&
For advertising information visit www.samplerpublications.com or call 859.225.4466 | January 2015
Approved
Obesity
Drugs
By Angela S. Hoover,
Staff Writer
There is a difference between
being overweight and being obese.
An individual is considered obese
when weight is 20 to 25 percent or
more over the maximum desirable
for their height. When an adult is
more than 100 pounds overweight
they are considered morbidly obese.
Anti-obesity medication aims to
reduce or control weight by altering
weight regulation, altering appetite, or by altering the absorption
of calories in obese and morbidly
obese people. Anti-obesity drugs
are used when diet and exercise are
not enough but the individual does
not want to undergo weight loss
surgery.
Drugs that work on suppressing
the appetite are catecholamines
and their derivatives (phentermine
and other amphetamine-based
drugs) and anorectics. Most anorectic drugs are also stimulants,
like Dexedrine and digoxin. Antidepressants and mood stabilizers
(bupropion and topiramate) are
also sometimes used for appetite
suppression. In the future, drugs
that block the cannabinoid receptors may be a future strategy.
Other drugs work on increasing
the body’s metabolism. And other
drugs interfere with the body’s ability to absorb specific nutrients in
food, such as fats or carbohydrates.
Additionally, over the counter fiber
supplements glucomannan and
guar gum have been used to inhibit
the digestion and lowering caloric
absorption.
Currently, only one anti-obesity
medication – orlistat (Alli, Xenical)
– is approved by the FDA for long
term use in the United States. For
other drugs, certain weight loss
benchmarks are set – usually 12
weeks. After 12 weeks, or if these
benchmarks are not met within this
time, then the medication should
be stopped. Due to potential side
effects, anti-obesity drugs are only
prescribed for obesity when it is
believed the benefits outweigh
these risks. Some of these drugs
can have severe and even lethal
side effects. Some are also habit
forming. Stimulants can cause high
blood pressure, faster heart rate,
palpitations and closed-angle glau-
coma, drug addiction, restlessness,
agitation and insomnia. One of the
problems with anti-obesity drugs is
that we do not fully understand the
neural basis of appetite and how to
modulate it. The body uses many
chemicals and hormones to protect
its stores of fat but we do not know
how to circumvent this bodily process. This is why anti-obesity drugs
are not practical for long-term use.
Following are some of the most
commonly prescribed anti-obesity
medications. All of these have
numerous side effects so anyone
considering taking these drugs
should seriously weigh the risks and
benefits and talk in depth with their
doctor.
Acomplia
Generically known as
rimonabant, Acomplia works via
a specific blockade of the endocannabinoid system. It has been
approved in Europe for the treatment of obesity but has not yet
been approved in the United States
and Canada due to safety concerns.
Acarbose
This drug partially blocks
absorption of carbohydrates in the
small intestine and produces similar
side effects as Xenical (orlistat).
39
Alli / Xenical
Also known as orlistat, Xenical is
the only anti-obesity drug approved
by the FDA for long term use. It
reduces intestinal fat absorption
by inhibiting pancreatic lipase. As
a result of it blocking the absorption of dietary fats, oily spotting of )