Obesity Institute, Geisinger Medical Center, Danville, Pennsylvania, USA.
Curr Opin Endocrinol Diabetes Obes. 2013 Oct;20(5):407-11. doi: 10.1097/01.med.0000433059.78485.fa.
Despite being one of the most prevalent chronic diseases, obesity was not recognized as such until very recently. Although linked to ubiquitous diseases like diabetes, hypertension, coronary artery disease, obstructive sleep apnea, and many others, targeted treatments are few. Diet, exercise, and behavior modification are the pillars of weight loss. When they alone do not achieve the required weight reduction, medications may be used for patients with a BMI above 30 or above 27 if obesity-related comorbidities are present. The spectrum of pharmacologic agents aimed at obesity treatment will be reviewed.
Two medications, phentermine and orlistat, have been the only agents approved many years ago and now still standing. Others have come and gone, removed from the market by the Food and Drug Administration (FDA) because of harmful side-effects. However, in the last few years, new drugs have started to emerge. Since 2012, two new medications phentermine-topiramate extended-release combination and lorcaserin have been FDA approved, while at least one more, naltrexone SR/bupropion SR combination is expected to be re-evaluated by the FDA in 2014.
Treating obesity is crucial as it will ultimately result in the prevention of many related chronic diseases and will decrease morbidity and mortality. Weight loss medications are a valuable part of the clinician's toolbox in the treatment of obesity and should be used when appropriate. Having a variety of medications would be a great asset to accommodate various patients' needs and pre-existing medical conditions.
尽管肥胖是最常见的慢性疾病之一，但直到最近才被确认为一种疾病。尽管肥胖与糖尿病、高血压、冠心病、阻塞性睡眠呼吸暂停等常见疾病有关，但针对性的治疗方法却很少。饮食、运动和行为改变是减肥的基础。当这些方法单独使用不能达到所需的减肥效果时，可以为 BMI 高于 30 或存在肥胖相关合并症的患者使用药物。本文将对用于肥胖治疗的药物进行综述。
多年前，只有两种药物——苯丁胺和奥利司他获得批准，目前仍然在使用。其他药物因副作用大而被美国食品药品监督管理局（FDA）从市场上撤出。然而，在过去几年中，新的药物开始出现。自 2012 年以来，FDA 批准了两种新的药物——苯丁胺/托吡酯缓释组合和lorcaserin，而至少还有一种药物——纳曲酮 SR/安非他酮 SR 组合预计将在 2014 年重新接受 FDA 的评估。
治疗肥胖症至关重要，因为它最终将预防许多相关的慢性疾病，并降低发病率和死亡率。减肥药物是临床医生治疗肥胖症工具包中的一个有价值的部分，应在适当的时候使用。拥有多种药物将是满足各种患者需求和现有医疗条件的巨大优势。
