Pharmacological Treatments for Obesity

Obesity is a major risk factor for hypertension, cardiovascular disease development and diabetes mellitus, and represents a growing worldwide health problem. Several epidemiological studies have shown a high prevalence of cardiovascular complications and mortality in obesity and metabolic syndrome, type-2 diabetes or hypertension. For at “risk populations” predisposed to target organ damage, stringent targets for blood pressure control, dyslipidaemia, and glycaemia have been set in clinical guidelines, however clinical trial and real-life evidence suggest that these targets are difficult to achieve and sustain. The first line of treatment for hypertension, metabolic syndrome and diabetes associated with obesity is weight loss with lifestyle modification, such as a low caloric diet and exercise. An alternative for those with higher BMI or comorbidities is bariatric surgery. Perhaps the most important, difficult aspect in controlling obesity, however, is avoiding weight regain. Recently, anti-obesity drugs (Orlistat, Sibutramine, and Rimonabant) have been developed to help a weight loss program and also for maintenance of weight loss, but the precise effects on blood pressure and neurohormonal parameters have not been fully clarified and side effects, particularly with rimonabant and sibutramine, have led to their use being curtailed. The purpose of this article is to discuss the current findings on pharmacological anti-obesity pharmacological treatments.