Treatment of Obesity in 2015

Abstract

Obesity is a major health priority in the United States, as well as globally. It is associated with multiple comorbidities and reduced life expectancy. Effective management of obesity involves producing an intervention plan tailored to the individual patient. Potential contributory factors to weight gain, including dietary habits, physical inactivity, associated medical conditions, and medications, should be identified and addressed. Lifestyle interventions comprising diet modification, physical activity, and behavior therapy are foundational to the management of obesity. Caloric restriction is the most important component in achieving weight loss through negative energy balance, whereas sustained physical activity is important in maintaining the weight loss. Adjunctive therapies in the form of pharmacotherapy and bariatric surgery are required in patients who do not achieve targeted weight loss and health goals with lifestyle interventions. Currently there are 3 drugs approved for long-term management of obesity, orlistat, phentermine/topiramate extended release, and lorcaserin, and there are 2 on the horizon, bupropion/naltrexone and liraglutide. Bariatric surgery is an effective strategy recognized to produce durable weight loss with amelioration of obesity-related comorbidities and should be considered a treatment option in eligible patients.

Supraventricular tachycardia associated with phentermine use

“…8 Side effects of phentermine include tachycar- dia, hypertension, dry mouth, anxiety, insomnia and constipation. 1 Kim et al did a post marketing surveillance study on 837 obese patients on phentermine, and this revealed a 30% incidence rate of adverse effects. The three most common side effects were insomnia (11.4%), dry mouth (5.9%), and dizziness (2.7%).…”

“…6,7 Later in 2012, phentermine/ topiramate was approved by the FDA and became the first combination drug for long-term management of obesity. 1 Data from meta-analysis showed that patients taking phentermine lost 3.6 kg (CI, 0.6-6.0 kg) on average compared with placebo. 8 Side effects of phentermine include tachycar- dia, hypertension, dry mouth, anxiety, insomnia and constipation.…”

“…1 Phentermine, a sympathetic amine, is an adrenergic reuptake inhibitor, and it works by augmenting the adrenergic signalPakpoom Tantrachoti SVT with Phentermine ing in the central nervous system and peripheral tissue. 7 It stimulates the hypothalamus via β-adrenergic receptors to suppress appetite and act on the sympathetic nervous system to increase resting energy expenditure.…”

“…Side effects of phentermine include insomnia, dry mouth, dizziness, hypertension, and tachycardia. 1 Other cardiac arrhythmias have been rarely reported. 2 To raise clinicians' awareness, we report the case of a previously healthy young woman who developed supraventricular tachycardia (SVT) after the use of phentermine.…”

Long-Term Effects of Orlistat on Eating Behavior of Obesity Patients

“…Подавляя активность желудочно-кишечных липаз, орлистат уменьшает всасывание жиров, вызывая дефицит энергии и снижение массы тела. А также, уменьшая количество свободных жирных кислот и моноглице-ридов в просвете кишечника, уменьшает раствори-мость и всасывание холестерина и снижает гиперхо-лестеринемию [10][11][12].…”