Cabrerizo García Lucio, Ramos-Leví Ana, Moreno Lopera Carmen, Rubio Herrera Miguel A
Nutr Hosp. 2013 Sep;28 Suppl 5:121-7. doi: 10.3305/nh.2013.28.sup5.6927.
The prevalence of obesity in Western countries has increased at a much greater pace than the development of new efficient and safe drugs, beyond mere lifestyle changes, for the treatment of overweight. Numerous different types of drugs which had been used in the past for the treatment of obesity have currently been withdrawn due to undesirable long-term side effects. The only available drug in Europe is orlistat, which serves only as an aid for the treatment of obesity. In the USA, however, a few central adrenergic-mediators, for instance, diethylpropion and phentermine, have been available for decades to treat obesity during a short-term period (less than 12 weeks). The Food and Drug Administration (FDA) has recently approved lorcaserin and the combination phentermine/ topiramate for the treatment of obesity. The first one is a selective serotonin 2C receptor agonist that works by decreasing food intake with few side effects. Its outcomes on weight are modest, but may be helpful in certain selected patients. The phentermine/topiramate combination has proved to be highly effective, achieving a 10% reduction in weight in the majority of patients, although attention must be drawn to the possible development of side effects in both the short and the long-term follow-up. Further investigation regarding the mechanisms involved in weight balance will anticipate the development of new expectations for the treatment of obesity in the near future.
西方国家肥胖症的患病率增长速度远远超过了用于治疗超重的新型高效安全药物（不只是单纯的生活方式改变）的研发速度。过去曾用于治疗肥胖症的许多不同类型药物，目前已因不良的长期副作用而被撤市。欧洲唯一可用的药物是奥利司他，它仅作为肥胖症治疗的辅助药物。然而在美国，一些中枢肾上腺素能介质，如二乙胺苯丙酮和芬特明，已经有几十年可用于短期（少于12周）治疗肥胖症。美国食品药品监督管理局（FDA）最近批准了氯卡色林以及芬特明/托吡酯组合用于治疗肥胖症。前者是一种选择性5-羟色胺2C受体激动剂，通过减少食物摄入量起作用，副作用较少。其对体重的影响不大，但可能对某些特定患者有帮助。芬特明/托吡酯组合已被证明非常有效，大多数患者体重减轻了10%，不过在短期和长期随访中都必须注意可能出现的副作用。关于体重平衡所涉及机制的进一步研究将有望在不久的将来为肥胖症治疗带来新的期望。
