Definition
Obesity is not only an aesthetic disorder, but rather must be considered a disease in all respects, which can also cause serious problems for the patient who is affected. Obesity is the abnormal increase in fat in relation to lean mass: in practical terms, a person is obese when his body mass index exceeds the value of 30.
Causes
Obesity occurs when the calories you take far exceed those burned during daily activities and sports; obesity is the end result of a mixture of elements, among which a diet rich in fat, sugary and carbonated drinks and excessive sedentary lifestyle stand out. Among the other etiological factors that can contribute to obesity, we mention: genetic predisposition, pregnancy, taking some drugs, secondary pathologies.
Symptoms
Obesity clearly manifests itself with an exaggerated increase in body weight and fat mass; these unsightly symptoms can be associated with others, such as increased waistline, difficulty in moving, difficulty breathing, tiredness, snoring.
- Complications: obesity can promote sleep apnea, arthrosis, diabetes, dyslipidemia, hypertension, cardiovascular disease and even some cancers.
Diet and Nutrition
Information on Obesity - Drugs for Obesity Care is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Obesity - Drugs for Obesity Care.
drugs
Given that no drug is able to cure obesity definitively in the absence of a correction of eating and living habits, it is understandable how compliance with a hypocaloric diet associated with sport is essential to reduce the symptoms.
Obesity - as already highlighted - is not only an aesthetic problem, since this pathology is often associated with a multiplicity of secondary diseases, especially cardiovascular diseases; therefore, the correction of eating habits and lifestyle is necessary to undertake a therapeutic strategy against obesity. In general, the obese patient needs a medical team made up of nutritionists, dieticians and obesity specialists, who direct him towards a low-calorie and balanced diet. A loss of 5-10% of one's weight must already be considered a great achievement for the obese patient: a similar weight loss will allow the patient to improve his general health framework.
To help the obese patient, drugs play such an important, but secondary and paltry role in the absence of an adequate diet and lifestyle. The same goes for bariatric surgery, which should only be undertaken after the failure of the dietary, behavioral and pharmacological supply.
- Orlistat (eg Xenical, Alli): the drug (lipase inhibitor) is indicated as an adjunct to low-calorie diets: it works by blocking the absorption of lipids in the intestine, and the unabsorbed fat is eliminated in the faeces. Orlistat is the drug of choice used in the treatment of obesity, together with Sibutramine (until a few years ago). There are also side effects associated with the administration of this drug: intestinal urgency, meteorism, flatulence and steatorrhea. As an indication, the drug should be taken at a dose of 120 mg, orally, three times a day, during the meal and no later than an hour after the end of the same. It is recommended to take a multivitamin supplement in combination with orlistat: this drug, in fact, also hinders the absorption of certain nutrients and vitamins essential for the body to function properly.
- Sibutramine (eg Reductil, Ectiva, Reduxade, Meridia) similar to antidepressant drugs, sibutramine works by inhibiting the reuptake of serotonin, noradrenaline and dopamine, and favoring the feeling of satiety; reflexively, the patient suffering from obesity has less appetite. Furthermore, the drug stimulates the basal metabolism, exerting a thermogenic terapic effect (noradrenaline triggers an overactivation of the sympathetic). As an indication, take the drug at a dose of 10 mg orally once a day. Since 01/24/2010, the drug has been banned from the market due to its side effects (increased blood pressure, increased heart rate, dry mouth, insomnia, headache).
- Acarbose (eg Glucobay, Glicobase): also used in diabetes therapy. As an indication, it is recommended to take half a tablet (corresponding to 50 mg) 3 times a day, together with the meal. The dosage should be changed progressively based on the patient's response to treatment. Consult your doctor.
- Liraglutide (es.Saxenda®): already used for a few years in the treatment of type 2 diabetes, it has also recently been approved for use as an anti-obesity drug, thanks to its ability to increase the feeling of satiety and reduce the signs of hunger. It is given by subcutaneous injection in the thigh, upper arm or abdomen. The initial dose is 0.6 mg a day. Thereafter the dose should be increased up to 3.0 mg per day in 0.6 mg increments at one week intervals.
- Iodiocaseina and Thiamine Nitrate (eg Antiadiposo): it is a combination of two active ingredients, which are indicated in the treatment of obesity in children and adolescents. Currently, the drug is no longer on the market since 2009 due to its high iodine content (there have been numerous cases of hyperthyroidism and thyrotoxicosis after prolonged administration of these active ingredients).
- Naltrexone and bupropion (eg Mysimba ®): the action of the two active ingredients administered simultaneously causes a reduction in appetite and the amount of food consumed by patients, and increases their energy expenditure, helping them to adhere to a low-calorie diet and to lose weight. Treatment with Mysimba begins with taking a single tablet in the morning (containing 7.2 mg of naltrexone and 78 mg of bupropion). The dose is gradually increased over 4 weeks to reach the recommended dose of two tablets twice a day, preferably taken on a full stomach.
- Rimonabant (eg Acomplia, Zimulti): the drug is a cannabinoid receptor CB1 antagonist, located in both the CNS and adipocytes; for this reason, the drug rimonabant is sometimes used in therapy for the treatment of obesity. Take one tablet of medication per day, before breakfast; it is recommended to follow a low-calorie diet and a correct lifestyle.
- Amfepramone (eg Diethylpropion): it is recommended to take the drug (anorectic) at a dose of 25 mg, three times a day, possibly an hour before a meal and in the early afternoon. Thereafter, it is possible to take 75 mg per day, all at once. In Italy, the drug is currently banned.
- Phentermine chlorohydrate (ES. Adipex-P): the drug belongs to the class of amphetamines and is an active slimming (anorectic and hunger regulator). The administration of the drug (one 37.5 mg tablet, to be taken on an empty stomach, before breakfast) should not exceed 21-28 days (amphetamines are addictive and addictive); it is recommended to always combine a balanced diet and regular exercise. It is not a front-line drug for the treatment of obesity.
- Topiramate: it is a drug with an anticonvulsant action, which is especially indicated for the treatment of epilepsy and severe headache (migraine). Given that side effects include weight loss and appetite loss, it is sometimes used in obesity therapy. A drug (not on the market) known as Qnexa was designed, formulated with topiramate and another sympathomimetic anorectic agent (phentermine). The marketing for the marked side effects (suicidal thoughts, lack of memory, palpitations) is not approved.
Fiber and fiber supplements:
The administration of these products, natural or pharmaceutical, is useful to give a perception of gastric fullness to those who take them; consequently, the patient feels less the stimulus of hunger.
- Methylcellulose: even if methylcellulose ideally reduces the intake of food by favoring satiety, actually the obese patients who use it do not observe satisfactory results. It is more used for the treatment of constipation than for obesity.
- Psyllium (ex. Fibrolax): this drug is formulated with the seeds of Ispaghula Husk: at the dosage of 3.5 mg, to be repeated 2-3 times a day after meals, psyllium can be a natural remedy to contribute to the reduction of weight in the context of the metabolic syndrome (hyperglycemia, dyslipidemia, obesity), decreasing the sensation of appetite.
