Treatment of Obesity in Underprivileged Adolescents

Andelman, Morten B.; Jones, C. O. H.; Nathan, S

doi:10.1177/000992286700600607

Cited by 19 publications

(5 citation statements)

References 3 publications

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“…The classical anorexiants, such as phentermine, 207 diethylpropion 208 and mazindol, 209–212 alter the release and reuptake of neurotransmitters (that is, norepinephrine, serotonin and dopamine) that impact on appetite. 213 No weight loss medication with these mechanisms of action is currently approved for pediatric use and no available data support their long-term (>1 year) safety or efficacy in pediatric populations.…”

Section: Pharmacological Approaches To Treat Pediatric Obesitymentioning

confidence: 99%

“…213 No weight loss medication with these mechanisms of action is currently approved for pediatric use and no available data support their long-term (>1 year) safety or efficacy in pediatric populations. Only small trials, using phentermine 207,214 or diethylpropion, 208,215 that lasted no more than 12 weeks, have been reported in a pediatric population.…”

Section: Pharmacological Approaches To Treat Pediatric Obesitymentioning

confidence: 99%

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An evolving scientific basis for the prevention and treatment of pediatric obesity

et al. 2014

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The 2013 Pennington Biomedical Research Center’s Scientific Symposium focused on the treatment and management of pediatric obesity and was designed to (i) review recent scientific advances in the prevention, clinical treatment and management of pediatric obesity, (ii) integrate the latest published and unpublished findings and (iii) explore how these advances can be integrated into clinical and public health approaches. The symposium provided an overview of important new advances in the field, which led to several recommendations for incorporating the scientific evidence into practice. The science presented covered a range of topics related to pediatric obesity, including the role of genetic differences, epigenetic events influenced by in utero development, pre-pregnancy maternal obesity status, maternal nutrition and maternal weight gain on developmental programming of adiposity in offspring. Finally, the relative merits of a range of various behavioral approaches targeted at pediatric obesity were covered, together with the specific roles of pharmacotherapy and bariatric surgery in pediatric populations. In summary, pediatric obesity is a very challenging problem that is unprecedented in evolutionary terms; one which has the capacity to negate many of the health benefits that have contributed to the increased longevity observed in the developed world.

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Section: Pharmacological Approaches To Treat Pediatric Obesitymentioning

confidence: 99%

Section: Pharmacological Approaches To Treat Pediatric Obesitymentioning

confidence: 99%

An evolving scientific basis for the prevention and treatment of pediatric obesity

et al. 2014

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“…Considering the six included studies in the probability of adverse reactions meta-analysis (20,23,24,27,34,35), only one presented results favoring the placebo (52.0% vs. 28.8%) (27), with an OR=1.847 (95% CI: 1.057; 3.229); I 2 : 0.0%; p=0.619) (see summary of findings: efficacy, safety and metabolic outcomes in the Supplemental Materials). Studies showing greater withdrawal due to adverse reactions in the amfepramone group were not identified.…”

Section: Direct Meta-analysismentioning

confidence: 99%

Systematic Review and Meta-Analysis of The Efficacy And Safety Of Amfepramone and Mazindol As A Monotherapy for The Treatment of Obese or Overweight Patients

et al. 2017

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The aim of this study was to evaluate efficacy and safety of amfepramone, fenproporex and mazindol as a monotherapy for the treatment of obese or overweight patients. A systematic review of primary studies was conducted, followed by a direct meta-analysis (random effect) and mixed treatment comparison. Medline and other databases were searched. Heterogeneity was explored through I 2 associated with a p-value. Of 739 identified publications, 25 were included in the meta-analysis. The global evaluation of Cochrane resulted in 19 studies with a high level of bias and six with unclear risk. Due to the lack of information in primary studies, direct meta-analyses were conducted only for amfepramone and mazindol. Compared to placebo, amfepramone resulted in higher weight loss in the short-term (o180 days; mean difference (MD) -1.281 kg; po0.05; I 2 : 0.0%; p=0.379) and long-term (X180 days; MD -6.518 kg; po0.05; I 2 : 0.0%; p=0.719). Only studies with long-term follow up reported efficacy in terms of abdominal circumference and 5-10% weight reduction. These results corroborated the finding that the efficacy of amfepramone is greater than that of placebo. Treatment with mazindol showed greater short-term weight loss than that with placebo (MD -1.721 kg; po0.05; I 2 : 0.9%; p=0.388). However, metabolic outcomes were poorly described, preventing a meta-analysis. A mixed treatment comparison corroborated the direct meta-analysis. Considering the high level of risk of bias and the absence of important published outcomes for anti-obesity therapy assessments, this study found that the evaluated drugs showed poor evidence of efficacy in the treatment of overweight and obese patients. Robust safety data were not identified to suggest changes in their regulatory status.

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“…Phentermine, 43 diethylpropion 44 and mazindol 45–48 are anorexiants approved by the FDA for short-term use in adults that exert anorexiant effects primarily by increasing adrenergic tone. 49 They decrease food intake and also increase resting energy expenditure.…”

Section: Current Pharmacotherapeutic Options For Obesity Treatmentmentioning

confidence: 99%

“…54 Other drugs such as benzphetamine and phendimetrazine are also approved for short term use with caution because of the potential risks such as pulmonary hypertension and valvular disease. 55, 56 Only small pediatric trials using phentermine 43, 57 or diethylpropion 44, 58 that lasted no more than 12 weeks have been reported. The adverse effect profiles of phentermine and diethylpropion in adults include insomnia, restlessness, and euphoria, palpitations, hypertension and cardiac arrhythmias, dizziness, blurred vision, and ocular irritation.…”

Section: Current Pharmacotherapeutic Options For Obesity Treatmentmentioning

confidence: 99%

Pharmacotherapy for childhood obesity: present and future prospects

Sherafat-Kazemzadeh

Yanovski

2012

Int J Obes

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Pediatric obesity is a serious medical condition associated with significant comorbidities during childhood and adulthood. Lifestyle modifications are essential for treating children with obesity, yet many have insufficient response to improve health with behavioral approaches alone. This review summarizes the relatively sparse data on pharmacotherapy for pediatric obesity and presents information on obesity medications in development. Most previously studied medications demonstrated, at best, modest effects on body weight and obesity-related conditions. It is to be hoped that the future will bring new drugs targeting specific obesity phenotypes that will allow clinicians to use etiology-specific, and therefore more effective, anti-obesity therapies.

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Treatment of Obesity in Underprivileged Adolescents

Cited by 19 publications

References 3 publications

An evolving scientific basis for the prevention and treatment of pediatric obesity

An evolving scientific basis for the prevention and treatment of pediatric obesity

Systematic Review and Meta-Analysis of The Efficacy And Safety Of Amfepramone and Mazindol As A Monotherapy for The Treatment of Obese or Overweight Patients

Pharmacotherapy for childhood obesity: present and future prospects

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