body weight control
TRANSCRIPT
BODY WEIGHT CONTROL
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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 )
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Classification of Overweight and Obesity
Acc. To BMI BMI define body weight relative to person’s height .
BMI=Ib/
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NOT All Overweight people are Obese
but All Obese are Overweight !!!
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Summary
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Body Weight Control
1- Non-Medication Control 2- Anti-Obesity Drugs Low Caloric Deit .
Physical Exercises . A-Synthetic B-Natural Life Style Modifications.
3- Surgery
Fat absorption Appetite
Inhibitors Suppressor
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Strategy for body weight control
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1- Hypertension
2- NIDDM (Type 2) 3- Dyslipidemia
4- Heart Diseases
obesity-related health complications
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“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.
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A-Synthetic Anti-obesity Medications
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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 .
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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).
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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4- Diethylpropion
One of the safest noradrenergic appetite suppressants
Used in patients with mild to moderate HTN or angina.
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5- Metformin (Glucophage)
Reduce weight limit the amount of
glucose produced by the liver and
increases muscle consumption of glucose .
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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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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.
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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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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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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1- Lorcaserin (approved June 28, 2012 )
2- Qsymia (formerly Qnexa) (approved July 17, 2012)
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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.
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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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B- Herbal / Natural Products
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1-GlucomannanGlucomannan 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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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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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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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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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
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Conclusion BMI : Normal weight should be from 18.5 to 24.9 Kg/
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.
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