Overweight and obesity are issues of major socioeconomic importance throughout the world. The connection between a high body mass index and diseases of the cardiovascular system has been proven. Obesity is one of the risk factors most important for the development of type 2 diabetes mellitus, hormonal imbalance, reproductive disorders, and malignant neoplasms. The incidence of overweight children is growing, and with age it is becoming increasingly difficult to reduce it.
Obesity. Increased body weight is most often associated with excessive consumption of food and significantly reduced motor activity. Modern everyday life creates a number of prerequisites for increasing kilograms. The consumption of foods rich in fats, excessive consumption of fried foods and sodas, the bad habit of “eating in front of the TV”, combined with all the possible excuses for playing sports are the main predisposing factors for the development of excess weight.
The main means used in the fight against extra pounds are the so-called appetite suppressing drugs, which are mainly used in patients with a body mass index above 30 and obesity of the first, second or even third degree. They are drugs of various pharmacological groups that activate the center of saturation located in the ventromedial nucleus of the hypothalamus.
Appetite Suppressing Factors
Key anorexigenic factors (appetite suppressants) include:
- corticotropin releasing hormone levels
- degrees of thyrotropin-releasing hormone
- plasma nutrient levels (lipids, glucose, amino acids)
- gastrointestinal hormones (ghrelin, cholecystokinin, peptide)
- leptin values
- plasma insulin levels
Drugs that suppress appetite, to varying degrees, cause a feeling of satiety. The reduction in energy consumption in combination with the corresponding physical regime leads to a significant reduction in body weight in individual patients. The approach for individuals with obesity is individual, and for each patient, therapy is prescribed after a thorough physical examination, interrogation by a doctor and analysis of time indicators.
The main means of suppressing appetite include the following three large groups of relevant representatives of drug groups:
- drugs with a central mechanism of action: fenfluramine, phentermine, dexfenfluramine, sibutramine, ethylamphetamine.
- peripheral dietary agents, for example, orlistat.
- cannabinoid receptor antagonists, such as rimonabant and its analogues.
Fenfluramine and dexfenluramine stimulate the release of serotonin and inhibit its reuptake, thereby increasing the feeling of satiety. These drugs have been banned since 1997, since their use is associated with an increased risk of severe cardiovascular complications, such as damage to heart valves, pulmonary hypertension.
Sibutramine blocks the reuptake of norepinephrine and, to a lower degree, serotonin and dopamine. It increases the feeling of satiety and increases the overall metabolism of the body, finding application in the treatment of diabetes mellitus associated with obesity, as well as dyslipidemia.
It is not recommended for patients with heart failure, coronary heart disease, arrhythmia, hypertension, liver failure, glaucoma. Often leads to severe side effects, such as tachycardia, constipation, headache, nausea, insomnia, dizziness, and a change in taste.
Due to the risk of developing serious cardiovascular complications, such as myocardial infarction and stroke, the use of sibutramine-containing drugs has been discontinued since 2010.
Orlistat is a reversible lipase inhibitor of the stomach and pancreas, suppressing up to a third of food intake of fat. After inactivation of lipases, fats taken with food cannot be hydrolyzed and, accordingly, are not digested by the body. Good results are achieved when combining the drug with a low-calorie diet and appropriate physical activity.
Orlistat leads to a number of unpleasant side effects, such as flatulence, frequent bowel movements, fecal incontinence, secretion of oily stools, spotting underwear, headache. Reduces the absorption of fat-soluble vitamins (A, D, E, K) and with prolonged use can cause hypovitaminosis and related complications. Orlistat is contraindicated in patients who are allergic to the main substance, with cholestasis, malabsorption syndrome, as well as during lactation.
Rimonabant has an anorexigenic effect, which is realized by binding to cannabinoid receptors KB1. Its use is associated with an increased risk of depression, suicidal thoughts and actions, so the drug has been banned since 2009.
The use of drugs to reduce appetite hides the risk of developing various pronounced side effects, while the desired result is not always achieved.
Too strict diets, starvation and exhausting workouts are not recommended, a balanced regime is needed. You can start with small changes, such as giving up sodas, sweets, snacks, pasta, and increase your intake of fruits and vegetables and teas.
If the gym does not tolerate you, then you can take long walks in the park or ride a bicycle. Swimming is especially suitable for patients with severe obesity, as it does not unnecessarily burden your cardiovascular system.
In some patients, a good effect is achieved through the use of natural products to suppress appetite, for example:
- fruits, mainly apples, lemons, grapefruit;
- nettle, burdock root, parsley;
- green tea;
It is recommended that you consume enough water, as very often patients confuse thirst with hunger and take extra calories. In addition, in the pharmacy chain you can find many nutritional supplements that stimulate fat burning. Such, for example, preparations containing amino acids, L-carnitine, L-tyrosine, extract from the fruits of the plant Garcinia cambogia, canna extract (skeleton), conjugated linoleic acid and others. Their use is necessarily combined with appropriate physical activity, otherwise, a visible effect is not observed. The most popular drugs for weight loss are Personal Slim и Bentolit.
The use of appetite-suppressing drugs must first be consulted with a doctor in order to establish a therapeutic regimen suitable for a particular patient.Ask a question