[The obesity epidemics--do diet pills have a place in the treatment?].
BACKGROUND
Many experts consider obesity a chronic disease that may require long-term therapy. A loss of 5-15% of body weight is associated with improvements in cardiovascular risk factors and morbidity. However, most studies show that the majority of patients who lose weight relapse. Patients may be unable to maintain a low energy intake when confronted with an almost limitless supply of food. Moreover, a number of physiological mechanisms favour a set point for body weight, that may be altered with anti-obesity drugs.


RESULTS
In the current paper we describe actions and effects of current anti-obesity drugs. The centrally acting drug, sibutramine, is an adrenaline and serotonine re-uptake inhibitor which was recently approved in the USA for obesity. The USA, the European Union and Norway have approved orlistat, a pancreatic lipase inhibitor for weight reduction for up to two years. Patients must maintain a low fat intake in order to avoid gastrointestinal discomfort. In recent studies, orlistat and diet reduced body weight by 9% versus 6% on placebo and diet. No studies have documented long-term safety of anti-obesity drugs.


CONCLUSIONS
Treatment of a lifestyle-related disease like obesity with medications is controversial, however, such treatment may not differ substantially from treatment of type II diabetes, hyperlipidaemia or hypertension.
Tonstad
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Preventiv kardiologi Medisinsk divisjon Ullevål sykehus, Oslo.
Birkeland
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D019440:Anti-Obesity Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001067:Appetite Depressants / Q000008:administration & dosage* / Q000009:adverse effects; D003503:Cyclobutanes / Q000008:administration & dosage / Q000009:adverse effects; D005277:Fenfluramine / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007783:Lactones / Q000008:administration & dosage / Q000009:adverse effects; D020738:Leptin / Q000008:administration & dosage / Q000009:adverse effects; D009765:Obesity / Q000188:drug therapy* / Q000517:prevention & control; D009767:Obesity, Morbid / Q000188:drug therapy* / Q000517:prevention & control; D000077403:Orlistat; D010645:Phentermine / Q000008:administration & dosage / Q000009:adverse effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D015431:Weight Loss / Q000187:drug effects
D019440:Anti-Obesity Agents; D001067:Appetite Depressants; D003503:Cyclobutanes; D005277:Fenfluramine; D007783:Lactones; D020738:Leptin; D000077403:Orlistat; D010645:Phentermine; D017367:Selective Serotonin Reuptake Inhibitors; C058254:sibutramine