N.T.R.U.H.S. Government Guntur Medical college, Guntur, India.
Government Medical College, Amritsar, Punjab, India.
Rom J Intern Med. 2024 Mar 23;62(1):3-11. doi: 10.2478/rjim-2023-0023. Print 2024 Mar 1.
Obesity and overweight are the major risk factors for numerous chronic diseases, including cardiovascular diseases such as heart disease and stroke, which are the leading causes of death worldwide. The prevalence of obesity has dramatically risen in both developed and developing countries, making it a significant public health concern and a global crisis. Despite lifestyle modifications being the first-line treatment, the high risk of relapse has led to a growing interest in non-invasive pharmacotherapeutic interventions to achieve and maintain weight loss and reverse the growth of the obesity epidemic. Cardiovascular diseases and cancer account for the highest mortality rates among other comorbidities associated with obesity and overweight. Excess and abnormally deposited adipose tissue secretes various inflammatory mediators, leading to cardiovascular diseases and cancers. Weight loss of 5-10% significantly reduces cardiometabolic risk. Medications currently approved in the USA for long-term management of obesity are orlistat, naltrexone, bupropion, phentermine/topiramate, and Glucagon Like Peptide-1 (GLP-1) agonists such as liraglutide and semaglutide. The benefit-to-risk of medications, comorbidities, and individual responses should guide the treatment decisions. The article provides a comprehensive overview and discussion of several weight loss medications used previously and currently, including their efficacy, mechanisms of action, and side effects.
肥胖和超重是许多慢性疾病的主要危险因素,包括心血管疾病,如心脏病和中风,这些疾病是全球死亡的主要原因。肥胖在发达国家和发展中国家的患病率都显著上升,这使得肥胖成为一个重大的公共卫生问题和全球性危机。尽管生活方式的改变是一线治疗方法,但高复发风险导致人们越来越关注非侵入性的药物治疗干预措施,以实现和维持体重减轻并扭转肥胖流行的趋势。心血管疾病和癌症是与肥胖和超重相关的其他合并症中死亡率最高的疾病。过多和异常沉积的脂肪组织会分泌各种炎症介质,导致心血管疾病和癌症。体重减轻 5-10%可显著降低心血管代谢风险。目前在美国批准用于长期肥胖管理的药物有奥利司他、纳曲酮、安非他酮、苯丁胺/托吡酯和胰高血糖素样肽-1(GLP-1)激动剂,如利拉鲁肽和司美格鲁肽。药物的获益-风险、合并症和个体反应应指导治疗决策。本文全面概述和讨论了以前和目前使用的几种减肥药物,包括它们的疗效、作用机制和副作用。