Medications for treatment of obesity - Essay Example

?Medications for treatment of obesity Obesity is a pathological condition which has now become a matter of global concern. It is a disease associatedwith the excessive accumulation of fats in the body of individual. Obesity is a condition which can be the base for many degenerative diseases affecting major bodily systems and an interesting aspect is that it can also affect the psychological condition of a person (Standford Hospital and Clinics 2010). Obesity has now become a worldwide issue due to its increasing rise and the risks that it poses. It is a very common condition in the Unites States with two third of the population of United States suffering either from obesity or increased weight and approximately one third of the population being obese according to the National Health and Nutrition Examination Survey (Weight Control and Information Network 2010). In UK, the Health Survey for England in the year 2008 presented that 24.5% people above the age of 15 were suffering from obesity. The same survey showed that the rate of obesity between the ages of 2 and 10 years was 13.9% (Department of Health 2009). Another research shows that in 1993, obesity rates in the UK were 13.2% among men whereas, 16.4% among women. But it is observed that by 2005 obesity rates had soared to 22.1% of males and 21.9% of females (Information Center, 2006). Obesity is a condition which has been associated with biological and physical reasons but psychological issues also play a role in the high incidence of this disease. Treatment of Obesity Considering the effects of obesity as a whole it is necessary in some instances that medications are prescribed to the patient. The medications prescribed for obesity can be classified into two broad categories of long term obesity management and short term obesity management. The US Drug and Food Administration (FDA) approved only two drugs for the long term management of obesity. These drugs are sibutramine and orlistat which are being sold in the market as Meridia and Xenical respectively. The drugs for short term obesity management are Phentermine and diethylpropion (Foster & Nonas 2004). Sibutramine Sibutramine came in the market firstly as an antidepressant but because of its reduced efficacy for depression it was rather used for weight loss. It is a beta phenethylamine with a cyclobutyl group on its side chain. The mechanism of action of Sibutramine primarily revolves around the increase of satiety in an individual. It acts by inhibiting the release of three major neurotransmitters serotonin, norepinephrine and dopamine. It also acts by increasing the metabolism of the body which further increases the energy expenditures and thus helps a person to lose weight. While the person reduces his weight the metabolism of the body is still not reduced because of the activity of Sibutramine. Sibutramine has a role to play in nutrient drug interaction as it increases the metabolism of the body. It is necessary that the drug is prescribed with a regular balanced diet so that the satiety of the person is satisfied. Its side effects include increased blood pressure, dry mouth, insomnia and headache (Foster & Nonas 2004; Poston & Foreyt 2004). Orlistat Orlistat is also a drug prescribed for patients who are suffering from obesity. Orlistat is a derivative of lipstatin which acts differently than Sibutramine. Their primary mechanism of action is to lower the amount of calories absorbed from the gut. Orlistat inhibits the action of pancreatic lipases so that the fats cannot be digested and absorbed. This helps in reducing the caloric intake of an obese individual. It works in a dose dependent manner which determines as to how much fat would be absorbed from the intestine. The effect of orlistat is such that after having a meal with high content of fat the patient usually has steatorheal diarrhea. But this diarrhea cannot prove to be fatal for the patient. The patients on orlistat usually have a deficiency of fat soluble vitamins as they cannot be absorbed from the gut and this is the reason why these patients are recommended multivitamins. It also has a considerable effect on the lipoproteins of the body because of its inhibitory nature on the lipases. It helps to reduce the amount of circulating Low Density Lipoproteins (LDL) in the body (Foster & Nonas 2004; Coulston et al 2001). The drug also has certain nutrient interactions which need to be monitored by the doctor. If a patient is on a low fat diet the drug would not prove to be of any use in decreasing the weight of the patient. Similarly if the patient is on a high fat diet he will suffer from gastrointestinal distress. Thus the patient should have a balanced diet of fat so that orlistat can work at its optimal level. The recommended dietary plan for orlistat’s effectiveness is 30% of fat in the food consumed. Orlistat is valuable in producing modest weight loss (Foster & Nonas 2004). Phentermine Phentermine is a short term obesity management drug which belongs to the phenethylamine class. The mechanism of action of phentermine primarily revolves around the reduction of hunger by stimulating the hypothalamus. It acts on the hypothalamus to release norepinephrine which acts on the satiety centre to reduce hunger. This increased amount of epinephrine also acts on the fat cells to increase the metabolism of fat. As it acts on the metabolism of the body it is important that an individual takes a proper diet with the drug. The person who is on phentermine should consume a specific amount of calories so that his weight can be reduced accordingly. Moreover exercise is also necessary while on the prescription of this drug. The long term effect of phentermine is not yet known and so it is not recommended for long term usage (Merck Manuals 2011; Foster & Nonas 2004). Diethylpropion Diethylpropion is also a short term obesity management drug which mimics the actions of sympathetic drugs. Its chemical structure is somewhat similar to amphetamines. One of the important features of this drug is that it does not show any tolerance in individuals who consume it for a longer time. The mechanism of action of diethylpropion also revolves around the suppression of the satiety center. It is through this action that the drug is able to suppress the desire for appetite in the patient. It acts on the adrenergic pathways to release norepinephrine which helps in decreasing the appetite of the individual. It also stimulates the central nervous system and may cause increased blood pressure. The diet given to the patients with diethylpropion should also be managed as the drug won’t be much effective in reducing the weight of the individual who have limited their calorie intake (Medline Plus 2011; Foster & Nonas 2004) All these drugs have their own advantages and disadvantages but they are classified differently in accordance to the class of obesity that the patient is suffering from. Sibutramine is the most effective drug recommended by the doctors these days for the obese patients. References STANFORD HOSPITAL AND CLINICS. (2010). Health Effects of Obesity. Stanford University. http://stanfordhospital.org/clinicsmedServices/COE/surgicalServices/generalSurgery/bariatricsurgery/obesity/effects.html WEIGHT CONTROL INFORMATION NETWORK. (2010) Statistics Related to Overweight and Obesity. National Institute of Health. http://www.win.niddk.nih.gov/statistics/index.htm DEPARTMENT OF HEALTH UK.(2009). Obesity General Information. http://www.dh.gov.uk/en/Publichealth/Healthimprovement/Obesity/DH_078098 GREAT BRITAIN. (2006). Statisitcs on obesity, physical activity and diet: England 2006. [London]: Information Centre. http://www.ic.nhs.uk/webfiles/publications/obesity/StatisticsOnObesity201206_PDF.pdf Top of Form Coulston, Ann M, Cheryl Rock, and Elaine R. Monsen.Nutrition in the Prevention and Treatment of Disease. San Diego, Calif: Academic Press, 2001. Print. Top of Form Poston, WS, and JP Foreyt. "Sibutramine and the Management of Obesity." Expert Opinion on Pharmacotherapy. 5.3 (2004): 633-42. Print. Top of Form Foster, Gary D, and Cathy Nonas. Managing Obesity: A Clinical Guide. Chicago, Ill: American Dietetic Association, 2004. Print. Bottom of Form Phentermine. Merck Manuals 2011. < http://www.merckmanuals.com/professional/lexicomp/phentermine.html> Diethylproprion. Medline Plus. < http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682037.html> Bottom of Form Bottom of Form Read More