Use of Drugs in the Treatment of Obesity
Obesity has become an epidemic in the United
States and in many other countries of the world. Obesity is a chronic
disease, not a failure of willpower. Diet, exercise, and behavioral modification
of lifestyle are rarely successful over the long term. Medications have
been used sparingly, because of concerns about addiction and ineffectiveness,
but used chronically, obesity drugs are effective.
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The two main categories of obesity
drugs are centrally active adrenergic and serotonergic agents. These
drugs reduce appetite, enhance satiety, and increase energy expenditure.
Use of single agents produces modest weight loss and use of combinations
increases loss, but few patients reach their goal weight. Co-morbidities
associated with obesity resolve or are reduced in severity with
weight loss. Adverse events of major concern are changes in brain
biochemistry and primary pulmonary hypertension. Published guidelines
for use of obesity medications recommend they be used only for medically
significant obesity.
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Source: Atkinson RL. Department of Medicine
and Nutritional Sciences, University of Wisconsin, Madison, USA. 1997
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