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PMID: 11725727 Published · ppublish English Journal Article Review

Drug treatment of obesity.

Reviews in endocrine & metabolic disorders ·Vol. 2 ·No. 4 ·2001-10-00 ·Pages 403-18

Bray GA

Abstract

At present only two drugs are approved for long-term treatment of obesity. Sibutramine inhibits the reuptake of serotonin and norepinephrine. In clinical trials it produces a dose-dependent 5-10% decrease in body weight. Its side effects include dry mouth, insomnia, asthenia, and constipation. In addition, sibutramine produces a small increase in blood pressure and pulse that is a contraindication to the use of this drug in some individuals with heart disease. Xenical is the other drug approved for long-term use in the treatment of obesity. It works by blocking lipase and thus increasing the fecal loss of triglyceride. One valuable consequence of this mechanism of action is the reduction of serum cholesterol that averages about 5% more than can be accounted for by weight loss alone. In clinical trials it produces a 5-10% loss of weight. Its side effects are entirely due to undigested fat in the intestine that can lead to increased frequency and change in the character of stools. It can also lower fat-soluble vitamins. The ingestion of a vitamin supplement before bedtime is a reasonable treatment strategy. The effect on weight loss during long-term trials with these two drugs is shown in Figs 7 and 8 above. Also in this figure is data on phentermine used in trials of six months or more. Although there were differences in mean weight losses with these drugs, when the placebo effect was taken into account they all had a surprisingly similar magnitude of weight loss.

MeSH Terms
Animals Anti-Obesity Agents/adverse effects,therapeutic use Appetite Depressants/adverse effects,therapeutic use Eating/drug effects Energy Metabolism/drug effects Humans Obesity/drug therapy,metabolism
Chemicals
Anti-Obesity Agents Appetite Depressants
Authors & Affiliations
1 authors, click to expand affiliations / ORCID
Bray G A
Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, Louisiana 70808, USA.
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Article Info
Journal
Reviews in endocrine & metabolic disorders
Abbr.
Rev Endocr Metab Disord
ISSN
1389-9155
DOI
10.1023/a:1011808701117
Published
2001-10-00
Pages
403-18
Language
English
Region
Germany
NLM ID
100940588
Subset
IM
External Links
PubMed source DOI: 10.1023/a:1011808701117 View journal details
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