OBESITASOleh:

Nama : Abulkhair AbdullahNIM : K11015R101

Big problem

Based onWHO

Major publichealth

concern

In 1997 Epidemic hazard worldwide Analysis of (BMI)

Metabolic disorders and and cardiovascular

diseases

Obese person incurs health care expenditures

at least 25% higher than a healthy person

In 2000

17.5 % overweight(36.7 million)

4.7 % obese(9.8 million)

210 million people in Indonesia

Obesity

The word obesity comes from the Latin obesitas, which means stout, fat, or plump.

Medically, obesity is a condition in which excess body fat has accumulated to the extend that it may have an adverse effect on

health, leading to reduced life expectancy and/or increased health problems.

How to assess obesity?

Causes1. Sedentary lifestyle Many people being an inactive lifestyle. Ex: Spend hours on TV/computer.2. Genetics Chances of being overweight are greater if one or both of our parents are overweight or obese3. Age As we get older, we tend to lose muscle, especially if we're less active. If we don't reduce our calorie intake as we get older, we may gain weight.4. Psychiatric illness The risk of overweight and obesity is higher in patients with psychiatric disorders than in persons without psychiatric disorders.5. Medicine Certain medicines may cause we to gain weight. Ex: some corticosteroids, antidepressants, and seizure medicines.

6. Emotional factors Some people eat more than usual when they're bored, angry, or stressed.7. Smoking Some people gain weight when they stop smoking because food often tastes and smells better after quitting smoking. However, quitting is more important than possible weight gain.8. Pregnancy During pregnancy, women gain weight to support their babies’ growth and development.9. Lack of sleep (leptin and ghrelin) Research shows that lack of sleep increases the risk of obesity. When we don't get enough sleep, our level of ghrelin goes up and our level of leptin goes down.

Therapy

1. Pharmacology therapy a. Chemical agents b. Natural agents2. Non pharmacology therapy

Anty obesitySibutraminePramlintide

Metformin

Orlistat

Rimonabant

Pharmacology Therapya. Chemical agents

ORLISTAT

In the March 15, 2004 issue of Cancer Research, Steven J. Kridel et al. state that orlistat may also inhibit growth of prostate cancer,

and in theory may be useful in treating other cancers, by interfering with the metabolism of fats.

Orlistas is a pancreatic lipase

inhibitor

Inhibiting the absorption of dietary fats

Unavailable to hydrolyze dietary

fat

Resulting caloric deficit

Pancreatic lipase an enzyme that breaks down fat in the intestine

SIBUTRAMINEreuptake

Sibutramine is a poten inhibitor

Serotonin

Norepinephrine

Promotes a sense of satiety

Decrease in appetite

Reducing food intake

Data from animal studies also suggest that sibutramine may also increase energy expenditure through thermogenic effects in both

the basal and fed states, but this has not been confirmed in humans.

RIMONABANT

In the RIO-North America trial, 3040 patients were randomized to receive either placebo or one of two doses of rimonabant (5 mg or 20 mg per day). Patients taking 20 mg rimonabant had significant

weigh loss, decrease in waist circumference, improved insulin sensitivity, and increases in HDL cholesterol, compared to patients

on placebo.

Rimonabant is a specific CB1 cannabinoid receptor

antagonist

Inhibiting the endocannabinoid system

Over activity of the endocannabinoid system obesitycauses

METFORMINMetformin is an oral antihyperglycemic

agent

Activation AMP-activated protein kinase

(AMPK)

Decreasing intestinal absorption of glucose

Decreasing hepatic glucose production

Improving insulin sensitivity

May also be used for the management of metabolic and reproductive abnormalities associated with polycystic ovary

syndrome (PCOS).

PRAMLINTIDE

Like insulin, amylin is deficient in individuals

with diabetes.

Prevention of post-prandial rise in glucagon levels

Modulation of the rate of gastric emptying

Increasing sensations of satiety

Pramlintide is a synthetic analog of

amylin

Has activity in a number of gastrointestinal and glucodynamic systems

Reducing caloric intake and potentiating weight

loss

For the treatment of type 1 and type 2 diabetes mellitus as an adjunct to preprandial insulin therapy in patients without

adequate glycemic control of insulin therapy.

Side Effect

1. Steatorrhea2. Stomach pain3. Flatulence4. Constipation5. Dizziness6. Dry mouth7. Weakness

8. Skin Problems9. Nausea10.Hypoglycemia11.Vomiting12.Headache13.Fatigue14.Etc

Pharmacology Therapyb. Natural agents

Panax japanicus

Coffea canephora

Vitis vinifera

Citrus aurantium

Camellia sinensis

Pinus koraiensis

Garcinia cambogia

Palm oil

Humulus lupulus

Zea mays

Soybean

Morus albam

Non Pharmacology Therapy

1. Dietary intervention2. Diet control3. Physical activity4. Surgery