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Published in: Drugs & Therapy Perspectives 1/2006

01-01-2006 | Disease Management

Pharmacotherapy for the treatment of obesity has only modest benefits and should be used in combination with lifestyle modifications

Published in: Drugs & Therapy Perspectives | Issue 1/2006

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Excerpt

Pharmacotherapy to reduce obesity is only considered an appropriate adjunctive option for patients with a severe weight problem who have failed to lose weight by a reasonable trial of other means (diet and/or lifestyle alterations). Only a few pharmacotherapies are currently approved for the management of weight loss. Safety issues have resulted in many therapies being withdrawn or having limited availability. The only two drugs approved for long-term use are sibutramine and orlistat. Both result in modest weight loss over periods of 1–2 years and appear to have reasonable safety profiles. …
Literature
1.
go back to reference Ioannides-Demos LL, Proietto J, McNeil JJ. Pharmacotherapy for obesity. Drugs 2005; 65(10): 1391–418PubMedCrossRef Ioannides-Demos LL, Proietto J, McNeil JJ. Pharmacotherapy for obesity. Drugs 2005; 65(10): 1391–418PubMedCrossRef
3.
go back to reference National Institutes of Health, National Heart, Lung, and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. NIH Publication no. 98-4083. Washington, DC: US Government Press, 1998 Sep National Institutes of Health, National Heart, Lung, and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. NIH Publication no. 98-4083. Washington, DC: US Government Press, 1998 Sep
4.
go back to reference Wadden TA, Berkowitz RI, Womble LG, et al. Randomized trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med 2005 Nov 17; 353(20): 2111–20PubMedCrossRef Wadden TA, Berkowitz RI, Womble LG, et al. Randomized trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med 2005 Nov 17; 353(20): 2111–20PubMedCrossRef
5.
go back to reference Munro JF, MacCuish AC, Wilson EM, et al. Comparison of continuous and intermittent anorectic therapy in obesity. Br Med J 1968; 1: 352–4PubMedCrossRef Munro JF, MacCuish AC, Wilson EM, et al. Comparison of continuous and intermittent anorectic therapy in obesity. Br Med J 1968; 1: 352–4PubMedCrossRef
6.
go back to reference Truant AP, Olon LP, Cobb S. Phentermine resin as an adjunct in medical weight reduction: a controlled, randomized, double-blind prospective study. Curr Ther Res Clin Exp 1972; 14: 726–38PubMed Truant AP, Olon LP, Cobb S. Phentermine resin as an adjunct in medical weight reduction: a controlled, randomized, double-blind prospective study. Curr Ther Res Clin Exp 1972; 14: 726–38PubMed
7.
go back to reference Shekelle PG, Hardy ML, Morton SC, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003; 289: 1537–45PubMedCrossRef Shekelle PG, Hardy ML, Morton SC, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003; 289: 1537–45PubMedCrossRef
8.
go back to reference US Food and Drug Administration. Dietary supplements containing ephedrine alkaloids: final rule summary [online]. Available from URL: http://www.fda.gov[Accessed 2005 Oct 12] US Food and Drug Administration. Dietary supplements containing ephedrine alkaloids: final rule summary [online]. Available from URL: http://​www.​fda.​gov[Accessed 2005 Oct 12]
9.
go back to reference Chanoine JP, Hampl S, Jensen C, et al. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA 2005; 293: 2873–83PubMedCrossRef Chanoine JP, Hampl S, Jensen C, et al. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA 2005; 293: 2873–83PubMedCrossRef
10.
go back to reference Aydin N, Topsever P, Kaya A, et al. Orlistat, sibutramine, or combination therapy: which performs better on waist circumference in relation with body mass index in obese patients? Tohoku J Exp Med 2004; 202: 173–80PubMedCrossRef Aydin N, Topsever P, Kaya A, et al. Orlistat, sibutramine, or combination therapy: which performs better on waist circumference in relation with body mass index in obese patients? Tohoku J Exp Med 2004; 202: 173–80PubMedCrossRef
11.
go back to reference Wadden TA, Berkowitz RI, Womble LG, et al. Effects of sibutramine plus orlistat in obese women following 1 year of treatment by sibutramine alone: a placebo-controlled trial. Obes Res 2000; 6: 431–7CrossRef Wadden TA, Berkowitz RI, Womble LG, et al. Effects of sibutramine plus orlistat in obese women following 1 year of treatment by sibutramine alone: a placebo-controlled trial. Obes Res 2000; 6: 431–7CrossRef
12.
13.
go back to reference Padwal R, Li SK, Lau DC. Long-term pharmacotherapy for obesity and overweight. Cochrane Database Syst Rev 2004; 3: CD004094PubMed Padwal R, Li SK, Lau DC. Long-term pharmacotherapy for obesity and overweight. Cochrane Database Syst Rev 2004; 3: CD004094PubMed
14.
go back to reference Hauner H, Meier M, Jockel KH, et al. Prediction of successful weight reduction under sibutramine therapy through genotyping of the G-protein β3 subunit gene (GNB3) C825T polymorphism. Pharmacogenetics 2003; 13: 453–9PubMedCrossRef Hauner H, Meier M, Jockel KH, et al. Prediction of successful weight reduction under sibutramine therapy through genotyping of the G-protein β3 subunit gene (GNB3) C825T polymorphism. Pharmacogenetics 2003; 13: 453–9PubMedCrossRef
15.
go back to reference Kim SH, Lee YM, Jee SH, Nam CM. Effect of sibutramine on weight loss and blood pressure: a meta-analysis of controlled trials. Obes Res 2003; 11: 1116–23PubMedCrossRef Kim SH, Lee YM, Jee SH, Nam CM. Effect of sibutramine on weight loss and blood pressure: a meta-analysis of controlled trials. Obes Res 2003; 11: 1116–23PubMedCrossRef
16.
go back to reference McMahon FG, Weinstein SP, Rowe E, et al. Sibutramine is safe and effective for weight loss in obese patients whose hypertension is well controlled with angiotensin-converting enzyme inhibitors. J Hum Hypertens 2002; 16: 5–11PubMedCrossRef McMahon FG, Weinstein SP, Rowe E, et al. Sibutramine is safe and effective for weight loss in obese patients whose hypertension is well controlled with angiotensin-converting enzyme inhibitors. J Hum Hypertens 2002; 16: 5–11PubMedCrossRef
17.
go back to reference McMahon FG, Fujioka K, Singh BN, et al. Efficacy and safety of sibutramine in obese white and African American patients with hypertension: a 1-year, double-blind, placebo-controlled, multicenter trial. Arch Intern Med 2000; 160(14): 2185–91PubMedCrossRef McMahon FG, Fujioka K, Singh BN, et al. Efficacy and safety of sibutramine in obese white and African American patients with hypertension: a 1-year, double-blind, placebo-controlled, multicenter trial. Arch Intern Med 2000; 160(14): 2185–91PubMedCrossRef
18.
go back to reference Torgerson JS, Hauptman J, Boldrin MN, et al. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004; 27: 155–61PubMedCrossRef Torgerson JS, Hauptman J, Boldrin MN, et al. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004; 27: 155–61PubMedCrossRef
19.
go back to reference Jain AK, Kaplan RA, Gadde KM, et al. Bupropion SR vs. placebo for weight loss in obese patients with depressive symptoms. Obes Res 2002; 10: 1049–56PubMedCrossRef Jain AK, Kaplan RA, Gadde KM, et al. Bupropion SR vs. placebo for weight loss in obese patients with depressive symptoms. Obes Res 2002; 10: 1049–56PubMedCrossRef
20.
go back to reference Anderson JW, Greenway FL, Fujioka K, et al. Bupropion SR enhances weight loss: a 48-week double-blind, placebo-controlled trial. Obes Res 2002; 10: 633–41PubMedCrossRef Anderson JW, Greenway FL, Fujioka K, et al. Bupropion SR enhances weight loss: a 48-week double-blind, placebo-controlled trial. Obes Res 2002; 10: 633–41PubMedCrossRef
21.
go back to reference Goldstein DJ, Rampey AH Jr, Enas GG, et al. Fluoxetine: a randomized clinical trial in the treatment of obesity. Int J Obes Relat Metab Disord 1994; 18: 129–35PubMed Goldstein DJ, Rampey AH Jr, Enas GG, et al. Fluoxetine: a randomized clinical trial in the treatment of obesity. Int J Obes Relat Metab Disord 1994; 18: 129–35PubMed
22.
go back to reference Darga LL, Carroll-Michals L, Botsford SJ, et al. Fluoxetine’s effect on weight loss in obese subjects. Am J Clin Nutr 1991; 54: 321–5PubMed Darga LL, Carroll-Michals L, Botsford SJ, et al. Fluoxetine’s effect on weight loss in obese subjects. Am J Clin Nutr 1991; 54: 321–5PubMed
23.
go back to reference Griffen L, Anchors M. The “Phen-Pro” diet drug combination is not associated with valvular heart disease. Arch Intern Med 1998; 158: 1278–9PubMedCrossRef Griffen L, Anchors M. The “Phen-Pro” diet drug combination is not associated with valvular heart disease. Arch Intern Med 1998; 158: 1278–9PubMedCrossRef
24.
go back to reference Gadde KM, Franciscy DM, Wagner II HR, et al. Zonisamide for weight loss in obese adults: a randomized controlled trial. JAMA 2003; 289: 1820–5PubMedCrossRef Gadde KM, Franciscy DM, Wagner II HR, et al. Zonisamide for weight loss in obese adults: a randomized controlled trial. JAMA 2003; 289: 1820–5PubMedCrossRef
25.
go back to reference VanGaal LF, Rissanen AM, Scheen AJ, et al. Effects of the cannabinoid-1 receptor blocker rimonabant on weight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study. Lancet 2005; 365: 1389–97PubMedCrossRef VanGaal LF, Rissanen AM, Scheen AJ, et al. Effects of the cannabinoid-1 receptor blocker rimonabant on weight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study. Lancet 2005; 365: 1389–97PubMedCrossRef
Metadata
Title
Pharmacotherapy for the treatment of obesity has only modest benefits and should be used in combination with lifestyle modifications
Publication date
01-01-2006
Publisher
Springer International Publishing
Published in
Drugs & Therapy Perspectives / Issue 1/2006
Print ISSN: 1172-0360
Electronic ISSN: 1179-1977
DOI
https://doi.org/10.2165/00042310-200622010-00003

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