Pharmacotherapy of obesity – more risks than benefits

Authors

  • Dorota Owsianik Apteka otwarta, Rzeszów
  • Karolina Statek Instytut Położnictwa i Ratownictwa Medycznego, Uniwersytet Rzeszowski

Keywords:

pharmacotherapy of obesity, poisoning, adverse effects

Abstract

An epidemic of overweight and obesity concerns more than half of the European population. Not only is this a problem of an aesthetic nature, but it also contributes to various diseases caused primarily by excessive body weight. In order to lose weight, it is necessary to achieve negative energy balance which can be done by means of a suitable diet and increased physical activity. The process is long-drawn-out and requires numerous sacrifices. Those patients whose BMI (Body Mass Index) is higher than 30 kg/m2 are advised to introduce pharmacotherapy as a complementing method of losing weight. Over the course of time, many different types of drugs have been used to fight obesity. However, they have been gradually withdrawn from the market due to their recorded side effects. Despite that, they are still relatively easily available online or they are included in supplements advertised as herbal weight loss enhancers. This article provides an overview of those supplements while emphasizing the potential risks involved in using them. The effort to maintain their dieting regime is the reason why patients become prone to self-reliant pharmacological treatment which puts them under the risk of inadvertent poisoning.

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References

http://www.euro.who.int/en/health-topics/noncommunicable-diseases/obesity (10.02.2014)

Chan R, Woo J. Prevention of Overweight and Obesity: How Effective is the Current Public Health Approach. Int J Environ Res Public Health 2010;7: 765 783.

Pardell H, Rouke E, Drygas W. East—West differences in reported preventive practices. A comparative study of six European areas of the WHO-CINDI programme. Eur J Public Health 2001;11: 393-396.

Pupek-Musialik D, Kujawska-Łuczak M, Bogdański P. Otyłość i nadwaga – epidemia XXI wieku. Przew Lek 2008;1: 117-123.

Pergola G, Silvestris F. Obesity as a Major Risk Factor for Cancer. J Obes 2013 http://www.hindawi.com/journals/jobe/2013/291546/ (10.02.2014)

Banegas JR, Lpez-García E, Gutiérrez-Fisac JL, Guallar-Castilln P, F Rodríguez-Artalejo F. A simple estimate of mortality attributable to excess weight in European Union. Eur J Clin Nutr 2003;57: 201-208.

Tsigos C, Hainer V, Basdevant A i wsp. Postępowanie w otyłości dorosłych: europejskie wytyczne dla praktyki klinicznej. Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw 2009;5: 87-98.

Tang M, Chen S, Ng SW, Chan A, Mak T. Case series on a diversity of illicit weight – reducing agents: from well known to the unexpected. Br J Clin Pharmacol 2011;71: 250-253.

Yuen YP, Lai CK, Poon WT, Ng SW, Chan A, Mak T. Adulteration of over-the-counter slimming products with pharmaceutical analogues – an emerging threat. Hong Kong Med J 2007;13: 216-220.

Korek E, Krauss H, Piątek J, Chęcińska Z. regulacja hormonalna łaknienia. Med. Og Nauk Zdr. 2013; 19(2): 211-217.

Dmitrzak-Węglarz M. Genetyka jadłowstrętu psychicznego – istniejący stan wiedzy i perspektywy przyszłych badań. Psychiatria 2010; 7(6): 203-226.

Wynne K, Stanley S, McGowan B, Bloom S. Appetite control. J Endocrinol. 2005; 184(2): 291-318.

Arora S, Anubhuti. Role of neuropeptides in apetite regulation and obesity – a review. Neuropeptides 2006; 40(6): 375-401.

Dunlop DM. The use of 2:4-dinitrophenol as a metabolic stimulant. Br Med J 1934;1: 524-527.

Rabinowitch IM, Fowler AF. Dinitrophenol. Can Med Assoc J 1934; 30:128–133.

Rabinowitch IM. The Danger from Dinitrophenol. Can Med Assoc J 1934;30: 564–565.

RodinFH. Cataracts Following the Use of Dinitrophenol: A Summary of Thirty-two Cases. Cal West Med 1936;44: 276–279.

Grundlingh J, Dargan I, El-Zanfaly M, Wood D. 2,4-Dinitrophenol (DNP): A Weight Loss Agent with Significant Acute Toxicity and Risk of Death. J Med Toxicol 2011;7: 205-212.

Tewari A, Ali T, O’Donnell J, Butt MS. Weight loss and 2,4-dinitrophenol poisoning. Br J Anaesth. 2009;102: 566-567.

Van Veenendaal A, Baten A, Pickkers P. Surviving the life-threatening 2,4-DNP intoxication: Almost dying to be thin. Neth J Med 2011;69: 154.

Miranda EJ, McIntyre IM, Parker DR, Gary RD, Logan BK. Two Deaths Attributed to the Use of 2,4-Dinitrophenol. J Anal Toxicol 2006;30: 219-222.

http://www.gif.gov.pl/rep/gif/pdf-y/KO/KOGIF_2013-06-10-03.pdf (2014.02.08)

Astrup A, Toubro S, Christensen N, Quaade F. Pharmacology of thermogenic drugs. Am J Clin Nutr 1992;55: 246-248.

Dulloo AG, Miller DS. Aspirin as a promotor of ephedrine-induced thermogenesis: potential use in the treatment of obesity. Am J Clin Nutr 1987;45: 564-569.

Haller CHA, Benowitz N. Adverse cardiovascular and central nervous system events associated with diet ary supplements containing ephedra alkaloids. N Engl J Med 2000;343: 1833-1838.

Hallas J, Bjerrum L, Stvring H, Andersen M. Use of Prescribed Ephedrine/Caffeine Combination and the Risk of Serious Cardiovascular Events: A Registry-based Case-Crossover Study. Am J Epidemiol 2008;168: 966-973.

Heal DJ, Cheetham SC, Prow MR, Martin KF, Buckett WR. A comparision of the effects on central 5-HT function of sibutramine and the other weight-modifying agents. Br J Pharmacol 1998;125: 301-308.

Finer N. Sibutramine: its mode of action and efficacy. Int J Obes 2002;26: 29-33.

King DJ, Devaney N. Clinical pharmacology of sibutramine hydrochloride (BTS54524), a New antidepressant, in healthy volunteers. Br J Clin Pharmacol 1988;26: 607-611.

Kelly F, Jones SP, Lee JK. Sibutramine: weight loss in depressed patients. Int J Obes 1995;19: 397.

Bray GA, Ryan DH, Gordon D, Hedingsfelder S, Cerise F, Wilson K. A double-blind randomized placebo-controlled trial of sibutramine. Obes Res 1996;4: 263-270.

Lean ME. Sibutramine – a review of clinical efficancy. Int Obes Relat Metab Disord 1997;21: 30-36.

Connoley IP, Liu YL, Frost I, Reckless IP, Heal DJ, Stock MJ. Thermogenic effects of sibutramine and its metabolites. Br J Pharmacol 1999;126: 1487-1495.

James WP, Astup A, Finer N i wsp. Effect of sibutramine on weight maintenence after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance. Lancet 2000;356: 2119-2125.

Bosello O, Carruba MO, Ferrannini E, Rotella CM. Sibutramine lost and found. Eat Weight Disord 2002;7: 161-167.

James WPT, Caterson ID, Coutinho W i wsp. Effect of Sibutramine on Cardiovascular Outcomes in Overweight and Obese Subjects. N Engl J Med 2010;363: 905-917.

Sein Anand J, Chodorowski Z. Działania niepożądane spowodowane stosowaniem chińskiego środka odchudzającego Meizitanc. Przegl Lek 2007;64: 346-347.

Müller D, Weinmann W, Hermanns-Clausen M. Chinese slimming capsules containing sibutramine sold over the Internet. Dtsch Arztebl Int 2009;106: 218-222.

Chong CSY. Psychosis Related to the Use of Sibutramine Disguised as Over the counter Herbal Weight Loss Remedies: a Report of Two Patients. East Asian Arch Psychiatry 2010;20:186-189.

Gazdag G, Szabó Z. Sibutramine-associated psychosis (case report). Neuropsychopharmacol Hung 2008;10: 107-110.

Guimares C, Pereira LRL, Iucif N i wsp. Tolerability and Effectiveness of Fluoxetine, Metformin and Sibutramine in Reducing Anthropometric and Metabolic Parameters in Obese Patients. Arq Bras Endocrinol Metab 2006;50: 1020-1025.

Afkhami-Ardekani M, Sedghl H. Effect of fluoxetine on weight reduction in obese patients. Indian J Clin Biochem 2005;20: 135-138.

Mancini M, Halpern A. Pharmacological Treatment of Obesity. Arq Bras Endocrinol Metab 2006;50: 377-389.

Alastair S, Heisler G, Heisler L. Pharmacological targeting of the serotonergic system for the treatment of obesity. J Physiol 2009;587: 49-60.

http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm179871.htm (2014.02.10)

Hiatt WR, Thomas A, Goldfine A. What Cost Weight Loss? Circulation 2012;125: 1171-1177.

Kyoung Kon K, Hi-Jung Ch, Hee-Cheol K, Bang-Bu Y, Kyu Rae L. Effects on Weight Reduction and Safety of Short-Term Phentermine Administration in Korean Obese People. Yonsei Med J 2006;47: 614-625.

Munro JF, MacCuish AC, Wilson EM, Duncan LJ. Comparision of continuous and intermittent anorectic therapy in obesity. Br Med J 1968;1: 352-354.

Skopp G, Jantos R. Phentermine – a “weighty” or dangerous substance? Arch Kriminol 2013; 231: 116-129.

Glazer G. Long-therm pharmacotherapy of obesity 2000: a review of efficacy and safety. Arch Intern Med 2001;161: 1814-1824.

Inoue S. Clinical studies with mazindol. Obes Res 1995;3: 549-552.

Kruk ZL, Zarrindast MR. Mazindol anorexia is mediated by activation of dopaminergic mechanisms. Br J Pharmacol 1976;58: 367-372.

Inoue S, Egawa M, Satoh S. Clinical and basic aspects of an anorexiant, mazindol, as an antiobesity agent in Japan. J Clin Nutr 1992;55: 199-202.

http://www.drugs.com/sfx/mazindol-side-effects.html (2014.02.10)

Scheen AJ. CB1 receptor blockade and its impact on cardiometabolic risk factors: overview of the RIO programme with rimonabant. J Neuroendocrinol 2008;20: 139-146.

Van Gaal L, Pi-Sunyer X, Després JP, McCarthy C, Scheen A. Efficacy and safety of rimonabant for improvement of multiple cardiometabolic risk factors in overweight/obese patients: pooled 1-year data from the Rimonabant in Obesity (RIO) program. Diabetes Care 2008;31: 221-240.

Colman E. Food and Drug Administration’s Obesity Drug Guidance Document. A Short History. Circulation 2012;125: 2156- 2164.

Sam AH, Salem V, Ghatei MA. Rimonabant: From RIO to Ban. J Obes 2011: 432607.

Bryl W, Hoffman K, Pupek-Musialik D. Otyłość w populacji wieku rozwojowego – choroba łatwa do rozpoznania trudna do interwencji. Prz Kardiodiabetol 2009;4: 170-174.

Olszanecka-Glinianowicz M, Dąbrowski P, Kocełek P i wsp. Long-term inhibition of intestinal lipase by orlistat improves release of gut hormones increasing satiety in obese women. Pharmacol Rep 2013;65: 666-671.

Hong JL, Meier Ch, Sandler R, Jick SS, Stürmer T. Risk of colorectal cancer after initiation of orlistat: matched cohort study. BMJ 2013;347: 5039.

Torgerson JS, Hauptman J, Boldrin NM, Sjöström L. XENIcal in the prevention of diabetes in the obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004;27: 155-161.

http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm213038.htm (2014.02.14)

Heal DJ, Gosden J, Smith SL. A review of late-stage CNS drug candidates for the treatment of obesity. Int J Obes 2013; 37(1): 107-117.

Yanovski S, Yanovski J. Long-term drug treatment for obesity: a systematic and clinical review. JAMA 2014; 311(1):74-86.

Castaneda-Gonzalez L, Camberos-Solis R, Bacardi-Gascon M, Jimenes-Cruz A. Long-term randomized clinical trials of pharmacological treatment of obesity: systematic review. Colombia Medica 2010; 40(1): 17-25.

Márquez-Ibáez B, Armendáriz-Anguiano AL, Bacardí-Gascón M, Jiménez-Cruz A. Review of controlled clinical trials of behavioral treatment for obesity. Nutr Hosp 2008; 23(1): 1-5.

Published

2014-09-30

How to Cite

Owsianik, D., & Statek, K. (2014). Pharmacotherapy of obesity – more risks than benefits. European Journal of Clinical and Experimental Medicine, 12(3), 275–288. Retrieved from https://journals.ur.edu.pl/ejcem/article/view/12558