Drug treatment of obesity in the cardiovascular patient.
OBJECTIVE
The incidence of obesity and its associated comorbidities have significantly increased over the years with adverse health and financial consequences for society. Lifestyle changes are essential for the prevention and treatment of obesity but their benefit appears limited as inadequate and nonsustained weight loss results have been reported. Pharmacotherapy is frequently advocated as part of a weight loss strategy. In this review, we will discuss the antiobesity drugs with Food and Drug Administration approval and their cardiovascular implications.


RESULTS
Orlistat (Xenical) remains the single monotherapy that has approval in Europe. Topiramate (Topamax) and phentermine have long been approved in the United States, whereas lorcaserin and the extended release combination of phentermine with topiramate have recently gained approval. The development of single peptides targeting gut hormones or other host signals related to obesity may represent promising therapeutic options.


CONCLUSIONS
Despite the recent failures of a number of antiobesity drugs, the pharmacotherapy of obesity is progressing rapidly. Treating the obese cardiovascular patient has proven challenging. Efficacy, safety and the sustainability of weight loss are key areas of focus in drug development strategies.
Vascular Physiology Unit, Institute of Child Health, London, UK. charakidadoc@gmail.com
Marietta
M
Charakida
Dimitris
D
Tousoulis
Nicholas
N
Finer
D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007783:Lactones / Q000627:therapeutic use; D009765:Obesity / Q000150:complications / Q000188:drug therapy*; D000077403:Orlistat; D010645:Phentermine / Q000627:therapeutic use; D000077236:Topiramate
D019440:Anti-Obesity Agents; D001552:Benzazepines; D007783:Lactones; D000077236:Topiramate; D005632:Fructose; C506658:lorcaserin; D000077403:Orlistat; D010645:Phentermine