[Mode of action and indication for appetite depressants in the treatment of obesity].

After a brief introductory discussion of methods generally used in the treatment of overweight (dieting; fasting; behavioral therapy; physical activity), the pharmacology of anorexigenic drugs and the considerations governing their clinical use and indications are discussed. All currently available anorexigens exert their action through nor-adrenergic stimulation at receptor sites located in the hypothalamus (amphetamine and ephedrine derivatives) or in the limbic system (Mazindol). In view of the CNS-stimulatory effect of these agents, drug addiction must be considered a potential hazard of their prolonged use. Since any drug treatment of obesity interferes with the patient's motivation to subject himself to the prolonged and possibly life-long changes in his eating habits and exertional behavior which are mandatory for the achievement of long-term therapeutic success, the use of drugs is rarely indicated in the treatment of obesity and should remain the exception. In view of their additional potential to induce drug addiction, this is particularly true of appetite suppressants.