Approaches to the Pharmacological Treatment of Obesity

Victoria Salem; Stephen R Bloom

Disclosures

Expert Rev Clin Pharmacol. 2010;3(1):73-88. 

In This Article

Health Consequences

Overweight and obesity are independently linked to an increased risk of cardiovascular disease, as well as contributing to other established risk factors such as hypertension, dyslipidemia impaired glucose metabolism.[2–4] This has been supported by an increased understanding of the role of excess adipose tissue, particularly intra-abdominal visceral fat, as a producer of free fatty acids (FFAs) and proinflammatory cytokines that cause insulin resistance, abnormal lipid metabolism, endothelial dysfunction, prothrombotic and proatherosclerotic effects.[5]

Overweight and obesity are the most important risk factors for the development of Type 2 diabetes, with all of its attendant risks of macrovascular disease, limb loss, blindness and renal failure. Furthermore, obesity has been linked to the development of numerous cancers, obstructive sleep apnea, musculoskeletal disorders, infertility and depression, as well as many other morbidities.[6,7] Longer-term follow-up studies of patients undergoing bariatric surgery, which is presently the most effective treatment for obesity in terms of producing significant and sustained weight reduction, have provided compelling evidence that weight loss can ameliorate many obesity-related conditions and improve life expectancy.[8–11] In 2007, a retrospective cohort study of obese subjects who were undergoing weight-loss surgery showed a 40% reduction in all-cause mortality, a 92% reduction in diabetes deaths, a 56% reduction in coronary artery disease deaths and a 60% reduction in cancer deaths.[12]

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