Institute of Endocrinology, Prague, Czech Republic.
Diabetes Metab Res Rev. 2012 Dec;28 Suppl 2:8-20. doi: 10.1002/dmrr.2349.
The increasing global prevalence of obesity urgently requires an implementation of efficient preventive and therapeutic measures. Weight loss and its maintenance should be considered one of the most important strategies to reduce the incidence of obesity-related co-morbidities such as diabetes and cardiovascular diseases. Lifestyle modification focused on diet and physical activity represents the essential component of any kind of weight management. However, only an intensive lifestyle intervention can be efficient in terms of long-term weight loss. Anti-obesity drugs affect different targets in the central nervous system or peripheral tissues and improve regulatory and metabolic disturbances that contribute to the development of obesity. Anti-obesity medications provide modest additional fat loss to that achieved by lifestyle modification alone, reduce visceral fat stores, improve programme adherence, weight loss maintenance, diminish obesity-related health risks and improve a quality of life. Anti-obesity drugs do play a role in weight management. Their replacement with placebo is followed by weight regain. Due to adverse events, several anti-obesity drugs were withdrawn from the market over the past few years and currently only orlistat remains available for long-term obesity management. Drug withdrawals, failure of clinical trials with several new anti-obesity compounds as well as inappropriate demands of drug regulating agencies concerning the study protocol led to scepticism about the perspectives in the pharmacotherapy of obesity. However, recently developed anti-obesity medications such as gut hormone analogues and drug combinations provided encouraging results in terms of weight loss, safety and improvement of cardio-metabolic health risks.
肥胖症在全球的发病率不断上升，迫切需要实施有效的预防和治疗措施。减轻体重和维持体重应被视为降低肥胖相关合并症（如糖尿病和心血管疾病）发生率的最重要策略之一。以饮食和身体活动为重点的生活方式改变是任何体重管理的基本组成部分。然而，只有强化的生活方式干预才能在长期减重方面有效。抗肥胖药物作用于中枢神经系统或外周组织的不同靶点，改善导致肥胖发生的调节和代谢紊乱。抗肥胖药物可适度增加单独通过生活方式改变所实现的脂肪损失，减少内脏脂肪储存，提高方案依从性、体重维持率，降低肥胖相关健康风险并改善生活质量。抗肥胖药物在体重管理中确实发挥了作用。用安慰剂替代会导致体重反弹。由于不良反应，过去几年有几种抗肥胖药物已从市场上撤出，目前只有奥利司他可用于长期肥胖管理。抗肥胖药物的撤市、几种新的抗肥胖化合物临床试验的失败以及药物监管机构对研究方案的不适当要求，导致人们对肥胖症药物治疗的前景产生了怀疑。然而，最近开发的抗肥胖药物，如肠道激素类似物和药物联合疗法，在体重减轻、安全性和改善心血管代谢健康风险方面提供了令人鼓舞的结果。
