Do we need anti‐obesity drugs?

Abstract

SummaryThe increasing global prevalence of obesity urgently requires an implementation of efficient preventive and therapeutic measures. Weight loss and its maintenance should be considered one of the most important strategies to reduce the incidence of obesity-related co-morbidities such as diabetes and cardiovascular diseases. Lifestyle modification focused on diet and physical activity represents the essential component of any kind of weight management. However, only an intensive lifestyle intervention can be efficient in terms of long-term weight loss. Anti-obesity drugs affect different targets in the central nervous system or peripheral tissues and improve regulatory and metabolic disturbances that contribute to the development of obesity. Antiobesity medications provide modest additional fat loss to that achieved by lifestyle modification alone, reduce visceral fat stores, improve programme adherence, weight loss maintenance, diminish obesity-related health risks and improve a quality of life. Anti-obesity drugs do play a role in weight management. Their replacement with placebo is followed by weight regain. Due to adverse events, several anti-obesity drugs were withdrawn from the market over the past few years and currently only orlistat remains available for long-term obesity management. Drug withdrawals, failure of clinical trials with several new anti-obesity compounds as well as inappropriate demands of drug regulating agencies concerning the study protocol led to scepticism about the perspectives in the pharmacotherapy of obesity. However, recently developed anti-obesity medications such as gut hormone analogues and drug combinations provided encouraging results in terms of weight loss, safety and improvement of cardio-metabolic health risks.

PPARγ neddylation essential for adipogenesis is a potential target for treating obesity

“…The mode-of-actions of currently used anti-obesity drugs can be roughly classified into reduced appetite, increased energy expenditure, and reduced fat absorption. 38 However, considering that the overgrowth of fat tissue is the prime event in obesity, it is plausible that adipogenesis is regarded as one of ideal targets for obesity control. We here identified that PPARγ neddylation is essential for both adipogenesis and fat accumulation and it also showed the possibility that obesity is pharmacologically controlled through inhibition of the neddylation.…”

Effect of inulin supplementation in male mice fed with high fat diet on biochemical profile and α-amylase gene expression

“…[3]. However, implementing such changes in patients' lives is usually difficult, and alternative therapeutic means such as drugs, are widely sought after [4]. The use of artificial sweeteners has been proposed as a way to help weight control through lessening energy intake [5].…”

Pharmacological treatment and therapeutic perspectives of metabolic syndrome

“…Previously, anti-obesity drugs such as sibutramine and orlistat had shown that they reduced body weight and central obesity, resulting in improvement of the components of metabolic syndrome [51]. Rimonabant improved glycemic homeostasis and lipid components of metabolic syndrome: increase in HDL-C levels by 23 % and decrease in triglyceride levels by 15 % [52,53].…”