Drug treatments for obesity/Bibliography

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A list of key readings about Drug treatments for obesity.
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Review Articles

  1. Aronne LJ, et al. New Targets for Obesity Pharmacotherapy.
  2. Baxter JD, Webb P (2009) Thyroid hormone mimetics: potential applications in atherosclerosis, obesity and type 2 diabetes. Nat Rev Drug Discov 8(4): 308-20l. "Over the past decade, thyroid hormone analogues that are capable of uncoupling beneficial effects from deleterious effects have been developed. Such drugs could serve as powerful new tools to address two of the largest medical problems in developed countries — atherosclerosis and obesity.
  3. Bray G (2008) Lifestyle and Pharmacological Approaches to Weight Loss: Efficacy and Safety. J Clin Endocrinol metab. 93: S81–S88 (There is currently no evidence that clearly supports a superiority of one macronutrient composition for diets used for weight loss...Physical activity is particularly important in helping patients maintain a weight loss once achieved and is less valuable for weight loss itself...but only a few drugs have been developed that tap these mechanisms. Orlistat, which blocks intestinal lipase, is one; sibutramine, a serotoninnorepinephrine reuptake inhibitor, is a second.)
  4. Bulik CM. (1992). Abuse of drugs associated with eating disorders. J Subst Abuse. 4(1):69-90. ...Effects on appetite and weight are discussed for drugs used by bulimic women to reduce appetite or weight or to induce purging (e.g. diuretics, emetics, laxatives, and diet aids).
  5. Coutinho W (2009) The first decade of sibutramine and orlistat: a reappraisal of their expanding roles in the treatment of obesity and associated conditions. Arquivos Brasileiros De Endocrinologia E Metabologia. 53:262-270 (The most widely used anti-obesity agents are sibutramine and orlistat, both available in clinical practice for about a decade.)
  6. Diepvens K, Westerterp KR, Westerterp-Plantenga MS. (2007). Obesity and thermogenesis related to the consumption of caffeine, ephedrine, capsaicin, and green tea. Am J Physiol. 292(1):R77-85. "A combination of caffeine and ephedrine has shown to be effective in long-term weight management, likely due to different mechanisms that may operate synergistically."
  7. Desilets AR, Dhakal-Karki S, Dunican KC. (2008). Role of metformin for weight management in patients without type 2 diabetes. Ann Pharmacotherapy. 42(6):817-26. "The weight loss effects of metformin in overweight or obese adults and adolescents without diabetes appear promising; however, trials have been limited by small patient populations and weak design."
  8. Elangbam C.S (2009) Current Strategies in the Development of Anti-obesity Drugs and Their Safety Concerns. vet pathol. 26:10-24 (This review covers the current state of antiobesity drugs and their safety concerns, and highlights new therapeutic targets and scientific advances toward the development of appropriate animal models by using novel techniques that will aid in understanding pathogenesis and pathophysiology of anorexigen-related safety issues.)
  9. Greenway FL. (2001). The safety and efficacy of pharmaceutical and herbal caffeine and ephedrine use as a weight loss agent. Obes Rev. 2(3):199-211. "The cardiovascular, stimulatory and other potential adverse effects of caffeine and ephedrine are at placebo levels in a few weeks while the benefits of weight loss persist for at least a year.
  10. Kintscher U (2008) The cardiometabolic drug rimonabant: after 2 years of RIO-Europe and STRADIVARIUS. European Heart Journal. "Data from the Rimonabant in Obesity (RIO) trial programme revealed that 1-year therapy with rimonabant results in a 4.7 kg greater mean weight loss than placebo... In addition, rimonabant treatment has been shown to exert beneficial actions on metabolic risk factors, with an increase in high-density lipoprotein (HDL)-cholesterol, a decrease in triglycerides, and an improvement of insulin sensitivity parameters (e.g. HOMA-IR index)"
  11. Knowler WC et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.N Engl J Med. 346(6):393-403. "as compared with placebo; the lifestyle intervention was significantly more effective than metformin."
  12. Kristensen P et al (1998) Hypothalamic CART is a new anorectic peptide regulated by leptin. Nature 393(6680):72-6. "Here we show that CART (cocaine- and amphetamine-regulated transcript), a brain-located peptide is a satiety factor and is closely associated with the actions of two important regulators of food intake, leptin and neuropeptide"
  13. Siraj ES. (2003). Is there a role for metformin or acarbose as a weight-loss agent in the absence of diabetes? Cleve Clin J Med. 70(8):702-4. "several studies found that patients with type 2 diabetes lost weight while taking metformin, with significant reductions in total body fat and visceral fat in those with preexisting abdominal or visceral obesity."
  14. Tziomalos K et al. (2009) The use of sibutramine in the management of obesity and related disorders: An update. Vascular Health and Risk Management 5:1 pp. 441-452. (Sibutramine, in conjunction with lifestyle measures, is a useful drug for reducing body weight and improving associated cardiometabolic risk factors and obesity-related disorders. Studies of longer duration are required to determine the precise indications of the drug, to evaluate safety issues and to assess its efficacy on cardiovascular mortality. )
  15. Wagner JC. (1991). Enhancement of athletic performance with drugs. An overview. Sports Med. 12(4):250-65. "...Other drugs used by athletes include beta-blocking agents, diuretics, and a variety of nutritional supplements. In addition, diuretics and probenecid may be taken to mask drug contents in the urine."
  16. Woo T (2009) Pharmacotherapy and Surgery Treatment for the Severely Obese Adolescent. Journal of Paediatric Health Care 23:4 pp.206-212 (Originally studied as an antidepressant, sibutramine is a serotonin and norepinephrine re-uptake inhibitor, with metabolites (M1 and M2) that weakly inhibit dopamine, causing satiety when taken at therapeutic doses. Multiple trials in adults have demonstrated that the appetite suppressant effects of sibutramine lead to weight loss, including the Sibutramine Trial of Obesity Reduction and Maintenance (STORM) trial, a long-term trial demonstrating a sustained weight loss while taking sibutramine for up to 2 years.)
  17. Zanella M, Filho F (2009) Emerging drugs for obesity therapy. Arq Bras Endocrinol Metab. 53(2):271-280 (Fortunately, recent fundamental insights into the neuroendocrine mechanisms regulating body weight provide an expanding list of molecular targets for novel, rationally designed antiobesity drugs. In this review, the therapeutic potential of some antiobesity molecules in the development will be analyzed based on an understanding of energy homeostasis.)
  18. 'Many different diets have been tried to treat obesity, and weight loss occurs with all of them.... Food intake is controlled through many different mechanisms, but only a few drugs have been developed that tap these mechanisms. Orlistat, which blocks intestinal lipase, is one; sibutramine, a serotoninnorepinephrine reuptake inhibitor, is a second. Surgical approaches provide the most dramatic weight loss and have been demonstrated to reduce long-term mortality and reduce the incidence of diabetes.'

Primary Research Papers

  • Hauptman J, Lucas C, Boldrin M, Collins H (2000) Orlistat in the Long-term Treatment of Obesity in Primary Care Settings. Arch Fam Med 9:160–167 "More patients treated with orlistat lost 5% or more of their initial weight in year 1 (48.8% and 50.5% of patients in the 60-mg and 120-mg groups, respectively) compared with placebo (30.7%; P,.001), and approximately 34% of patients in the orlistat groups sustained weight loss of 5% or greater over 2 years compared with 24% in the placebo group (P,.001)."
  • Kristensen P et al (1998) Hypothalamic CART is a new anorectic peptide regulated by leptin. Nature 393(6680):72-6. "Here we show that CART (cocaine- and amphetamine-regulated transcript), a brain-located peptide is a satiety factor and is closely associated with the actions of two important regulators of food intake, leptin and neuropeptide Y
  • Lee A, Morley JE. (1998). Metformin decreases food consumption and induces weight loss in subjects with obesity with type II non-insulin-dependent diabetes. Obes Res. 6(1):47-53. "metformin decreases calorie intake in a dose-dependent manner and leads to a reduction in bodyweight in NIDDM patients with obesity."
  • Rossner S, Sjostrom L, Noack R, Meinders A, Noseda G (2000) Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. Obesity Research.8:41-61 "Orlistat administered for 2 years promotes weight loss and minimizes weight regain. Additionally, orlistat therapy improves lipid profile, blood pressure, and quality of life."
  • Astrup A et al. (2009). Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study. The Lancet. Early online publication. "Participants on liraglutide lost significantly more weight than did those on placebo and orlistat... Liraglutide reduced blood pressure at all doses, and reduced the prevalence of prediabetes."

Books

  • Boon NA, Colledge NR, Walker BR, Hunter JAA (2006) Davidson's Principles & Practice of Medicine 111-117.
  • Rang H, Dale M, Ritter J, Moore P (2007) Pharmacology. Churchill Livingstone, Elsevier. 250-254
  • Rang H, Dale M, Ritter J, Moore P (2007) Pharmacology. Churchill Livingstone, Elsevier. 417-418.
  • Rang H, Dale M, Ritter J, Moore P (2007) Pharmacology. Churchill Livingstone, Elsevier. 441-444.

Websites

  • NHS National Institute for Health and Clinical Excellence: Guidance: Obesity - rimonabant (withdrawn) (2008), Viewed 15 October 2009. Available http://www.nice.org.uk/TA144
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