2. Obesity
Obesity is the state of excess body fat stores.
Energy Intake > Energy consumption .
WHO states
1.5 billion obese population
U.S. 68% obese ( Largest Market )
2
3. Classification of Overweight
and Obesity
Acc. To BMI
BMI define body weight relative to
person’s height .
BMI=
𝐵𝑊(𝐼𝑏)×703
𝐻𝑒𝑖𝑔ℎ𝑡 (𝑖𝑛𝑐ℎ)2 Ib/𝑖𝑛𝑐ℎ2
3
9. 9
“There is no magic pill for obesity,
The best effect you're going to get is with
a concerted long-term regimen of diet and
exercise. If you choose to take a drug
along with this effort, it may provide
additional help.” says David Orloff,
Director of the FDA's Division of Metabolic
and Endocrine Drug Products.
11. 11
1- Orlistat ( Xenical )
Approved by the FDA in 1999 .
Only drug approved by FDA for long term use .
Approved by FDA for over-the-counter sale in Feb 2007.
M.O.A.
Reduces intestinal fat absorption ( lipase Inhibitor ).
S.E.
Steatorrhea-Intestinal discomfort-diarrhea-flatulence
Interfere absorption of fat-soluble vitamins & cyclosporine.
Improve lipid profiles & glucose control .
12. 2- Phentermine
M.O.A. (appetite suppressant)
Act on brain hypothalamus stimulating adrenal glands
to release norepinephrine reducing hunger.
S.E.
increased blood pressure - palpitations – arrhythmia
(FDA) recommended that phentermine used
short-term (up to 12 weeks).
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13. 3- Sibutramine (Meridia)
M.O.A.
Anorectic, serotonin & NE levels in brain .
S.E.
Increased bl. Pressure & Heart Rate - dry mouth -
constipation-headache-insomnia.
Approved by the FDA in 1997.
Withdrawn from U.S. & Canadian markets in 2010 .
Its risks (M.I. and stroke) more than the benefits.
Not used in patients with history of
stroke - heart disease - bl. Pressure -
arrhythmias – MOA inhibitors (SRI)
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14. 14
4- Diethylpropion
One of the safest noradrenergic appetite suppressants
Used in patients with mild to moderate HTN or angina.
15. 5- Metformin (Glucophage)
Reduce weight limit the amount of
glucose produced by the liver and
increases muscle consumption of glucose .
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16. 6- Exenatide (Byetta)
Long-acting analogue of GLP-1 hormone .
GLP-1 promotes a feeling of satiety.
Some obese people are deficient in
GLP-1.
Used for ttt of DM type 2 .
Exenatide is currently being tested in
non-diabetics as a treatment for obesity.
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17. 7- Pramlintide (Symlin)
Synthetic analogue Amylin hormone.
Amylin promotes a feeling of satiety.
Used along with insulin by Type 1 and
Type 2 diabetics.
Symlin is currently being tested in
non-diabetics as a treatment for obesity.
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18. N.B.
Orlistat is moderately effective produce average weight
loss of 5 to 22 pounds over a 1 year period .
Response to Anti-obesity medications , some people
experience more weight loss than others.
Some people lose >10% of body weight ,
Reduce the risk of high blood pressure, diabetes and
other obesity-related health complications .
Patients experience max. weight loss within 6 months.
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19. Anti-obesity Medication
withdrawn from market
1- Fen-phen (Fenfluramine + Phentermine ) .
Due to valvular heart disease and pulmonary HTN.
2- Redux (Dexfenfluramine)
Due to Cardiovascular side-effects reports
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20. Anti-obesity Medication
NOT Approved
1- Rimonabant
• Cannabis smokers often experience hunger !!! Thus ,
blockade of the endocannabinoid system decreasing
appetite.
• NOT approved Due to psychiatric Hazards .
2- Amphetamines
• Appetite Suppressant
• NOT approved Due to powerful stimulant & addictive
potential .
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22. 22
1- Lorcaserin
Appetite suppressor ,affecting levels serotonin.
patients lost about 4 % of their body weight.
For obese people and overweight people having
at least one weight-related health condition.
In combination with a healthy diet and exercises
S.E.
Headache – dizziness – fatigue – nausea -
dry mouth - constipation.
23. 2- Qsymia
Combination of two FDA-approved drugs:
1- Phentermine appetite suppressant .
2- Topiramate anticonvulsant drug treat migraines &
epilepsy , has weight-loss side effects.
In combination with a healthy diet and exercises.
help patients lose about 10-12 % of their body weight.
S.E.
heart problems - birth defects -cognitive effects such as
mental disturbance or lack of concentration .
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25. 1-Glucomannan
Glucomannan is a water-soluble polysaccharide.
(FDA) has not approved any product containing
glucomannan for the treatment of these medical
conditions.
MOA : Glucomannan dietary fibers interfere with
the motility and absorption of nutrients from the
gut.
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26. 2-Green Tea (caffeine)
Anti-oxidant rich – Noradrenergic .
Have weight-loss-promoting effects,
such as speeding up your metabolism
and suppressing your appetite.
Drinking more than five cups a day may
lead to caffeine-related side effects
Headache - nervousness -
sleep problems - irregular heartbeat
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27. 3-Chitosan
chitosan limiting fat absorption, which would make
it useful for dieting
Adverse effects
1- Constipation
2- upset stomach
3- reduce absorption of essential nutrients
(including calcium and vitamins A, D, E & K)
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28. 4- Chromium Picolinate
Insulin simulator , aid glucose & fat metabolism,
managing the breakdown of glucose and fat.
Adverse effects
behavioral changes - irregular heartbeat
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29. Antiobesity drugs not cure -all , must be combined
with physical exercises & healthy diet over long time .
Some people experience more weight loss than others.
Some people lose >10% of body weight ,
Reduce the risk of high blood pressure, diabetes and
other obesity-related health complications
29
30. 30
Conclusion
BMI :
Normal weight should be from 18.5 to 24.9 Kg/𝑚2
Anti-obesity drugs :
a- Fat absorption inhibitors (Orlistat).
b- Appetite suppressant (Phentramine)
c- Recent medications (Qysmia & lorcaserin).
Herbal and natural products for weight loss
a- Chitosan.
b- Green tea.
