Obesity has become a major health problem worldwide. The prevalence and morbidity of obesity-related diseases including diabetes, hypertension, cerebro-cardiovascular diseases, and tumors also have remarkably increased. Treatment of obesity poses a challenge for clinicians. Anti-obesity treatment is helpful to improve and even reverse obesity-related complications. Diet control and physical exercises remain the predominant interventions for obese patients. Anti-obesity drugs can be considered in those who respond poorly to behavioral intervention or those who have developed obesity-related complications. The commonly used anti-obesity drugs include gastrointestinal lipase inhibitors and appetite suppressants. Glucagon-like peptide 1 has also been found to be effective in reducing body weight. Some more drugs are under development, which include selective 5-HT 2c agonist, β3 receptor agonist, and melanocortin receptor 4 agonist, may also be promising.
Anti-Obesity Agents ; therapeutic use ; Appetite Depressants ; therapeutic use ; Glucagon-Like Peptide 1 ; therapeutic use ; Humans ; Obesity ; drug therapy

According to WHO global estimates from 2008, more than 1.4 billion adults were overweight and among them, over 200 million men and 300 million women were obese. Although the main treatment modalities for overweight and obese individuals remain dieting and physical exercise, the synthetic anti-obesity medications have been increasingly used due to their perceived convenience. Generally, anti-obesity medications are classified as appetite suppressants or fat absorption blockers. In the present study, we examined the adverse side-effects in respect of behavior changes of phentermine and Ephedra sinica (mahuang) that are anti-obesity drugs currently distributed to domestic consumers. Phentermine is mainly classified as an anorexing agent and mahuang a thermogenic agent. Because phentermine and mahuang are considered to display effectiveness through the regulation of nerve system, their potential influences of on behavioral changes were examined employing animal experiments. From the results of experiments testing locomotor activity through the use of treadmill, rota-rod, and open field system, phentermine and mahuang were commonly revealed to induce behavioral changes of rats by reducing a motor ability, an ability to cope with an external stimulus, and a sense of balance or by augmenting wariness or excitement. These adverse effects of phenternime and mahuang in behavioral changes need to be identified in humans and anti-obesity medications such as phentermine and mahuang should be prescribed for only obesity where it is anticipated that the benefits of the treatment outweigh their potential risks.
Absorption ; Adult ; Animal Experimentation ; Animals ; Anti-Obesity Agents* ; Appetite Depressants ; Diet ; Diethylpropion ; Ephedra sinica ; Exercise ; Female ; Humans ; Male ; Models, Animal* ; Motor Activity ; Obesity ; Overweight ; Phentermine* ; Rats ; Rats, Sprague-Dawley*

PURPOSE: In Korea, few studies have examined the acute toxicity of anti-obesity drugs. The purpose of this study is to analyze the general characteristics and clinical aspect of acute anti-obesity drug intoxication. METHODS: We retrospectively investigated patients admitted to the emergency department after anti-obesity drug intoxication between March, 2004 and February, 2012. The medical records of these patients were reviewed for demographic data, toxicologic history, time elapsed to presentation, clinical symptoms and signs, treatment, and outcome. RESULTS: There were a total of 18 anti-obesity intoxication cases during the study period; of 16 which were included in our study. The purchasing route of the anti-obesity drug was mainly through a doctor's prescription (68.8%), however, some were obtained through the internet and the pharmacies. The mean time to The most commonly ingested anti-obesity drug was sibutramine (31.3%) and many of the cases (62.5%) were multi-drug ingestions. The most common clinical manifestations were gastrointestinal symptoms (94%), but, CNS symptoms (75%) and cardiovascular symptoms (75%) were almost equally present. 13 patients (81%) were discharged after clearance of toxic symptoms and signs with a mean observational period of 7.0 hours. 3 patients were admitted for observation and treatment; of which 1 patient died due to fatal complications. CONCLUSION: Most anti-obesity intoxications show mild toxicity and a nonfatal clinical course. However, the recent trend toward prescribing psychostimulant anti-obesity medication, which can be fatal after an acute overdose, calls physicians' attention to treating of anti-obesity intoxications.
Anti-Obesity Agents ; Cyclobutanes ; Emergencies ; Humans ; Internet ; Korea ; Medical Records ; Obesity ; Pharmacies ; Prescriptions ; Retrospective Studies

A safe and effective way to control weight in patients with affective disorders is needed, and phentermine is a possible candidate. We performed a PubMed search of articles pertaining to phentermine, sibutramine, and affective disorders. We compared the studies of phentermine with those of sibutramine. The search yielded a small number of reports. Reports concerning phentermine and affective disorders reported that i) its potency in the central nervous system may be comparatively low, and ii) it may induce depression in some patients. We were unable to find more studies on the subject; thus, it is unclear presently whether phentermine use is safe in affective disorder patients. Reports regarding the association of sibutramine and affective disorders were slightly more abundant. A recent study that suggested that sibutramine may have deleterious effects in patients with a psychiatric history may provide a clue for future phentermine research. Three explanations are possible concerning the association between phentermine and affective disorders: i) phentermine, like sibutramine, may have a depression-inducing effect that affects a specific subgroup of patients, ii) phentermine may have a dose-dependent depression-inducing effect, or iii) phentermine may simply not be associated with depression. Large-scale studies with affective disorder patients focusing on these questions are needed to clarify this matter before investigation of its efficacy may be carried out and it can be used in patients with affective disorders.
Anti-Obesity Agents ; Central Nervous System ; Cyclobutanes ; Depression ; Humans ; Mood Disorders ; Obesity ; Phentermine

Recently, the number of obesity and diabetes mellitus have increased rapidly not only in Korea but also around the world. It is even called the new pandemic of the 21st century. In Korea, the diabetes growth rate, which exceeds the obesity growth rate, is a bigger problem. Accordingly, the simultaneous treatment of diabetes and obesity has become a global issue. In this article, we will review various obesity treatments to help diabetes remission and take a look at meaningful previous study about dietary methods for obesity. This overview includes the update of medications for obesity and the practical method for clinicians in field of obesity treatment in Korea.
Anti-Obesity Agents ; Diabetes Mellitus ; Diet Therapy ; Korea ; Methods ; Obesity ; Pandemics

PURPOSE: Low grade inflammation is a well-known characteristic in obese subjects. We investigated body weight changes and inflammatory markers after 12-week intervention trial. MATERIALS AND METHODS: Twenty-six obese subjects were enrolled and 19 (13 men and 6 women) completed the study. Sibutramine is an FDA-approved drug for body weight control; therefore, we chose this drug as the standard treatment medication in this study. Patients were randomly allocated to receive an anti-inflammatory agent (Diacerein treatment group; n = 12) or placebo (n = 7) for 12 weeks. Anthropometry, body proportion by dual-energy X-ray absorptiometry, and metabolic parameters at the beginning and end of study were measured and compared. RESULTS: The treatment group had a tendency towards more reduction in anthropometry as compared to the placebo group, in body weight reduction (- 7.0 kg vs. - 4.6 kg), body mass index (- 2.51 kg/m2 vs. - 1.59 kg/m2), and waist circumference (- 7.3 cm vs. - 4.4 cm). These reductions were not statistically significant. Changes in levels of high-sensitivity C-reactive protein and adiponectin in the treatment group were more favorable than in the placebo group. CONCLUSION: This small pilot study showed no statistical difference for changes in anthropometry, and inflammatory markers between the two groups. Therefore, we could not find any additional effects of Diacerein on weight loss and inflammatory variables in this study.
Absorptiometry, Photon ; Adiponectin/blood ; Adult ; Anthraquinones/*therapeutic use ; Anti-Inflammatory Agents/*therapeutic use ; Appetite Depressants/therapeutic use ; C-Reactive Protein/analysis ; Cyclobutanes/*therapeutic use ; Double-Blind Method ; Female ; Humans ; Inflammation ; Lipoproteins, LDL/blood ; Male ; Obesity/*drug therapy/immunology ; Pilot Projects ; Tumor Necrosis Factor-alpha/blood ; Waist Circumference/drug effects/immunology ; Weight Loss/drug effects/*immunology

Oesity is a major global health problem. However, current therapeutic strategies for obesity are limited. Obesity results from an imbalance between energy intake and energy expenditure, and the treatment of obesity is based on the correction of this metabolic imbalance. Anti-obesity drugs can shift this balance in a favorable way by reducing food intake, altering metabolism, and by increasing energy expenditure. There is a growing consensus that pharmacotherapy is appropriate for many individuals who are unable to lose weight through less intensive measures. However, side effects may ensue phamacotherapy for obesity. Only two drugs (sibutramine and orlistat) are currently approved for the long-term treatment of obesity. Sibutramine inhibits the reuptake of serotonin and norepinephrine. Orlistat works by blocking the pancreatic lipase. However, phamarcotherapy may not be the ultimate resolution for obesity management. Because the underlying pathophysiology in each individual varies in many aspects, it is recommended to provide individualized and tailored medication in addition to other antiobesity supportive treatments.
Anti-Obesity Agents ; Consensus ; Drug Therapy ; Eating ; Energy Intake ; Energy Metabolism ; Health Expenditures ; Lipase ; Metabolism ; Norepinephrine ; Obesity* ; Serotonin

The current recommendations for the treatment of obese people include increased physical activity and reduced calories intake. When the behavioral approach is not sufficient, a pharmacologic treatment is recommended. In past years, numerous drugs have been approved for the treatment of obesity; however, most of them have been withdrawn from the market because of their adverse effects. In fact, amphetamine, rimonabant and sibutramine licenses have been withdrawn due to an increased risk of psychiatric disorders and non-fatal myocardial infarction or stroke. Even if orlistat is not as effective as other drugs in reducing body weight, orlistat is presently the only available choice for the treatment of obesity because of its safety for cardiovascular events and positive effects on diabetic control. Hopefully, more effective and better tolerated anti-obesity drugs will be developed through an improved understanding of the multiple mechanisms and complex physiological systems targeting appetite.
Amphetamine ; Anti-Obesity Agents ; Appetite ; Body Weight ; Cyclobutanes ; Lactones ; Licensure ; Motor Activity ; Myocardial Infarction ; Obesity ; Piperidines ; Pyrazoles ; Stroke

Obesity has become a global public health problem. The importance of obesity is highlighted by the fact that obesity-related comorbidities, such as type 2 diabetes, cardiovascular disease, and cancer, are a leading cause of death in Westernized countries. As endorsement of lifestyle modifications has proven to be inadequate to combat obesity, pharmacological treatment has become more critical for weight reduction as well as for the treatment of obesity-related morbidity and mortality. However, safety issues dampened the success of the development of anti-obesity drugs, leaving orlistat as the single approved drug for long-term weight management until 2012, when two new anti-obesity drugs were approved by the FDA: lorcaserin and phentermine/topiramate. In 2014, another two drugs were approved by the US FDA for the treatment of obesity: naltrexone/bupropion and liraglutide. In this review, we describe the new FDA-approved anti-obesity drugs and briefly introduce other anti-obesity drugs still under development.
Anti-Obesity Agents ; Cardiovascular Diseases ; Cause of Death ; Comorbidity ; Life Style ; Liraglutide ; Mortality ; Obesity* ; Public Health ; Weight Loss

Obesity is a chronic disorder that is a significant risk factor for diabetes, cardiovascular diseases, malignancy, and other chronic diseases. Lifestyle modifications form the basis of most treatments for obesity, but it has become clear that such modifications alone are not enough for many obese patients. When a behavioral approach is insufficient, pharmacological treatment may be recommended. In recent years, the US Food and Drug Administration (FDA) has withdrawn several therapeutic options for obesity due to their side effects, but has approved four novel anti-obesity agents. Until recently, orlistat was the only drug approved for the management of long-term obesity, but the US FDA approved the novel anti-obesity drugs lorcaserin and phentermine/topiramate in 2012, and naltrexone/bupropion and liraglutide in 2014. The present review discusses the different pharmacotherapeutic options for the treatment of obesity.
Anti-Obesity Agents* ; Cardiovascular Diseases ; Chronic Disease ; Humans ; Life Style ; Liraglutide ; Obesity ; Risk Factors ; United States Food and Drug Administration