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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The treatment of obesity is one of the major measures available today in the field of preventive medicine. In particular, the coronary epidemic of Western civilisation would be halted, and most cases of maturity-onset diabetes prevented, if obesity were to be treated effectively. Anorectic drugs act mainly on the satiety centre in the hypothalamus to produce anorexia. They also have various metabolic effects involving fat and carbohydrate metabolism, but many of these may be secondary to loss of weight. Most of the drugs are related directly or indirectly to amphetamine and in addition act by increasing general physical activity. Anorectic drugs tend to lose their effect after some months, and part of this reduction in effect may be due to chemical alterations produced by the drugs in the brain. All the drugs, with the exception of fenfluramine, have a stimulant effect on the central nervous system in some individuals, resulting in restlessness and nervousness, irritability and insomnia. Fenfluramine commonly produces drowsiness in normal doses, but has stimulant effects with overdosage. Dexamphetamine, phenmetrazine and benzphetamine all tend to cause euphoria and the risk of addiction is therefore considerable. Euphoria occasionally occurs with diethylpropion, phentermine and chlorphentermine, but to a much lesser extent. Side-effects also occur due to sympathetic stimulation and gastro-intestinal irritation. These side-effects may cause some individuals to stop taking the drug, but are never serious or dangerous. Drug interactions may occur with monoamine oxidase inhibitors and to a clinically unimportant extent, with antihypertensive drugs. The anorectic drugs have a very definite part to play in the treatment of obesity, mainly for those individuals who have altered their eating habits but have come to a plateau of weight which they find difficult to get below. The drugs are best given in a long-acting form and can safely be continued as long as weight loss persists, provided that the clinician exercises careful supervision. Dexamphetamine, phenmetrazine and benzphetamine should rarely be used because of the danger of addiction, and chlorphentermine is potentially hazardous for long-term use. Diethylpropion emerges as the drug of first choice, as fenfluramine has a tendency to cause depression and has a higher incidence of side-effects. Fenfluramine is mainly useful for people who are especially tense and for obese maturity-onset diabetics who have been unable to lose weight with the biguanides. Mazindol and phentermine appear to be useful as alternative drugs.
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PMID:Anorectic drugs: use in general practice. 78 35

Physicians treating adipose patients often hesitate to include drugs. Considering new developments in obesity research and drug-therapy, this attitude should be discussed. Anorectics of the amphetamine-group and analogues (derivates) react with the noradrenergic system and induce appetite-suppression. Fenfluramine in the d-1 configuration and isomeric dextro-rotation influence release of serotonin, reduce intake of food and increase sensation of saturation. In addition, various eating behavior disorders like nibbling and addiction to sweets are discussed. Use of Dextro-fenfluramine for these special situations is discussed as well as its side effects, duration of drug intake and form of application. Importance of concomitant therapeutic means like hypocaloric diet and personal attendance are emphasized.
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PMID:[Judicious use of anorectics]. 200 74

Purpose of this study is an investigation about the experience on the body Self and many relevant symbolic meanings in the massive obesity before and after the surgical therapy as well as a checking of the former obese patients in order to find out if such a heavy intervention may involve a modification of the body Self Perception in comparison with the former massive obesity situation. The investigation covered a sample group of 82 patients, and 12 of them were submitted again, after one year, to the Rorschach test with relevant evaluation through the Rausch de Trauenberg Self Representation Scale. The data thus obtained were considered again in a later phase by means of a sub-group of 10 obese patients compared with two checking groups consisting of subjects suffering from addiction pathologies (alcohol and opiate dependence) by means of the same method.
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PMID:[The experience of the corporal self and the Rorschach test in severe obesity under medical-surgical treatment]. 208 Aug 23

The position of pharmacotherapy of obesity is still controversial. Different groups of drugs are currently available in Switzerland--none is covered by the health insurances. Apparently the authorities are not convinced of their efficacy. Various groups of drugs have been tried, such as amphetamine derivatives, adrenergic drugs, serotonin agonists or hormones with thermogenic effects, intestinal enzyme inhibitors and dietary fibres. The results of sympathomimetic drugs demonstrate a relatively high incidence of side-effects, and with some preparations there is also the risk of addiction. The serotoninergic drug fenfluramine has been demonstrated in several controlled studies to be an effective weight-reducing agent; however, its effect was relatively modest: It lasted only as long as the drug was taken. Fenfluramine is relatively free of side-effects and is reported to diminish 'carbohydrate craving'.
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PMID:[Drugs against obesity]. 217 Nov 53

A total of 837 healthy volunteers presenting with various degrees of obesity participated in a large-scale, double-blind, placebo-controlled evaluation of the subjective effects of phenylpropanolamine (PPA), with particular attention to measurement of the euphoriant or stimulant potential of therapeutic doses of the compound. Dosage forms studied were PPA 75 mg sustained release, PPA 25 mg, and placebo. Subjects were recruited from four independent clinical sites. At each site, subjects were stratified according to degree of overweight (normal, mildly overweight, moderately overweight, or severely overweight) and randomly assigned to one of the three drug treatment regimens. Subjective effects were measured 11 times during the 12-hour experimental session using a short-form version of the Addiction Research Center Inventory. Data analysis did not indicate discernible subjective effects that would differentiate PPA from placebo, but did show typical circadian fluctuations. These results provided evidence that therapeutic doses of PPA do not produce the euphoriant or "stimulant" subjective effects that characterize drugs of abuse.
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PMID:Subjective profile of phenylpropanolamine: absence of stimulant or euphorigenic effects at recommended dose levels. 265 92

Observations related to the safety of fluoxetine in the treatment of obese patients are reviewed. The adverse event profile in obese patients, though differing slightly from that seen in depressed patients, was similar in that events observed were generally mild and well tolerated. Other than rash, no potentially serious adverse events believed to be related to fluoxetine were observed. Special evaluations of pharmacokinetics, psychomotor impairment, cardiac effects, phospholipidosis and addiction potential have identified no major problems in these areas. It is concluded that fluoxetine use for the treatment of obesity should carry with it minimal risk.
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PMID:Safety of fluoxetine in the treatment of obesity. 350 95

Fewer men responded to a personal advertisement in which a woman identified herself as obese than to one in which she indicated a history of drug addiction. The men who responded to the two advertisements also disclosed their own obesity or addiction.
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PMID:Men's preferences in romantic partners: obesity vs addiction. 864 81

The aim of this study is to explore the effectiveness of a short-term psychodynamic oriented group therapy with a selected sample of obese patients. We selected, from the patients referred to the Eating Disorders Consultation Service, 7 obese patients. Selection criteria were as follows: 1) aged between 20 and 40; 2) absence of severe organic disorders, as determining factors for the onset of obesity; 3) absence of severe psychiatric symptomatology. In addiction the selected subjects had to be sufficiently motivated to take up a psychological treatment. Subject underwent a clinical semi-structured interview and two questionnaires (SCL90 and TFEQ) were administered. Patients were re-evaluated at the end of the treatment and a two-years follow-up has been carried out. The group was conducted by a psychiatric and a psychologist, supervised by a group therapist. The group therapy lasted 6 months with 75' minutes weekly sessions. When the therapy was over all subjects showed an improved clinical picture: two of them had a remarkable weight reduction and one subject reached his ideal weight. The weight loss and maintenance at follow-up compared favorably with the results reported for other psychological treatments for obesity. The group setting, for its homogeneity, allowed great cohesiveness and let the members achieve, an increased emotional awareness of their self-image. This experience seem to confirm the effectiveness of a short-term group therapy in an institutional setting.
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PMID:[Psychodynamic group psychotherapy with obese patients]. 880 97

We present a plausible and powerful explanation for nicotine addiction that is consistent with recent findings. Sleep apnea, the periodic cessation of breathing during sleep, may be responsible for the addictive nature of nicotine. The main symptoms of sleep apnea are somnolence and obesity. Nicotine has been shown to decrease these two symptoms as well as reduce the frequency and duration of apneas. When an apneic youth uses tobacco, the nicotine may begin to treat the apnea and reduce the symptoms. The response of the human system is, naturally, to continue that which improves life, assuring addiction of the apnea to the nicotine. Many of the illnesses attributed to tobacco use and passive parental smoking may actually be confounded by the inherited influence of sleep apnea. Treating the apnea may be a necessary precondition for a successful tobacco cessation program. Understanding the apnea-tobacco relationship may be an important step in the development of a tobacco prevention program for youth.
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PMID:Is sleep apnea a predisposing factor for tobacco use? 896 Dec 40

The study, conducted over 4 years among 400 diabetic patients, reports the epidemiological and clinical aspects of diabetes mellitus at the National Hospital of Ouagadougou, Burkina Faso. Epidemiologically, diabetes mellitus affects men by 64% and women by 36%. 76% are over 40 y. o., whereas only 2.2% are under 20. Clinically, the classification of diabetic patients shows that 10.7% are insulin-dependent and 76.5% non insulin-dependent. No usual tropical diabetes has been found. The calcifications observed in 2.5% of cases were combined with chronic alcoholic pancreatitis. The classic triad (polyuria, polyphagia, polydipsia) led to diagnostic by 41% of the patients, whereas 27.5% have been identified when having complications, and 23% by a systematic check-up. Cardio-vascular risk factors combined with diabetes have been found: obesity (28%), high blood pressure (20%), hyperuricaemia (14%), addiction to smoking (20%). The epidemiological characteristics, as well as the various clinical aspects, mostly complies with the observations of the african authors.
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PMID:[Diabetes mellitus at the National Hospital Center of Ouagadougou (Burkina Faso)]. 899 12


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