Klin Farmakol Farm. 2006;20(2):103-107

Pharmacotherapy of obesity and health risks

doc. MUDr. Vojtěch Hainer CSc

Centrum pro diagnostiku a léčbu obezity VFN, III. interní klinika 1. LF UK, Praha

The prevalence of obesity is increasing world-wide and has reached epidemic proportions in both developed and developing countries. Overweight and obesity are associated with increased health risks, especially with metabolic and cardiovascular diseases. Increased body weight impairs quality of life and reduces life expectancy. Pharmacotherapy of obesity should be an integral part of the comprehensive obesity management which includes low energy diet, increased physical activity and cognitive behavioral modification of lifestyle. Antiobesity drugs affect target tissues (central nervous system /CNS/, gastrointestinal tract /GIT/, peripheral tissues) to improve regulatory and metabolic abnormalities contributing to the development of obesity. Currently, only two drugs, orlistat and sibutramine, have been approved for the long-term treatment of obesity. Sibutramine affects satiety and energy expenditure by inhibition of serotonin and noradrenaline reuptake in the CNS, whereas orlistat, as a lipase inhibitor, reduces fat absorption in the GIT. Rimonabant is a new perspective antiobesity drug which reduces body weight and cardiometabolic health risks by blocking cannabinoid-1 receptors. It should be taken into account that even a minor weight loss (5–10%) leads to a significant reduction of obesity-related health risks. It has been clearly demonstrated that the treatment with antiobesity drugs not only reduces fat stores, but also diminishes health risks and prevents development of obesity-related diseases. Antiobesity drug treatment should usually be lifelong as is the case with drug treatment of other diseases. It is necessary to emphasize that the attitudes to the treatment of obesity within the health care system should be similar to those applied to the treatment of other complex diseases, for example, hypertension.

Keywords: obesity, health risks, antiobesity drug treatment, sibutramine, orlistat

Published: September 1, 2006  Show citation