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Anti-Obesity Potential of Indian Traditional Medicinal Plants and Their Phytochemicals
Published in Parimelazhagan Thangaraj, Medicinal Plants, 2018
Vellingiri Vadivel, Pichai Venkatalakshmi, Pemaiah Brindha
In addition to losing weight, Orlistat within a prescribed limit has been shown to be safe and more effective than diet alone in modifying some of the risks of coronary artery disease and other obesity-related comorbidities. The most commonly reported adverse effects of Orlistat are a range of gastrointestinal side effects, including steatorrhoea, bloating, oily spotting, fecal urgency and fecal incontinence, as well as hepatic adverse effects (Viner et al. 2010). These adverse effects are similar to those observed for other lipase inhibitors tested in phase II studies, such as Cetilistat (Kopelman et al. 2007). On the other hand, the inhibition of fat absorption could be accompanied by fat-soluble vitamin deficiencies, which could be prevented by the vitamin supplementation strategy, as other authors have recommended when vitamin deficiency occurs in patients undergoing Orlistat therapy (Melia et al. 1996). Hence, researchers are interested in finding new natural substances that show potent inhibitory activity against pancreatic lipase, and have fewer side effects than the current ones.
Current research and future hope
Published in G. Michael Steelman, Eric C. Westman, Obesity, 2016
Greenway Frank L., R. Smith Steven
Cetilistat is a lipase inhibitor like orlistat and appears to give similar efficacy and similar side effects, although the side effects may be less severe (77). Cetilistat has completed phases I and II in the United States and is now in phase III trials in Japan.
Psychopharmacological advances in eating disorders
Published in Expert Review of Clinical Pharmacology, 2018
Hubertus Himmerich, Janet Treasure
Drugs used for obesity may also reduce weight in BED as there is a significant overlap between both diagnoses [86–92]. Therefore, we would like to briefly mention these drugs as well, even though they are not yet tested for BED but only for obesity. Liraglutide is an analog of the anorexigenic bowel hormone GLP-1 which binds to the GLP-1 receptors in the hypothalamus. It has been shown to lead to significant weight loss in obese patients and to an improvement regarding the various health consequences of obesity in a number of RCTs [151–156]. Two RCTs with naltrexone plus bupropion showed superior weight outcomes to placebo in patients with obesity with no adverse effects [157,158]. This combination is thought to lead to weight loss by modulation of opioid, dopamine, and norepinephrine signaling in both the self-regulatory and the reward system. Further new pharmacological approaches for obesity include the norepinephrine reuptake inhibitor reboxetine [159], the monoamine reuptake inhibitor tesofesin [160], the CB1 receptor antagonist taranabant [161], the peptide YY3-36 [162] which is a product of enteroendocrine cells, the pancreatic and lipase inhibitor cetilistat [163]. From preclinical and healthy studies, there is also evidence for the efficacy of intranasal insulin to reduce appetite and food intake [164]. Furthermore, there is already sufficient evidence from RCTs for the beneficial clinical effect of the serotonin receptor agonist lorcaserin [165] and the combination of the stimulant phentermine which has similarities with amphetamine plus topiramate [166–169].
Obesity medications in development
Published in Expert Opinion on Investigational Drugs, 2020
Candida J. Rebello, Frank L. Greenway
This review will examine selected clinical trial evidence for the treatment of obesity. However, the primary objective is to provide an opinion on the state of the science as it relates to the pipeline of emerging treatments for obesity. A search was conducted on PubMed using the terms ‘Obesity AND Medications’ restricted to clinical trials reported in English. Using similar terms a search was also conducted on ClinicalTrials.gov. The United States (US) is at the forefront of anti-obesity drug development. Other nations such as Japan (mazindol and cetilistat), China (orlistat), and Europe (orlistat, the combination of naltrexone with bupropion, and liraglutide) have few approved anti-obesity medications. Therefore, this paper will present the US perspective.