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Cited by 149Pharmacology and Obesity TreatmentRegulation of Appetite and ObesityBariatric Surgery and Outcomes

Pharmacological Therapies for Obesity

Kaplan, Lee M.·2005·Gastroenterology Clinics of North America
DOI 10.1016/j.gtc.2004.12.002
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Abstract

Pharmacological therapy for obesity is in transition. Historically,there have been few effective agents, and many have been with-drawn because of unacceptable side effects. Current options include three medications approved by the FDA for the treatment of obesity: phentermine, sibutramine and orlistat. Phentermine and sibutramine suppress appetite and promote thermogenesis,and orlistat blocks fat digestion and absorption in the gut. Several drugs approved for other indications often promote weight loss, including bupropion, metformin, topiramate and zonisamide; they have been used empirically for treatment of obesity and to counter the weight-promoting effects of other medications. Expanding knowledge of the physiological mechanisms of body weight regulation has revealed new molecular targets, and more than 150 novel agents are under active development. Because weight regulation is complex, and redundant systems protect against perceived starvation, optimal treatment of obesity will likely require combinations of therapies. The accelerating emergence of new medications will facilitate the development of such effective combinations.

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  • The only three drugs currently approved by the FDA specifically for weight loss decrease energy intake, either by acting at satiety centers in the brain (sibutramine and phentermine) or by reducing the efficiency of intestinal absorption (orlistat).

    “The only three drugs currently approved by the FDA specifically for weight loss decrease energy intake, either by acting at satiety centers in the brain (sibutramine and phentermine) or by reducing the efficiency of intestinal absorption (orlistat) 5, thereby reducing the elevated energy intake that is critical in maintaining the obese state 6.”

    From Cellular bioenergetics as a target for obesity therapy (2010) · cites this paper as [5]

  • Phentermine promotes weight loss by activation of the central nervous system and sympathetic nervous system, with a subsequent decrease in food intake and increased resting energy expenditure.

    “Phentermine, an adrenergic agonist, is thought to promote weight loss by activation of the central nervous system and SNS, with a subsequent decrease in food intake and increased resting energy expenditure.193”

    From Obesity‐Related Hypertension: Pathogenesis, Cardiovascular Risk, and Treatment: A Position Paper of <i>The Obesity Society</i> and the <i>American Society of Hypertension</i> (2013) · cites this paper as [193]

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Authors
Kaplan, L. M.
Affiliations
Harvard University (US)
Corresponding author
Kaplan, Lee M.
ORCID
Kaplan, Lee M.
Venue
Gastroenterology Clinics of North America
Publisher
Elsevier BV
Published
2005-03
Volume
34
Issue
1
Pages
91-104
ISSN
0889-8553 (ISSN-L)
DOI
10.1016/j.gtc.2004.12.002
OpenAlex
W1967220509
Cited by
149
References
38
Citations by year
2025: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 4 · 2019: 7 · 2018: 3 · 2017: 6 · 2016: 8 · 2015: 8 · 2014: 10 · 2013: 15 · 2012: 17
FWCI
5.74
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Gastroenterology Clinics of North America (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200, DK99010, DK 43351, P30DK043351, DK46200.)
  • U.S. National Library of Medicine (U54LM008748)
Topics
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords
obesity pharmacotherapy, phentermine, sibutramine, orlistat, appetite suppression, thermogenesis, bupropion, metformin, topiramate, zonisamide, body weight regulation, combination therapy
MeSH terms
Appetite Depressants, Clinical Trials as Topic, Female, Humans, Male, Obesity, Severity of Illness Index, United States, United States Food and Drug Administration, Weight Loss, Body Mass Index, Treatment Outcome, Patient Satisfaction, Drug Approval, Risk Assessment, Patient Selection, Anti-Obesity Agents

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