Pharmacotherapy for obesity

Abstract

Obesity is a chronic metabolic disorder that affects one third of American adults. Modest weight losses of just 5% to 10% of body weight, which are achievable with lifestyle modification and pharmacotherapy, can lead to remarkable improvements in many obesity-associated co-morbidities, including dyslipidemia, hypertension, and type 2 diabetes. In this review, the indications for pharmacotherapy and the goals of treatment are discussed, and current and future pharmacologic approaches to the treatment of obesity are examined. Current pharmacologic therapies for obesity are limited, but recent advances in our understanding of the complex and overlapping endocrine pathways that regulate body weight have led to new opportunities for antiobesity drug development. Important drug targets that are highlighted in this review include adipocyte-derived hormones, hypothalamic neuropeptides, and gastrointestinal hormones.

The influence of body mass index on in vitro fertilization outcome

“…If verified, it may be suggested that attention be directed to improving response to COH. In obese poor responders, weight reduction and any other intervention aiming at correcting the hormonal or metabolic derangements associated with obesity [20,21] should be vigorously applied before proceeding with COH for IVF.…”

New Directions in the Pharmacological Treatment of Food Addiction, Overeating, and Obesity

“…It improves glycemic control, slows gastric emptying, decreases food intake, enhances satiety, and reduces body weight when used to treat type 2 diabetes (Johns, 2007). In addition to improved hemoglobin A1C, the patients exhibited dose-dependent weight losses of 2.8 kg in the 10 μg group and 1.6 kg in the 5 μg group (Neff & Aronne, 2007). The most common side effects are nausea, diarrhea, and vomiting.…”

“…Exenatide and liraglutide are injectable antidiabetic medications that are glucagon-like peptide-1 analogs that increase insulin secretion and suppress glucose-dependent glucagon release (Neff & Aronne, 2007). Exenatide is FDA approved for patients with type 2 diabetes who have failed to achieve adequate glycemic control on oral antidiabetic medications.…”

“…Amylin is a small peptide hormone that is released by the β-cells in the pancreas along with insulin (Neff & Aronne, 2007) and is completely absent in individuals with type 1 diabetes (Johns, 2007).While not FDA approved for weight loss, it has been shown to promote weight loss by increasing satiety and reducing food intake. A phase 2 multicenter trial in 204 non-insulin-treated obese subjects with or without type 2 diabetes showed weight loss of 3.7% and a reduction in waist circumference of 3.6 cm (Edelman, Maier, & Wilhelm, 2008).…”

Pathophysiology of Non-Alcoholic Steatohepatitis and Basis for Treatment

“…Drug therapy of obesity (orlistat and sibutramine) [46] has not shown a direct beneficial effect on the liver independent of the beneficial effect of weight loss. However, these drugs may enhance the beneficial effects of behavioral therapy.…”