-
1.
Appetite Reducing Herbal Drugs from the Perspective of Avicenna and Aghili in Iranian Traditional Medicine (Persian medicine).
Parsa, E, Mokaberinejad, R, Khodadoost, M, Zareiyan, A, Mojahedi, M, Yaghmaei, F, Jafari, P, Hakimi, F
Current drug discovery technologies. 2019;(4):400-405
Abstract
The increasing prevalence of obesity is one of the major problems of today's society. Man needs food to continue living, daily activities, and even the metabolism of food; and appetite plays an important role in receiving foods. Appetite and weight reducing synthetic drugs, which are mostly costly and have significant side effects, are recommended for some patients, and have limited effectiveness in the treatment of obesity. Given the epidemic of obesity and the lack of satisfaction with synthetic drugs these days, people are more likely to use herbal medicines. Complementary medicine has always been considered for the choice of new treatment. This medicine has a long history. Persian Medicine is one of the traditional medicine systems. This study was a qualitative study on the Books of Canon and the Makhzan Al-Aladvia. Saffron has been introduced in both modern medicine and in Iranian medicine to reduce appetite. In the case of Purslane seed and Chio nut, Figs, Sesame seeds, Camphor, and Solomon's seal, and Opium poppy, which have been appetite suppressant in traditional medicine books, in the books and articles of modern medicine, they have not proved to be appetite reducing. Modern medicine has known Gourd as a weight reducing food with the effects on fat but there is no talk about its effects on appetite. According to traditional Iranian medicine, Chio nut causes anorexia due to weakness in the stomach. Therefore, it is not advisable for weight loss. More clinical studies are conducted to prove the effects of appetite suppressant and weight loss effects of these herbal medicines seem logical.
-
2.
Treatment of Pediatric Obesity: An Umbrella Systematic Review.
Rajjo, T, Mohammed, K, Alsawas, M, Ahmed, AT, Farah, W, Asi, N, Almasri, J, Prokop, LJ, Murad, MH
The Journal of clinical endocrinology and metabolism. 2017;(3):763-775
Abstract
OBJECTIVE Multiple interventions are available to reduce excess body weight in children. We appraised the quality of evidence supporting each intervention and assessed the effectiveness on different obesity-related outcomes. METHODS We conducted a systematic search for systematic reviews of randomized controlled trials evaluating pediatric obesity interventions applied for ≥6 months. We assessed the quality of evidence for each intervention using GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach. RESULTS From 16 systematic reviews, we identified 133 eligible randomized controlled trials. Physical activity interventions reduced systolic blood pressure and fasting glucose (low to moderate quality of evidence). Dietary interventions with low-carbohydrate diets had a similar effect to low-fat diets in terms of body mass index (BMI) reduction (moderate quality of evidence). Educational interventions reduced waist circumference, BMI, and diastolic blood pressure (low quality of evidence). Pharmacological interventions reduced BMI (metformin, sibutramine, orlistat) and waist circumference (sibutramine, orlistat) and increased high-density lipoprotein cholesterol (sibutramine) but also raised systolic and diastolic blood pressure (sibutramine). Surgical interventions (laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, sleeve gastrectomy) resulted in the largest BMI reduction (moderate quality of evidence). Combined interventions consisting of dietary modification, physical activity, behavioral therapy, and education significantly reduced systolic and diastolic blood pressure, BMI, and triglycerides. Combined parent-child interventions and parent-only interventions had similar effects on BMI (low quality of evidence). CONCLUSIONS Several childhood obesity interventions are effective in improving metabolic and anthropometric measures. A comprehensive multicomponent intervention, however, appears to have the best overall outcomes.
-
3.
Review of the Ongoing Story of Appetite Suppressants, Serotonin Pathway, and Pulmonary Vascular Disease.
Bazan, IS, Fares, WH
The American journal of cardiology. 2016;(10):1691-1696
Abstract
Obesity is pandemic in the Western Hemisphere, especially in the United States (US) and is associated with morbidity and mortality. Recent data show that a large proportion of the US population is at least overweight and almost 2 in 5 Americans are obese. This ongoing trend of increasing obesity rates has led to a thriving market for anorexigens. Despite the health benefits of weight loss, several anorexigens had devastating side effects including pulmonary vascular disease which manifests as the clinical syndrome of pulmonary arterial hypertension (PAH). PAH is an incurable and fatal disease and is characterized by vascular constriction, hypertrophy, and proliferation that over time lead to right-sided cardiac failure. Over the past few decades, several weight loss medications have been associated with the development of PAH, possibly caused by an increase in systemic serotonin levels, resulting in vasoconstriction of the pulmonary arteries and initiating a cascade of pathologic vascular remodeling leading to vascular fibrosis. Once sufficient evidence for the association of these drugs with PAH or other related pathologies was found, many were removed from the market. However, there are other appetite suppressants still currently on the market (whether Food and Drug Administration-approved or "dietary supplements") that have to some extent similar mechanisms of action to those associated with PAH but lack robust enough data to prove or disprove an association. The serotonin pathway seems to be repeatedly implicated. In conclusion, given that PAH is a progressive and debilitating disease, it is important to highlight possible risk factors that could be avoided.
-
4.
New Dietary Supplements for Obesity: What We Currently Know.
Ríos-Hoyo, A, Gutiérrez-Salmeán, G
Current obesity reports. 2016;(2):262-70
Abstract
Obesity and its associated cardiometabolic alterations currently are considered an epidemic; thus, their treatment is of major importance. The cornerstone for such treatment involves therapeutic lifestyle changes; however, the vast majority of cases fail and/or significant weight loss is maintained only in the short term because of lack of compliance. The popularity of dietary supplements for weight management has increased, and a wide variety of these products are available over the counter. However, the existing scientific evidence is insufficient to recommend their safe use. Hence, the purpose of this article is to review the clinical effects, proposed mechanism of action, and safety profile of some of the new dietary supplements, including white bean extract, Garcinia cambogia, bitter orange, Hoodia gordonii, forskolin, green coffee, glucomannan, β-glucans, chitosan, guar gum, and raspberry ketones.
-
5.
Efficacy comparison of medications approved for chronic weight management.
Kumar, RB, Aronne, LJ
Obesity (Silver Spring, Md.). 2015;:S4-7
Abstract
For the first time, patients who are obese are able to benefit from 5 different FDA approved pharmacologic agents for chronic weight management. Although weight loss from all of these medications was limited to 5% to 10% of total body weight loss in the Phase III clinical trials, patients are capable of losing more weight when a cumulative approach of diet, exercise, and multiple medications are used. A pilot study of adding phentermine to lorcaserin yielded double the weight loss than lorcaserin alone. A higher percentage of total body weight is lost with use of combination phentermine/topiramate compared to orlistat, lorcaserin, and bupropion/naltrexone but there are more contraindications to its use and potential cardiovascular adverse effects due to adrenergic agonism. Lorcaserin and bupropion/naltrexone yielded similar weight loss but carry different adverse effect profiles and interactions with other psychiatric medications may preclude use of one over the other. When choosing a medication for obesity, several factors need to be considered, such as comorbidities, medication interactions, and risk of potential adverse effects.
-
6.
[Conservative obesity treatment - when and how?].
Blüher, M
Deutsche medizinische Wochenschrift (1946). 2015;(1):24-8
Abstract
With a prevalence of 24 %, obesity is a frequent disease in the general population in Germany. Obesity requires an effective prevention and treatment, mainly because it significantly increases the risk of developing type 2 diabetes, cardiovascular, orthopaedic, psychologic and other disorders. The indication for the treatment of obesity is based on BMI and body fat distribution, but also includes considerations based on comorbidities. Main treatment goals include body weight reduction and weight maintenance after weight loss. To achieve these goals, a conservative treatment strategy is primarily recommended which consists of energy-reduced diet with a daily deficit of 500 kcal, increased physical activity, behavioral modifications or treatment. Several multimodal conservative treatment programs have been evaluated. If individual treatment targets could not be achieved, stepwise conservative treatment intensification should be initiated with very low calorie diets, pharmacotherapy and / or endoscopic obesity therapies. Surgical interventions represent an additional step in the obesity treatment algorithm, which have been shown to be more effective than conservative approaches with regard to weight and body fat reduction, improvement in obesity-related comorbidities, long-term weight maintenance and reduced mortality.
-
7.
THE EFFECT OF GARCINIA CAMBOGIA AS COADJUVANT IN THE WEIGHT LOSS PROCESS.
Fassina, P, Scherer Adami, F, Terezinha Zani, V, Kasper Machado, IC, Garavaglia, J, Quevedo Grave, MT, Ramos, R, Morelo Dal Bosco, S
Nutricion hospitalaria. 2015;(6):2400-8
Abstract
INTRODUCTION due to the significant increase in the obesity rate in recent years, public health has been facing in many countries of the world, one of the major problems caused by this disease. Because of this, natural products arise, herbal, to assist in the treatment of obesity due to their safer effects. Among these, stands out the extract obtained from dried fruits of Garcinia Cambogia (GC), which has been studied and used as a natural supplement for weight loss. OBJECTIVE to investigate the GC administration as a coadjuvant factor in the treatment of obesity regarding to its effectiveness, way of action, recommended daily amount, side effects and contraindications, as a way of food and nutritional security for the population. METHODOLOGY literature review. There were consulted the database of LILACS-BIREME data, SciELO and MEDLINE and there were selected scientific articles published in English, Portuguese and Spanish, between the period of 2007 and 2014 that conducted studies involving the administration of the GC as a way of treatment for obesity. The descriptors used for research articles in the databases were the following: Garcinia Cambogia in Portuguese, and in English the terms used were "Garcinia Cambogia", "weight loss and obesity", and "Hydroxycitric Acid (HCA)"; this last one is not a descriptor indexed in Decs, but given the importance of this term for the search, it was adopted as a keyword. Thirty-four articles were identified, but only 21 were related to the objectives of this study. The first analysis of the articles was conducted by the title and then by the summary. In addition, 17 references were included because of their relevance to the study. RESULTS in some analyzed works, there was observed that the GC showed positive effects on weight loss process, appetite reduction, body fat percentage, triglycerides, cholesterol and glucose levels, lipogenesis process, while others had no effect. CONCLUSION studies suggest positive results about the effectiveness of the GC on the weight loss process. However, the ideal dosage has not been well established yet. There is little evidence of adverse effects and signs of protective effect against hepatotoxicity induced by ethanol. Therefore, it becomes necessary to carry out further studies to confirm the efficacy of this phytotherapy in the weight loss process.
-
8.
[The pharmacotherapy of obesity].
Budai, KA, Mirzahosseini, A, Noszál Béla, , Tóth, G
Acta pharmaceutica Hungarica. 2015;(1):3-17
Abstract
Obesity is considered the most concerning and blatantly visible--yet most neglected--public health problem by the WHO. The steadily increasing number of overweight and obese people has reached 2.3 billion and 700 million worldwide, respectively. Obesity is a complex condition, one that presents serious health risks with respect to type 2 diabetes, ischemic heart disease, and hypertension, therefore controlling the global obesity epidemic decreases not only health problems, but also expenditure. The underlying cause of obesity is a metabolic disorder of genetic, central nervous system or endocrine etiology that manifests in increased nutritional intake and/or decreased physical activity ultimately leading to excessive lipogenesis. The natural treatment of obesity, that is often advised, is comprised of healthy lifestyle choices, namely low-calorie diet and exercise. However, the pharmaceutic treatment of obesity is just as important; having a better compliance rate, anti-obesity drugs also improve quality of life and patient-care outcome concerning accompanying diseases. In most countries only one drug is currently available against obesity: orlistat, which is a specific and irreversible lipase inhibitor. One of the reasons for the scarce number of anti-obesity drugs is the complex pathomechanism involved in obesity. Interference with the intricate biochemical processes that govern alimentation may lead to widespread adverse effects. The advances of the field however, have prompted novel drug leads. In the past few years FDA has approved new drugs for the treatment of obesity, recently liraglutide in 2014. The approval of drug combinations, such as phentermine/topiramate and bupropion/naltrexone are also noteworthy, the components of which have been previously approved, but not necessarily for obesity as main indication. Furthermore, there are many anti-obesity drug candidates currently in clinical phase trials, with promisingly modest adverse effect profiles; hence the expansion of the anti-obesity agents in the near future can be foreseen. The present work summarizes the central and peripheral regulatory pathways of energy consumption, nutrition, and appetite. The possible drug targets, the currently available and novel anti-obesity agents, and the new trends in obesity research are also discussed.
-
9.
Effects of metformin on weight loss: potential mechanisms.
Malin, SK, Kashyap, SR
Current opinion in endocrinology, diabetes, and obesity. 2014;(5):323-9
Abstract
PURPOSE OF REVIEW Despite the known glucose-lowering effects of metformin, more recent clinical interest lies in its potential as a weight loss drug. Herein, we discuss the potential mechanisms by which metformin decreases appetite and opposes unfavorable fat storage in peripheral tissues. RECENT FINDINGS Many individuals struggle to maintain clinically relevant weight loss from lifestyle and bariatric surgery interventions. Long-term follow-up from the Diabetes Prevention Program demonstrates that metformin produces durable weight loss, and decreased food intake by metformin is the primary weight loss mechanism. Although the effect of metformin on appetite is likely to be multifactorial, changes in hypothalamic physiology, including leptin and insulin sensitivity, have been documented. In addition, novel work in obesity highlights the gastrointestinal physiology and circadian rhythm changes by metformin as not only affecting food intake, but also the regulation of fat oxidation and storage in liver, skeletal muscle, and adipose tissue. SUMMARY Metformin induces modest weight loss in overweight and obese individuals at risk for diabetes. A more detailed understanding of how metformin induces weight loss will likely lead to optimal co-prescription of lifestyle modification with pharmacology for the treatment of obesity independent of diabetes.
-
10.
The interaction of amylin with other hormones in the control of eating.
Lutz, TA
Diabetes, obesity & metabolism. 2013;(2):99-111
Abstract
Twenty years of research established amylin as an important control of energy homeostasis. Amylin controls nutrient and energy fluxes by reducing energy intake, by modulating nutrient utilization via an inhibition of postprandial glucagon secretion and by increasing energy disposal via a prevention of compensatory decreases of energy expenditure in weight reduced individuals. Like many other gastrointestinal hormones, amylin is secreted in response to meals and it reduces eating by promoting meal-ending satiation. Not surprisingly, amylin interacts with many of these hormones to control eating. These interactions seem to occur at different levels because amylin seems to mediate the eating inhibitory effect of some of these gastrointestinal hormones, and the combination of some of these hormones seems to lead to a stronger reduction in eating than single hormones alone. Amylin's effect on eating is thought to be mediated by a stimulation of specific amylin receptors in the area postrema. Secondary brain sites that were defined to mediate amylin action - and hence potential additional sites of interaction with other hormones - include the nucleus of the solitary tract, the lateral parabrachial nucleus, the lateral hypothalamic area and other hypothalamic nuclei. The focus of this review is to summarize the current knowledge of amylin interactions in the control of eating. In most cases, these interactions have only been studied at a descriptive rather than a mechanistic level and despite the clear knowledge on primary sites of amylin action, the interaction sites between amylin and other hormones are often unknown.