Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

At present only two drugs are approved for long-term treatment of obesity. Sibutramine inhibits the reuptake of serotonin and norepinephrine. In clinical trials it produces a dose-dependent 5-10% decrease in body weight. Its side effects include dry mouth, insomnia, asthenia, and constipation. In addition, sibutramine produces a small increase in blood pressure and pulse that is a contraindication to the use of this drug in some individuals with heart disease. Xenical is the other drug approved for long-term use in the treatment of obesity. It works by blocking lipase and thus increasing the fecal loss of triglyceride. One valuable consequence of this mechanism of action is the reduction of serum cholesterol that averages about 5% more than can be accounted for by weight loss alone. In clinical trials it produces a 5-10% loss of weight. Its side effects are entirely due to undigested fat in the intestine that can lead to increased frequency and change in the character of stools. It can also lower fat-soluble vitamins. The ingestion of a vitamin supplement before bedtime is a reasonable treatment strategy. The effect on weight loss during long-term trials with these two drugs is shown in Figs 7 and 8 above. Also in this figure is data on phentermine used in trials of six months or more. Although there were differences in mean weight losses with these drugs, when the placebo effect was taken into account they all had a surprisingly similar magnitude of weight loss.
 ...
PMID:Drug treatment of obesity. 1172 27

Sibutramine is a combined serotonin(5-HT) and noradrenaline (NA)re-uptake inhibitor. Sibutramine works predominantly through its two pharmacologically active metabolites (i.e. primary and secondary amines) which induce marked weight loss by affecting both food intake and energy expenditure. It is able to enhance the physiological process of satiety, and to stimulate thermogenesis, increasing the efferent sympathetic activity to thermogenically active brown fat. There is a dose-related reduction in body weight in clinical trials with sibutramine, with weight loss up to 11% below baseline, which can last up to 18 months with continued treatment. When weight loss is induced with a very low calorie diet (VLCDL), patients randomized to the sibutramine treatment continued to lose weight over a 1 year period, reaching 15% below baseline, whereas the placebo-treated patients regained some weight. Sibutramine improves metabolic fitness, by decreasing the biochemical risk factors associated with obesity, such as plasma triglycerides, total cholesterol and low density lipoprotein (LDL) cholesterol, glucose and insulin, and increasing HDL-cholesterol. In controlled studies, 84% of sibutramine-treated patients reported side effects, most commonly including dry mouth, constipation and insomnia, compared with 71% of patients receiving placebo. A small increase in heart rate and blood pressure also occurs and persists for as long as treatment is continued, which, therefore, requires monitoring. Nevertheless, successful treatment of moderately hypertensive obese patients with sibutramine has been demonstrated without undue blood pressure problems and even a mean lowering of blood pressure associated with weight loss. Finally, sibutramine does not have the potential for abuse that is characteristic of amphetamine and it is indistinguishable from placebo in abuse potential studies.
 ...
PMID:An assessment of the safety and efficacy of sibutramine, an anti-obesity drug with a novel mechanism of action. 1211 86

Exercise improves insulin resistance and has beneficial effects in preventing and treating type 2 diabetes. However, aerobic exercise is hindered in many type 2 diabetic patients because of advancing age, obesity, and other comorbid conditions. Weight lifting or progressive resistance training (PRT) offers a safe and effective exercise alternative for these people. PRT promotes favorable energy balance and reduced visceral fat deposition through enhanced basal metabolism and activity levels while counteracting age- and disease-related muscle wasting. PRT improves insulin sensitivity and glycemic control; increases muscle mass, strength, and endurance; and has positive effects on bone density, osteoarthritic symptoms, mobility impairment, self-efficacy, hypertension, and lipid profiles. PRT also alleviates symptoms of anxiety, depression, and insomnia in individuals with clinical depression and improves exercise tolerance in individuals with cardiac ischemic disease and congestive heart failure; all of these aspects are relevant to the care of diabetic elders. Moreover, PRT is safe and well accepted in many complex patient populations, including very frail elderly individuals and those with cardiovascular disease. The greater feasibility of using PRT over aerobic exercise in elderly obese type 2 diabetic individuals because of concomitant cardiovascular, arthritic, and other disease provides a solid rationale for investigating the global benefits of PRT in the management of diabetes.
 ...
PMID:Battling insulin resistance in elderly obese people with type 2 diabetes: bring on the heavy weights. 1271 22

The aim of the current study was to investigate the effects of sleep loss on the diurnal rhythm of circulating leptin levels. An indwelling forearm catheter was used to sample blood at 90-min intervals for a total of 120 h, which included 88 h of sustained sleeplessness, in 10 healthy men. The diurnal amplitude of leptin was reduced during total sleep deprivation and returned toward normal during the period of recovery sleep. This finding provides evidence that sleep influences the nocturnal leptin profile, and may have implications for the understanding of the role of sleep in metabolic regulation and the aetiologies of obesity and the night eating syndrome.
 ...
PMID:Sleep loss reduces diurnal rhythm amplitude of leptin in healthy men. 1289 79

Obesity is a multifactorial, chronic disorder that has reached epidemic proportions in most industrialised countries and is threatening to become a global epidemic. Clinical management of obese patients is complex and serious doubts have arisen with regard to safety and efficacy of drug therapy. Following the withdrawal of fenfluramine and dexfenfluramine in 1997, interest has focused on novel anti-obesity drugs. Pharmacological approaches to the management of obesity can, in broad terms, use different distinct strategies: firstly, to reduce energy intake; secondly, to increase energy expenditure; and thirdly, to alter the partitioning of nutrients between fat and lean tissue. Sibutramine is a serotonin-noradrenaline (norepinephrine) reuptake inhibitor indicated for the management of obesity in conjunction with a reduced calorie diet. The pharmacological mechanisms by which sibutramine exerts its weight loss effect are likely due to a combination of reduced appetite, feelings of satiety and possibly the induction of thermogenesis. The efficacy of sibutramine for inducing initial weight loss and the subsequent maintenance of weight loss is well proven in short- and long-term clinical trials of up to 2 years' duration. Most individual placebo-controlled trials and pooled estimates found that the drug produced statistically significant greater weight loss than placebo at all observed endpoints (weighted mean difference for weight change at 8 weeks: -3.4 kg; mean difference range for weight change at 6 months: -4.0 to -9.1 kg; and at 1 year: -4.1 to -4.8 kg). The most frequent dosage regimen in these trials was 10-20 mg daily. Findings suggested a dose-effect relationship in terms of weight loss. Sibutramine was also associated with better weight maintenance relative to placebo (statistically significant difference). Results from mainly small trials showed that sibutramine produced more favourable outcomes in terms of loss of fat mass, reduction in body mass index and loss of > or = 5-10% of initial bodyweight. The most commonly reported adverse effects of sibutramine are headache, constipation and nausea. Certain adverse events associated with the nervous system, including dizziness, dry mouth and insomnia, are reported by > 5% of patients receiving sibutramine. Increases in blood pressure and heart rate were possible adverse effects that require regular monitoring especially in obese hypertensive patients. Neither left-sided cardiac valve disease nor primary pulmonary hypertension was associated with the use of sibutramine. The assessment of the benefit-risk profile of sibutramine remained positive, although the product must be kept under regular review.
 ...
PMID:A benefit-risk assessment of sibutramine in the management of obesity. 1458 64

The pharmacological treatment of obesity should be considered when cannot be achieved a 10% weight loss with diet therapy and physical activity. The drugs effective in obesity treatment may act by different mechanisms such as reduction in food intake, inhibition of fat absorption, increase of thermogenesis and stimulation of adipocyte apoptosis. At present, we only have two marketed drugs for obesity treatment. Sibutramine is an inhibitor of norepinephrine, dopamine and serotonina reuptake which inhibits food intake and increases thermogenesis. Sibutramine administration for a year can induce a weight loss of 4-7%. Its main side effects are hypertension, headache, insomnia and constipation. Orlistat is an inhibitor of pancreatic lipase which is able to block the absorption of 30% of ingested fat. Its administration induces weight loss and reduction of ulterior weight regain. Also, this drug improves hypertension dyslipdaemia and helps to prevent diabetes in 52% of cases when administered over four years. The increase in frequency of stools and interference with vitamin absorption are its main side effects. Glucagon-like peptide 1, which increases insulin sensitivity and satiety, adiponectin and PPAR-gamma agonists which reduce insulin resistance and modulates adipocyte generation are the basis for future therapeutic approaches of obesity. Phosphatase inhibitors induce PPAR-gamma phosphorylation and UCP-1 expression leading to an increase in thermogenesis and reduction in appetite.
 ...
PMID:[Pharmacological treatment of obesity]. 1538 15

Although the physiological mechanisms that underlie sleep disorders in children differ little from those seen in adults, the clinical manifestations may differ considerably between the two. For example, sleep apnea in adults affects men more than women, is more prevalent in the obese, and presents with symptoms of snoring and excessive somnolence. In preadolescent children, sleep apnea affects both sexes equally, is more closely correlated with adenotonsillar enlargement than obesity, and may be more likely to present with daytime inattention and learning problems rather than frank somnolence. Likewise, the insomnia and associated bedtime struggles of a 3-year-old bear little resemblance to the insomnia of a mature adult apart from the fact that both individuals are unable to easily fall asleep. Sleep disorders in children are reviewed with particular focus on age-related changes in normal sleep and on sleep disorders that primarily or exclusively affect children. Pediatric aspects of other sleep disorders will be reviewed in more limited detail, with examination of how age, developmental level, and comorbid conditions cause clinical presentation and treatment to differ from that of adults.
 ...
PMID:Sleep and its disorders in children. 1544 25

The objective of this study was to compare the frequency of some sociocultural, clinical, and anthropometric data between men and women in a sample of 1745 patients referred to a Sleep Unit for symptoms of obstructive sleep apnea (OSA). A standardized questionnaire was administered and anthropometric data were measured. Patients underwent a polysomnography (during a night or a nap) or an overnight home cardiorespiratory polygraphy. A total of 1166 patients (male/female ratio 4.9:1) fulfilled criteria of OSA (apnea-hypopnea index > or = 10). Women were employed, habitual drivers or workers at risk occupations in a lower percentage than men. Women came to the clinical interview accompanied by their partner less frequently than men. The frequency of snoring and daytime hypersomnolence was similar in both genders, although witnessed apneas were more frequent in males. Fatigue, morning headaches, insomnia, depression and use of sedatives were more frequent in women than in men. Women were older than men, more obese (although with an obesity pattern less centrally distributed), and referred hypertension more frequently. It is concluded that it is likely that women with OSA may be underdiagnosed due to circumstances related to the family lifestyle and sociocultural factors in addition to different OSA clinical expression.
 ...
PMID:Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. 1548 Dec 75

The overweight and obesity represent severe problems for the health management system of developed countries. In the evolution of obesity, beside genetic background, the environmental factors also play important roles. In the daily routine, the majority of obese patients need drug treatment, over the diet and physical activity. Among the available medicines the inhibitors of monoamine re-uptake causes dry mouth, tachycardia, sleeplessness and elevated blood pressure, therefore, due to the frequently associated obesity and hypertension many physicians avoid using these compounds. The orlistat as a selective inhibitor of pancreatic and enteral lipase enzymes impedes the absorption of the highest calorie containing nutrients, the fats exerting beneficial effects in the treatment of obesity. The abdominal bloating and diarrhea as side effects of the drug may act as an advantage in many cases, since these happen especially in those cases when the patient neglects the previously suggested low fat diet and therefore the drug induced diarrhea and bloating may mean a feed-back for the patient in respect of the proper diet. Recent studies show many beneficial biochemical changes in obesity related pathological metabolic processes during the administration of orlistat. The authors, in their present work review in short the role of orlistat in the treatment of slimming cure.
 ...
PMID:[The role of orlistat in the treatment of obesity]. 1581 87

We used a self-report questionnaire to identify outpatients with chronic symptoms of sleep disorders and/or high pretest probability for sleep apnea as well as for restless legs syndrome (RLS), insomnia, and narcolepsy. Surveys were presented to patients waiting for an appointment in Veterans Administration (VA) Medical Center clinics in Northeast Ohio, USA. Items addressed the frequency of snoring behavior; wake time sleepiness or fatigue and history of obesity/hypertension for high risk for sleep apnea (Netzer et al. 1999), along with other symptoms, were scored as positive vs negative risk for insomnia, narcolepsy, and RLS. Of the patients offered the surveys, 886 (59.2%) provided timely responses to the questionnaire. Mean age was 62.5 years (range, 19 to 85 years); 95% were males; mean body mass index was 29.3 kg/cm(2) (range, 15.1 to 57.5 kg/cm(2)); and mean Epworth Sleepiness Scale score was 8.3 (range, 1 to 22) with 4.6% having a score >17. Of the respondents, 47.4% met high-risk criteria for sleep apnea, 41.7% for insomnia, 19% for restless leg syndrome, and 4.7% for narcolepsy. Twenty-four percent reported use of sleeping pills or bedtime alcohol. Drowsy driving >3-4 days a week or every day was reported in 5.7%. VA primary care patients have high prevalence for pretest probability for sleep apnea. This population also reports chronic symptoms for other sleep disorders and for drowsy driving.
 ...
PMID:Sleep problems and the risk for sleep disorders in an outpatient veteran population. 1587 29


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>