Current management of obesity
Nerys Williams, Sudhesh Kumar in Managing Obesity in the Workplace, 2018
This chapter deals with advice on nutrition and physical activity which individuals need to appreciate and action in order to lose weight and reduce their personal risks of heart disease, diabetes, hypertension and other health issues. There are many influences on this balance – genetic, familial and hormonal – but getting nutrition and physical activity right will lead to a reduction in weight and improvement in health risk factors. Several conventional diets advocated calorie counting; this suits some people but not all and calorie-counted diets were no more or less successful than any others. Many workers will be experts on diets because they have tried them all. The physical activity can be of any type – an intensive aerobic workout, a gentle run in the park, a brisk walk with the dog. Sibutramine makes the patient feel fuller on a smaller portion of food and so reduces their calorie intake.
Sibutramine
Karl G. Hofbauer, Ulrich Keller, Olivier Boss in Pharmacotherapy of Obesity, 2004
Sibutramine (marketed as Meridia in the U.S. and Reductil in Europe) is a selective reuptake inhibitor for norepinephrine, serotonin, and dopamine. The drug is rapidly metabolized to two active metabolites, whose half-life is 14 to 16 h, with the peak concentration at 3 to 4 h and a plateau from 3 to 7 h (Luque and Rey 1999). The chemical structures of sibutramine and those of its two active metabolites are illustrated in Figure 12.1. The pharmacological profile allows for dosing once a day, an advantage when appetite regulation is the aim. The drug was first evaluated as a potential antidepressant in three phase II clinical trials, with disappointing results in depression (Kelly et al. 1995). However, striking weight loss was observed in the enrolled depressed patients (Kelly et al. 1995), and the drug has been developed and marketed for weight loss.
Prescription Medications for Weight Loss
Lillian Brazin in Internet Resources on Weight Loss and Obesity, 2007
Barbara Hirsch, a medical journalist, is the developer and manager of this resource, which is aimed at both consumers and physicians. Portions of the site are only accessible to paid subscribers, but the “premium” sections are clearly color-coded. Read “Accuracy in Medical Reporting: A Consumer’s Guide” for criteria on gaging the quality of medical articles. Hirsch has put together so much information on the topic of obesity, that serious obesity researchers and consumers might find the annual individual (U.S.) subscription rate of $104 a good value. Read the information on orlistat (Xenical), a drug that inhibits the absorption of fat (lipase inhibitor), and sibutramine (Meridia), a serotonin and norepinephrine reuptake inhibitor (these brain chemicals may have an effect on appetite and satiety). Hirsch also includes extensive information on new diet medications currently in the human testing stage before Food and Drug Administration (FDA) approval. In addition to safety and efficacy, she explains the factors that may affect continuation of clinical trials for a new drug.
Panic Disorder Induced by a “Herbal” Product Containing Sibutramine: Case Series with Review of Literature
Published in Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology, 2015
Defne Eraslan, Aylin Aksoy Coban, Erhan Ertekin
Sibutramine is a serotonin and noradrenaline reuptake inhibitor which has been used for weight loss in obese patients. There are slimming products on the market claiming to be ‘natural’ which nevertheless contain sibutramine. In this report, we present three cases where panic attacks were associated with the use of a product and persisted even long after its discontinuation.
Sibutramine and the management of obesity
Published in Expert Opinion on Pharmacotherapy, 2004
Walker S Carlos Poston, John P Foreyt
Sibutramine is a selective serotonin and noradrenaline re-uptake inhibitor approved for the long-term management of obesity. Its primary mechanism of action is increased satiety, although some evidence also suggests increased energy expenditure could play a role in sibutramine-induced weight loss. It has established general efficacy in long-term trials, with clinically-approved doses of 10 and 15 mg. Sibutramine has also been studied in a number of unique populations, including obese controlled hypertensives, diabetics and ethnic minorities, further establishing its effectiveness. However, it does have a consistent effect of increasing blood pressure and pulse. Thus, blood pressure and heart rate should be monitored in patients using sibutramine and it may not be applicable in obese patients with significant cardiovascular disease.
Sibutramine: current status as an anti-obesity drug and its future perspectives
Published in Expert Opinion on Pharmacotherapy, 2008
Bikash Sharma, David C Henderson
Background: Obesity has become a global epidemic with recent estimates of > 400 million obese adults. Despite this, there are few safe and effective pharmacological interventions for obesity. Sibutramine is a weight loss agent, for use as an adjuvant to a comprehensive program of calorie restriction, exercise and behavioral therapy. Objective: The goal of this article is to review the available literature of pharmacological interventions for obesity and specifically to examine data with sibutramine for the short term on safety and efficacy for weight loss. Methods: The literature on sibutramine was reviewed after a PubMed and Medline search in March 2008. All randomized clinical trails were reviewed. Results/conclusions: Sibutramine appears to be safe and effective in producing clinically significant weight loss for up to 1 year. Longer prospective clinical studies with sibutramine are needed to evaluate its safety (effect on blood pressure) and ability to maintain weight loss, improve metabolic profiles and reduce the risk of cardiovascular diseases.
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