Obesity, a major social and health problem in many countries, is due to the accumulation of white adipose tissue in subcutaneous and visceral depots. The discovery of adipocytes capacity of synthesis of numerous adipocytokines and growth factors and the cross talk between adipocytes and cells of the adipose stromo-vascular fraction had highlighted the role of adipose tissue dysfunction in obesity. In visceral obesity the unbalanced synthesis of pro-and anti-inflammatory adipocytokines contributes to the development of the metabolic syndrome which cumulates the factors that increase the risk for ischemic heart disease and cerebral stroke. Adipose tissue accumulation is associated with a state of chronic inflammation, and local hypoxia is considered its underlying cause due to the hypertrophic or/and the hyperplasic growth of the fat pad. Adipose tissue hypoxia is one of the first pathophysiological changes and was placed as a missing link between obesity and low-grade inflammation present in the metabolic syndrome. Hypoxia is a major trigger for adipose tissue remodeling including adipocyte death, inflammation, tissue fibrosis, and angiogenesis. Recently, the role of hypoxia in brown adipose tissue dysfunction, a tissue presumed as the biologic counterbalance of the metabolic disturbances in human obesity, is discussed.

Pharmaceutical drugs-prescription drugs, not over-the-counter drugs-have prices that are negotiated between pharmaceutical companies and National Ministry of Health or national agency for medicines or national health insurers in every country. Prescription drug expenditures have increased every country's healthcare costs. Medication adherence (deined as not obtained reills of prescriptions or suboptimal dosing of prescribed drugs) is a growing concern to physicians and healthcare systems because of the multiple evidence of noncompliance among patients and correlated adverse outcomes. A patient is considered adherent if he/she takes 80% of his/her prescribed medicine(s). Diferent studies showed that patients do not take their prescribed medicines about half the time. Financial losses due to poor adherence are the result of unnecessary time-consuming work and costs for potential harm to patients. Hospitalization rates are reduced at higher levels of medication adherence. There are two types of inancial losses due to poor treatment adherence: medical costs (measured by hospitalization risk) and drugs costs (without patient copayments). This inancial loss analysis underlines the promotion of medication adherence by the patients.