Through thousands of years of starvation and poor nutrition, the human body has become adept at storing scarce nutrients. Today, in the United States and Canada particularly, the combination of sedentary habits and excessive intake of calories is imposing a dual burden on a physiologic system that is ill-equipped to handle it. Unable to rid itself of calories, the body's only defense is to store them all. The end result is obesity, with all its deleterious effects on health and longevity.
Obesity is a pandemic with many complications that increase the societal disease burden and cost of health care, and decrease longevity and quality of life. Currently, 1 in 3 adults in the United States is obese. Physicians must therefore regularly confront obesity and its consequent diseases, and develop strategies for effective treatment and management. This article summarizes current lifestyle modifications, pharmacological treatment, and surgical options for the management of obesity and discusses the benefits, limitations, and risks of each.
Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Obesity is a major health problem worldwide. It is associated with cardiovascular diseases, diabetes mellitus and decreased longevity. In managing obesity, diet and exercise are essential; pharmacological therapy may be added for obese patients or overweight patients with cardiovascular risk factors. Sibutramine is a serotonergic and adrenergic drug that reduces food intake and increases thermogenesis. It reduces bodyweight by about 4.2?kg after 12 months, and improves blood glucose and lipids; however, it can increase heart rate and blood pressure.
Many different treatments for obesity have proven somewhat successful, with none emerging as clearly superior to the others. Surgical approaches, although usually successful at achieving and maintaining weight loss, are accompanied by varied and often harmful side effects. Unless new, safer procedures are developed, treatment may continue to be as hazardous as the obesity itself. Because medical treatment alone has not achieved beneficial, lasting results, research aimed at finding new procedures should be encouraged.
BACKGROUND: Little is known about weight control strategies associated with successful weight loss among obese U.S. adults in the general population. PURPOSE: To identify strategies associated with losing at least 5% and 10% of body weight. METHODS: Multivariable analysis of data from obese adult (BMI ≥30) participants in the 2001-2006 NHANES to identify strategies associated with losing ≥5% and ≥10% of body weight (conducted in 2009-2011). RESULTS: Of 4021 obese adults, 2523 (63%) reported trying to lose weight in the previous year.
In this study, data collected in 1989 in a random-digit dialing telephone survey of 60,590 adults in 38 states and the District of Columbia were analyzed. Approximately 38% of women and 24% of men reported that they were currently trying to lose weight. Methods reported were counting calories (24% of women, 14% of men), participating in organized weight loss programs (10%, 3%), taking special supplements (10%, 7%), taking diet pills (4%, 2%), and fasting for 24 hours or longer (5%, 5%).
The rise in obesity and its complications has generated enormous interest in the regulation of feeding and body weight. We show that a spermine metabolite of cholesterol (MSI-1436) decreases body weight, specifically fat, by suppressing feeding and preventing the reduction in energy expenditure, hormonal changes, and patterns of neuropeptide expression normally associated with weight loss. MSI-1436 enters the brain after peripheral injection and is more potent when injected into the cerebral ventricle (intracerebroventricular [ICV]).
The rising tide of obesity and its related disorders is one of the most pressing health concerns worldwide, yet existing medicines to combat the problem are disappointingly limited in number and effectiveness. Recent advances in mechanistic insights into the neuroendocrine regulation of body weight have revealed an expanding list of molecular targets for novel, rationally designed antiobesity pharmaceutical agents.