title: The New Era of Drug Therapy for Obesity: The Evidence and the Expectations.
abstract: There is an urgent need for effective pharmacological therapies to help tackle the growing obesity epidemic and the healthcare crisis it poses. The past 3 years have seen approval of a number of novel anti-obesity drugs. The majority of these influence hypothalamic appetite pathways via dopaminergic or serotoninergic signalling. Some are combination therapies, allowing lower doses to minimize the potential for off-target effects. An alternative approach is to mimic endogenous satiety signals using long-lasting forms of peripheral appetite-suppressing hormones. There is also considerable interest in targeting thermogenesis by brown adipose tissue to increase resting energy expenditure. Obesity pharmacotherapy has seen several false dawns, but improved understanding of the pathways regulating energy balance, and better-designed trials, give many greater confidence that recently approved agents will be both efficacious and safe. Nevertheless, a number of issues from preclinical and clinical development continue to attract debate, and additional large-scale trials are still required to address areas of uncertainty.
authors.affiliation: Section of Investigative Medicine, Hammersmith Hospital, Imperial College London, 6th Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Jones
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Bloom
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D004734:Energy Metabolism / Q000187:drug effects; D005544:Forecasting; D006801:Humans; D009765:Obesity / Q000188:drug therapy*
chemical_list: D019440:Anti-Obesity Agents