10. drugs for obesity

BY
Dr. SAMINATHAN KAYAROHANAM
M.PHARM PhD , M.B.A, PhD
DRUGS FOR OBESITY
1

2
TABLE OF CONTENT
Dr.K.Saminathan.M.Pharm Ph.D, M.B.A Ph.D
S.NO TITLE PAGE
1 FACTS ABOUT OVERWEIGHT AND OBESITY 4
2 CAUSES OF OBESITY 15
3 RISK FACTORS OF OBESITY 17
4 TYPES OBESITY 21
5 PREVENTION OF OBESITY 23
6 ETIOLOGY OF OBESITY 24
7 IMPORTANCE OF LEPTIN 25
8 PATHOGENESIS OF OBESITY 28
9 PATHOGENESIS OF OBESITY 33
10 DRUGS FOR OBESITY 37

3Dr.K.Saminathan.M.Pharm Ph.D, M.B.A Ph.D
1. Able to explain the obesity and overweight
2. Able to determine the causes of obesity
3. Able to demonstrate the risk factors of obesity
4. Able to exhibit the type of obesity
5. Able to understand the prevention of obesity
6. Able to differentiate the pathogenesis of obesity
7. Able to explain the mechanism of obesity drugs
8. Able to understand the adverse effect of obesity drugs
LEARNING OUTCOMES

 Worldwide obesity has nearly tripled since 1975.
 In 2016, more than 1.9 billion adults, 18 years and older,
were overweight. Of these over 650 million were obese.
 39% of adults aged 18 years and over were overweight in
2016, and 13% were obese.
 Most of the world's population live in countries where
overweight and obesity kills more people than
underweight.
 41 million children under the age of 5 were overweight or
obese in 2016.
 Over 340 million children and adolescents aged 5-19 were
overweight or obese in 2016.
 Obesity is preventable.
1. FACTS ABOUT OVERWEIGHT AND OBESITY

PREVALENCE OF OBESITY IN SOUTHEAST ASIA

WHAT ARE OBESITY AND OVERWEIGHT
 Overweight and obesity are defined as abnormal or excessive fat
accumulation that may impair health.
 Body mass index (BMI) is a simple index of weight-for-height that is
commonly used to classify overweight and obesity in adults. It is defined as
a person's weight in kilograms divided by the square of his height in meters
(kg/m2).
ADULTS
For adults, WHO defines overweight and obesity as follows:
 overweight is a BMI greater than or equal to 25; and
 obesity is a BMI greater than or equal to 30.
 BMI provides the most useful population-level measure of overweight and
obesity as it is the same for both sexes and for all ages of adults. However, it
should be considered a rough guide because it may not correspond to the
same degree of fatness in different individuals.
 For children, age needs to be considered when defining overweight and
obesity.

•overweight is weight-for-height greater than 2
•obesity is weight-for-height greater than 3

overweight is BMI-for-age greater than 1 .
obesity is greater than 2

FORMULA FOR OBESITY CALCULATION

2. CAUSES OF
OBESITY

CAUSES OF
OBESITY
 Losing weight reduces fat mass, which leads to a
significant reduction in leptin levels.
 When leptin goes down, this leads to hunger, increased
appetite, and decreased amount of calories burned at rest.

3. RISK FACTORS OF OBESITY

RISK FACTORS OF OBESITY

4.TYPES OBESITY

TYPES OBESITY

5. PREVENTION OF OBESITY

6. ETIOLOGY OF OBESITY
 Genetic basis
 Imbalance between energy intake and expenditure.
Control of Energy
expenditure
 Normal Metabolism
 Physical activity
 Thermogenesis
OBESITY SYNDROMES
1. Laurence Moon Biedl syndrome
2. Congenital leptin deficiency
3. Prader Willi Syndrome
4. Bardet Biedl Syndrome
Endocrinal Abnormalities-
Cushing syndrome
Hypothyroidism
Insulinoma
Metabolic syndrome
PCOD
Disorders of Hypothalamus
 Tumours- Craniopharyngioma
 Inflammation
 Trauma
 GH decreases but Somatomedin is
normal.
***Actually leptin is a 16-kDa protein. It is secreted by adipocytes
and dominantly has major role in the body weight regulation by
maintaining a balance between food intake and expenditure of
energy. ... It was believed that leptin is an anti-obesityhormone.

7. IMPORTANCE OF LEPTIN

8. PATHOGENESIS OF OBESITY

ROLE OF LEPTIN

9. PATHOGENESIS OF OBESITY

PATHOGENESIS OF OBESITY

Feedback mechanism for control of food intake
Feeding stage :-Peptide YY
(PYY), cholecystokinin (CCK),
and insulin are gastrointestinal
hormones that are released -
suppress further feeding.
Excessive feeding: – Excess Fat –
Increased leptin Production –
Inhibition of food intake.
Fasting stage :-Ghrelin is
released by the stomach,
stimulates appetite.
PATHOGENESIS OF OBESITY

10. DRUGS FOR OBESITY

PHENTERMINE [FEN-TER-MEEN] AND DIETHYLPROPION [DYE-ETH-ILL-
PROE-PEEON] ARE CONSIDERED APPETITE SUPPRESSANTS.
Mechanism of action: Phentermine exerts its pharmacologic action
by increasing the release of norepinephrine and dopamine from the
nerve terminals and by inhibiting reuptake of these neurotransmitters,
thereby increasing levels of neurotransmitters in the brain. The increase
in norepinephrine signals a “fight-or-flight” response by the body, which,
in turn, decreases appetite.
ORLISTAT [OR-LIH-STAT] IS CURRENTLY THE ONLY AVAILABLE AGENT
IN A CLASS OF ANTIOBESITY DRUGS KNOWN AS LIPASE INHIBITORS.
Mechanism of action: Orlistat is a pentanoic acid ester that inhibits
gastric and pancreatic lipases, thus decreasing the breakdown of
dietary fat into smaller molecules that can be absorbed.
Administration of orlistat decreases fat absorption by about 30%. The
loss of calories from decreased absorption of fat is the main cause of
weight loss. However, adverse gastrointestinal effects associated with
the drug may also contribute to an overall decreased intake of food.
DRUGS FOR OBESITY

Mechanism of action: Lorcaserin selectively activates 5-HT2C receptors,
which are almost exclusively found in the central nervous system.
This activation, in turn, stimulates pro-opiomelanocortin neurons,which activate
melanocortin receptors, thereby causing a decrease in appetite. If a patient
does not lose at least 5% of their body weight after 12 weeks of use, the drug
should be discontinued.
LORCASERIN [LOR-KAS-ER-IN] IS A NEWER SEROTONIN AGONIST,
WITH SELECTIVITY FOR THE 2C SEROTONIN RECEPTOR (5-HT2C).
Lorcaserin mechanism of action POMC = pro-opiomelanocortin

ORLISTAT MECHANISM

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