Medical Therapy for Obesity

Abstract

Obesity results from a prolonged small positive energy imbalance, and treatment needs to reverse this imbalance. Many different diets have been tried to treat obesity, and weight loss occurs with all of them. There is currently no evidence that supports the superiority of one macronutrient composition for diets over any other. The principal effect seems to be the degree of adherence to the prescribed calorie reduction. Obesity drugs have been developed that tap brain mechanisms for controlling feeding and the gastrointestinal tract The prevalence of obesity now exceeds 30% of US adults, 1 but may be leveling off at an unacceptably high level. More than two-thirds of Americans are overweight, 1 and excessive weight is a problem for children and adolescents too. 2 The fundamental More than two-thirds of Americans, including children and adolescents, are overweight.problem is the result of a small, but prolonged, positive energy balance, where energy from food exceeds energy needed for everyday living. 3,4 REALITIES IN TREATING AN OBESE PATIENT One of the key messages for obese patients is that when caloric intake is reduced below that needed for daily energy expenditure, there is a predictable rate of weight loss. 4 Men generally lose weight faster than women of similar height and weight on any given diet, because men have more lean body mass and therefore higher energy expenditure. Similarly, older patients have a lower metabolic expenditure and as a rule lose weight more slowly than do younger subjects with similar adherence to weight-loss programs. Thus, adherence to any program is an essential component of success.

All roads bring to Rome: a different way for predicting success in the therapy of obesity through psychological features

“…Those include male gender and younger age [9], and greater muscle mass [10,11]; conversely, patients with medical comorbidities, a history of repeated attempts at losing weight and with weight cycling, as well as those treated with drugs which induce weight gain, have a lower probability to succeed [6,7,12]. In contrast with the above mentioned results, Jackson et al [13] in a recent study found that being female, heavier and older predicted weight loss in the Health and Retirement Study (performed in the United States), whereas the same predictors did not reach statistical significance in the English Longitudinal Study of Ageing.…”

Tumour necrosis factor‐α inhibition with lenalidomide alleviates tissue oxidative injury and apoptosis in ob/ob obese mice

“…With the marked increase in the prevalence of obesity in adults, adolescents and children, it has become more important to identify and characterize novel therapeutic targets to preserve organ function in the face of obesity. Nonetheless, the currently available therapeutic regimens for obesity and diabetes, such as pharmacological treatment, caloric restriction and exercise, have had somewhat limited success . Thus, it is necessary to identify novel effective drugs to better manage multiple organ damage in uncorrected obesity.…”

Orlistat and Phentermine in Weight Loss in Selected Czech Population

“…Pharmacological treatment of obesity should ensure a long-term sustainable weight loss, possibly positively influence metabolic disorders that cause the development of obesity [7,8]. The aim of the work is to show effectiveness of orlistat and phentermine in outpatient obesity management and to emphasize that pharmacotherapy for obesity is an integral part of the complex therapy of this serious disease.…”