common if the drug is withdrawn. 252,254,255 Despite these limitations, pharmacologic agents may be helpful in the treatment of obesity for carefully selected patients, as part of a multimodal therapy 257 that includes diet, exercise, and behavior modification.…”

Section: Weight Loss Medications In the Treatment Of Pediatric Obesitymentioning

confidence: 99%

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Recommendations for Treatment of Child and Adolescent Overweight and Obesity

et al. 2007

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In this article, we review evidence about the treatment of obesity that may have applications in primary care, community, and tertiary care settings. We examine current information about eating behaviors, physical activity behaviors, and sedentary behaviors that may affect weight in children and adolescents. We also review studies of multidisciplinary behavior-based obesity treatment programs and information about more aggressive forms of treatment. The writing group has drawn from the available evidence to propose a comprehensive 4-step or stagedcare approach for weight management that includes the following stages: (1) Prevention Plus; (2) structured weight management; (3) comprehensive multidisciplinary intervention; and (4) tertiary care intervention. We suggest that providers encourage healthy behaviors while using techniques to motivate patients and families, and interventions should be tailored to the individual child and family. Although more intense treatment stages will generally occur outside the typical office setting, offices can implement less intense intervention strategies. We not ony address specific patient behavior goals but also encourage practices to modify office systems to streamline office-based care and to prepare to coordinate with professionals and programs outside the office for more intensive interventions. S254SPEAR et al by guest on August 28, 2018 www.aappublications.org/news Downloaded from T REATMENT FOR CHILDREN who are overweight or obese seems easy, that is, just counsel children and their families to eat less and to exercise more. In practice, however, treatment of childhood obesity is time-consuming, frustrating, difficult, and expensive. In fact, choosing the most effective methods for treating overweight and obesity in children is complex at best. This is especially true for primary care providers, who have limited resources to offer interventions within their offices or programs and few providers to whom they can refer patients.The need for evidence-based treatment recommendations is a critical health care issue, because obese children and adolescents are at risk for developing many of the comorbidities seen in obese adults. Studies demonstrated that fasting serum glucose, insulin, and triglyceride levels and the prevalence of impaired glucose tolerance and systolic hypertension increase significantly as children become obese (BMI of Ն95th percentile). 1 Even children and adolescents who are overweight (BMI of 85th to 94th percentile) are at risk for comorbidities. Therefore, interventions using dietary modifications, increased physical activity, and behavioral therapy may be beneficial for overweight children and adolescents, with more-aggressive intervention directed toward obese children and adolescents. 2 Health care professionals, however, may find it difficult to determine which interventions will be most efficacious for their patients. To date, no clinical trials have determined whether specific dietary modifications alone (ie, without behavioral interven...

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Section: Weight Loss Medications In the Treatment Of Pediatric Obesitymentioning

confidence: 99%

Section: Weight Loss Medications In the Treatment Of Pediatric Obesitymentioning

confidence: 99%

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Recommendations for Treatment of Child and Adolescent Overweight and Obesity

et al. 2007

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“…De forma similar, grandes estudos clínicos nos quais se utilizaram apenas abordagens comportamentais para o tratamento da obesidade, revelaram que a perda de peso varia de 2 a 10%, e que a capacidade de manutenção do peso perdido após um período de acompanhamento maior que um ano é insatisfatória (8). Além disso, em estudos clínicos nos quais se utilizaram fármacos com propriedades anorexigênicas, obtiveram-se resultados pouco superiores àqueles obtidos pelas abordagens comportamentais (9). Assim, deve-se supor que, numa escala global, em não se introduzindo novas modalidades terapêuticas mais específicas e efetivas, as projeções da OMS para a década de 2020 deverão se concretizar.…”

Section: Introductionunclassified

O controle hipotalâmico da fome e da termogênese: implicações no desenvolvimento da obesidade

Velloso

2006

Arq Bras Endocrinol Metab

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RESUMOO aumento da prevalência de obesidade em várias regiões do planeta vem se revelando como um dos mais importantes fenômenos clínico-epidemiológicos da atualidade. Fatores como a mudança do hábito alimentar e o estilo de vida sedentário, aliados a determinantes gené-ticos ainda pouco conhecidos, desempenham um papel relevante na patogênese desta doença. Nos últimos dez anos, desde o descobrimento do hormônio leptina, avanços consideráveis foram obtidos na caracterização dos mecanismos hipotalâmicos do controle da ingestão alimentar e da termogênese. Tais avanços têm revelado as particularidades de um sistema complexo e integrado, e têm oferecido novas perspectivas para abordagens terapêuticas farmacológicas específi-cas. Esta revisão apresenta os mais recentes avanços nesta área, tendo como foco a ação hipotalâmica da leptina e da insulina e explorando a hipótese de que a resistência à ação central destes hormônios possa ser o elo entre a obesidade e as outras condições clínicas nas quais a resistência à insulina desempenha um papel patogenético proeminente. ABSTRACTThe Hypothalamic Control of Feeding and Thermogenesis -Implications on the Development of Obesity. The worldwide increase in the prevalence of obesity is becoming one of the most important clinical-epidemiological phenomena of the present days. Environmental factors such as changes in life-style and feeding behavior associated with poorly characterized genetic determinants are though to play the most important roles in the pathogenesis of this disease. During the last ten years, since the discovery of leptin, great advances were obtained in the characterization of the hypothalamic mechanisms involved in the control of food intake and thermogenesis. Such advances are unveiling a complex and integrated system and are opening a wide perspective for the finding of novel therapeutic targets for the treatment of this harming condition. This review will present some of the most recent findings in this field. It will be focused on the actions of leptin and insulin in the hypothalamus and will explore the hypothesis that hypothalamic resistance to the action of these hormones may play a role in the development of obesity and may act as a molecular link between obesity, type 2 diabetes mellitus and other clinical conditions on which insulin resistance plays an important pathogenetic role.

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“…[1][2][3][4] The possibility of modifying or blocking these processes using glycosidaseinhibiting sugar mimics for biological and therapeutic applications has attracted much attention, 5,6 especially in relation to cancer, 7,8 viral infection, 9,10 genetic disorders, 11-13 diabetes 14 and obesity. 15 The biomedical and biotechnological applications of glycosidase-inhibiting sugar mimics have been reviewed. 16 Inhibitors of glycoside-processing enzymes share structural homology with the natural enzymatic substrates that are often aminohydroxy-substituted five or six-membered heterocyclic rings.…”

Section: Introductionmentioning

confidence: 99%

Stereospecific synthesis of N-tosyl derivatives of dihydroconduramine E-2 and ent-F-2

Kurbanoglu¹,

Beşoluk²,

Zengin³

2010

Arkivoc

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Conduramines, dihydroconduramines and structurally related compounds belong to an important class of glycosidase inhibitors which are essential elements of many biologically active compounds. The synthesis and characterization of N-tosyl dihydroconduramine derivatives 9a and 10a starting from cyclohexadiene were carried out in the current study. The oxazolidinone 15 was prepared by the palladium-catalyzed reaction of bis-carbamate 14, synthesized from cyclohexenediol, derived in two steps from cyclohexadiene. Hydrolysis of 15 was achieved with methanolic potassium carbonate to afford 18 and the ketalization gave 21 in good yield. Osmylation of the double bond and acid-mediated acetonide removal of 21 gave 4-methyl-N-((1S,2R,3S,6S)-2,3,6-trihydroxycyclohexyl)benzenesulfonamide 9a. The epoxidation of 21 followed by acid-mediated epoxide ring opening and subsequent acetonide removal produced 4-methyl-N-((1S,2R,3R,6S)-2,3,6-trihydroxycyclohexyl)benzenesulfonamide 10a. The molecules may be evaluated for biological activity.

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Medications as Adjunct Therapy for Weight Loss: Approved and Off-Label Agents in Use

Cited by 37 publications

References 60 publications

Recommendations for Treatment of Child and Adolescent Overweight and Obesity

Recommendations for Treatment of Child and Adolescent Overweight and Obesity

O controle hipotalâmico da fome e da termogênese: implicações no desenvolvimento da obesidade

Stereospecific synthesis of N-tosyl derivatives of dihydroconduramine E-2 and ent-F-2

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