What about the drug therapy for obesity treatment?
Drug therapy is recommended as a treatment option for persons with: 1) a Body Mass Index (BMI) > 30 with no obesity-related conditions or 2) a BMI of > 27 with two or more obesity-related conditions. Drug treatment should be used with appropriate lifestyle modifications. Drug therapy may be used for weight loss and weight maintenance. Patients should be
regularly assessed to determine the effect and continuing safety of a drug.
Three weight loss drugs, approved by the US Food and Drug Administration (FDA) for treating obesity, are Orlistat (Xenical), Phentermine, and Sibutramine (Meridia). Orlistat works by blocking about 30 percent of dietary fat from being absorbed, and is the most recently approved weight loss drug. Phentermine, an appetite suppressant, has been available for many years. It is half of the "fen-phen" combination that remains available for use. The use of phentermine alone has not been associated with the adverse health effects of the fenfluramine-phentermine combination. Sibutramine is an appetite suppressant approved for long-term use. Drugs for weight loss fall into several categories.
Drugs that change appetite (sympathomimetic drugs):
Sibutramine - Today sibutramine is the only medication approved for long-term use. The drug suppresses your appetite by keeping your nerve endings from taking up the substances norepinephrine and serotonin. Side effects may include dry mouth, inability to sleep, and constipation. You should not take sibutramine if you have a history of heart disease or stoke.
NOTE: Maybe you have heard of the Fen-phen combination drug.[fenfluramine and phentermine] Fenfluramine has been pulled out of the marketplace because it had unacceptable side effects causing heart valve and lung problems.
Orlistat - Orlistat is the only drug that alters the way your body responds to fat intake. It works by preventing the action of lipases (enzymes that break down fat) produced in your pancreas, a gland behind your stomach. The pancreas secrets lipases into your intestine and block dietary fat digestion. The result, particularly in individuals who eat a high fat meal, are some gastrointestinal side effects, including stomach cramps, gas and a feeling like diarrhea or inability to control your bowels.
Drugs that increase the energy you spend:
Ephedrine - Ephedrine stimulates weight loss by reducing appetite and perhaps by stimulating your body to produce more heat. One form of this drug is found in the Chinese plant ma huang and is sold without a doctor's prescription. This drug is not proven safe or yet approved for the treatment of obesity.
Other substances that cause you to reduce your eating:
The following hormones and other substances are still being studied and are not yet approved as drugs for obesity:
Leptin is a hormone made in fat tissue. Mice without leptin become very fat, and taking leptin has helped mice and human subjects reduce their food intake and lose weight. High doses of leptin seem to be necessary and still need further testing.
Neuropeptide-Y is a substance found in nerve tissue which stimulates eating. Drugs that block the Y-receptors lower food intake.
Cholecystokinin plays a key role in facilitating digestion in the small intestine. It stimulates delivery of digestive enzymes and bile from the gall bladder.
Melanocortins are a group of pituitary peptide hormones. One of the receptors for these hormones is found in the hypothalamus gland in the brain and the protein that binds to it seems to play an important role in controlling body weight.
Glucagon is a protein hormone produced in the pancreas that helps to regulate your body's use of carbohydrates and helps to decrease food intake. A part of the glucagons molecule, glucagon-like peptide 1, also helps to reduce food intake.