Brandfon Skyler, Eylon Adi, Khanna Deepesh, Parmar Mayur S
Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.
Cureus. 2023 Oct 7;15(10):e46623. doi: 10.7759/cureus.46623. eCollection 2023 Oct.
Obesity is a major public health concern linked to health risks such as hypertension, hyperlipidemia, type 2 diabetes mellitus (T2DM), stroke, metabolic syndrome, asthma, and cancer. It is among the leading causes of morbidity and mortality worldwide caused by an unhealthy diet and lack of physical activity, but genetic or hormonal factors may also contribute. Over a third of adults in the United States are obese. Pharmacological agents have been designed to reduce weight gain caused by excessive calorie intake and low physical activity. They work by inhibiting the absorption of dietary fat or stimulating the secretion of satiety hormones. These drugs include lipase inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists. However, the current weight-loss strategies do not effectively treat genetic-related diseases, such as generalized lipodystrophy, Bardet-Biedl syndrome, and proopiomelanocortin (POMC) deficiency. Emerging therapies for these gene mutations have been developed targeting leptin and melanocortin-4 receptors (MC4Rs), restoring the normal function of leptin or melanocortin-4 receptors regulating energy balance and appetite. Leptin analogs and MC4R agonists are novel therapies that target genetic or hormonal causes of obesity. This article provides a comprehensive review of anti-obesity medications (AOMs). In this review, we discuss the clinical trials, efficacy, United States FDA-approved indication, contraindications, and serious side effects of different classes of drugs, including lipase inhibitors, GLP-1 agonists, leptin analogs, and MC4R agonists.
肥胖是一个主要的公共卫生问题，与高血压、高脂血症、2型糖尿病（T2DM）、中风、代谢综合征、哮喘和癌症等健康风险相关。它是全球范围内由不健康饮食和缺乏体育活动导致的发病和死亡的主要原因之一，但遗传或激素因素也可能起作用。美国超过三分之一的成年人肥胖。已经设计出药物制剂来减少因热量摄入过多和体育活动不足导致的体重增加。它们通过抑制膳食脂肪的吸收或刺激饱腹感激素的分泌来起作用。这些药物包括脂肪酶抑制剂和胰高血糖素样肽1（GLP-1）受体激动剂。然而，目前的减肥策略不能有效治疗与遗传相关的疾病，如全身性脂肪营养不良、巴德-比德尔综合征和促肾上腺皮质激素原（POMC）缺乏症。针对这些基因突变的新兴疗法已经开发出来，靶向瘦素和黑皮质素-4受体（MC4R），恢复调节能量平衡和食欲的瘦素或黑皮质素-4受体的正常功能。瘦素类似物和MC4R激动剂是针对肥胖的遗传或激素原因的新型疗法。本文对抗肥胖药物（AOMs）进行了全面综述。在本综述中，我们讨论了不同类药物的临床试验、疗效、美国食品药品监督管理局（FDA）批准的适应症、禁忌症和严重副作用，包括脂肪酶抑制剂、GLP-1激动剂、瘦素类似物和MC4R激动剂。
