Obesity

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Obesity

• Pharmacotherapy and Other Treatment Options
• Dr. Clower
• Chemistry 4205

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What is obesity?

• Body mass index
• Who is at risk?
• What causes obesity?
• Treatment options
• Diet and exercise
• Pharmacotherapy
• Salbutramine (Meridia)
• Orlistat (Xenical/alli)
• Surgery

http//win.niddk.nih.gov/publications/tools.htm
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Anti-obesity drugs

• Affect energy intake or energy expenditure
• Complex eating and fat-storage mechanisms

www.endocrine-source.com
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Neurotransmitters

• Monoamines

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Hormones
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Processing of dietary lipids
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Pharmacotherapy failures

• 1893 thyroid extracts
• 1934 dinitrophenol
• 1937 amphetamines
• 1967 rainbow pills
• 1971 Aminorex
• 1978 collagen-based very low calorie diets
• Most recent Fen-Phen
• Fenfluramine and Phentermine

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Fen-Phen what went wrong?

• Fenfluramine and dexfenfluramine
• Phentermine

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Sibutramine

• 1997
• Target serotonin receptors
• Inhibit reuptake
• Metabolites
• Dosage
• Lack of side effects

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Enzymatic degradation of TAGs

• Processing of dietary lipids Step 2
• lipase action

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Interfacial activation
Nature 362, 793 (1993).
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Orlistat

• Derived from lipstatin
• Dosage
• Side effects

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Surgery

• Failures
• 1889-1920s carving
• Jaw wiring
• Waist cords
• Jejunioleal bypass
• Intragastric balloons
• Esophageal banding
• Vertical-banded gastroplasty

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Gastric bypass surgery
http//www.angelfire.com/ok3/vbowen8/