Endocrinology and Metabolism Clinics of North America
Review articleObesity and pharmacologic therapy☆
Section snippets
Sibutramine
Originally developed as an antidepressant, sibutramine (Meridia) is a β-phenethylamine that inhibits norepinephrine and serotonin reuptake without the release of monoamines [5]. Instead of improving mood, however, treatment led to weight loss. Since 1997, sibutramine has been approved for long-term treatment of obesity. NIH guidelines recommend starting treatment at an oral dose of 10 mg/day [4]. Subsequently, the dose can be increased or decreased by 5 mg/day depending on efficacy and
Leptin
With its discovery in 1994, leptin established adipose as an endocrine organ. Leptin is a hormone released from adipocytes that conveys a message of energy availability to the hypothalamus. Leptin deficiency leads to severe obesity [51]. Leptin acts by means of its receptor to activate a Janus kinase/signal transduction and translation (JAK/STAT) system, which ultimately leads to the decreased expression of neuropeptide Y (NPY), a potent appetite stimulant, and the increased expression of
Summary
Obesity is a chronic, complex, multifactorial disorder with increasing prevalence in modern society. Lifestyle modification has had limited success in treating this disorder. Currently approved pharmacologic treatments for obesity include sibutramine and orlistat, which have been associated with significantly greater weight loss than that seen with dieting alone. In addition, a greater percentage of patients who receive medical treatment achieve weight losses of more than 5% to 10% of their
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2009, European Journal of Paediatric NeurologyCitation Excerpt :It is a concerned problem at any age, particularly in adolescence, a period of heightened awareness of body weight and image.5 This cosmetic condition is compounded by the high prevalence of depression among epileptic patients.6 Weight gain not only affects body image and self-confidence with adverse psychological effects leading to non-compliance to medications,7 but also is associated with pathologic consequences related to obesity as reproductive disorders, dyslipidemia, hypertension, insulin resistance, diabetes mellitus and atherosclerosis and its related vascular complications.8
Chapter 19 Metabolic Effects of AEDs. Impact on Body Weight, Lipids and Glucose Metabolism
2008, International Review of NeurobiologyCitation Excerpt :Currently, more than half of the adult US population is categorized as being either overweight or obese (Fig. 1) (Willett et al., 1999). Patients with epilepsy have an increased rate of obesity, some iatrogenically related to the prescribed AED treatment and others linked to the high prevalence of depression in patients with epilepsy (Thearle and Aronne, 2003). The pathologic consequences of obesity include deleterious effects on insulin resistance, reproductive disorders, cardiovascular disorders, gall bladder disease, bone and joint disease, and cancer (Aronne, 2002b).
Leptin and insulin homeostasis in epilepsy: Relation to weight adverse conditions
2007, Epilepsy ResearchCitation Excerpt :Few published studies did not show a correlation between weight gain and the type of epilepsy (Wirrell, 2003). Some studies correlated weight gain in epileptic patients to the high prevalence of associated depression (Thearle and Aronne, 2003). Animal models of epilepsy demonstrated significant increase in body weight in long-term amygdaloid kindled seizures (Bhatt et al., 2004) and this has been attributed to the role of amygdala in controlling feeding behavior (Rollins and King, 2000).
Nutritional Consequences of Weight-Loss Surgery
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2009, Proceedings of the Nutrition Society
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Louis J. Aronne has received grants and research support from, or functioned as a consultant or speaker for, the following companies: Roche Pharmaceuticals, Abbott Laboratories, Ortho-McNeil Pharmaceuticals, Regeneron Pharmaceuticals, Sanofi-Synthelabo, TAP Pharmaceuticals, Bristol-Myers Squibb.