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At least one article is seen in newspaper on obesity on daily basis; no other disease is searched (and articles are read on) as frequently as obesity. Such is the menace of obesity that even fast food giant McDonald's has put an advice in few of its offices “not to eat too much fast-food”. Obesity is defined as BMI (body mass index) 30kg\m2 or more. A person with a BMI between 25 and 29.9 are considered over weight but not obese. BMI is a simple index of weight-for-height that is commonly used to classify overweight and obesity in humans. It is also defined as a person’s weight in kilograms divided by the square of his height in meters (kg\m2). As per world health organization (WHO), BMI greater than or equal to 25 is overweight and BMI greater than or equal to 30 is obese. Obesity is a foremost health problem not only in developed nations but also in developing countries. It increases the risk of other diseases like diabetes, cardiovascular ailments, fatty liver and some forms of cancer1. Obesity is now so common in various geographies that it is beginning to replace conditions arising from malnutrition and infectious diseases as the most significant contributor to ill health. Obesity is measured using BMI and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors2. BMI is closely related to both percentage body fat and total body fat3. The global epidemic of obesity results from an amalgamation of such factors as genetic susceptibility, increased availability of high-energy foods and diminished need of physical activity in prevailing situation in modern society. Obesity is no more a cosmetic issue affecting certain individuals, but a pandemic threatening global well being because it exacerbates a large number of health-related problems, both independently and in association with other ailments4,5.

PharmaTutor (ISSN: 2347 - 7881)

Volume 2, Issue 1

Received On: 11/01/2014; Accepted On: 13/01/2014; Published On: 15/01/2014

How to cite this article: A Gangwal, Next Lipitor® will also be from metabolic therapy, PharmaTutor, 2014, 2(1), 8-12

Obesity threat is replacing morbidity and mortality arising from malnutrition and infectious disease as most significant contributor to ill health. The rising incidence and prevalence of obesity, especially in developing countries will warrant involvement of governments and individuals. Plant treatments may be more culturally acceptable for some people and exploiting foodstuffs as obesity treatments may be easier to incorporate into a lifestyle than taking a tablet or injections. Obesity is often a lifelong problem. Many of the currently available treatments for obesity aim to reduce body weight or manage obesity for impermanent period; there is a need for some solution which can address obesity in a longer lasting or permanent way. Once excess weight is gained, it is not easy to lose. Once lost, you will have to work at maintaining your healthier weight. The continuing rise in occurrence of obesity worldwide will require new solutions to be found for treatment, management and prevention of obesity. Because humanity does not appear inclined to take more exercise or avoid opulent life style, the emphasis over the next few decades is likely to be on treating obesity and might be possible that next Lipitor® will be again from metabolic therapy. Because such is the rate of prevalence of obesity and quite limited options that as soon as a successful antiobesity drug is launched (without side effects) in coming years, people will take it in no time and it will break the record of world’s biggest blockbuster brand Lipitor®. Lipitor® till date is the world’s largest sold drug; becoming the blockbuster brand containing Atrovastatin. There is an urgent need of exploring all the available options to address the menace of this metabolic disorder.

Advice put on the website6,7

“It is hard to eat a healthy diet when you eat at fast-food restaurants often.”

“Many foods are cooked with a lot of fat, even if they are not trans fats. Many fast-food restaurants do not offer any lower-fat foods.”

“Eat at places that offer a variety of salads, soups and vegetables.”

Mechanism of currently available or recalled drugs
Most of the drugs that have entered the market for treating obesity were originally developed to treat psychiatric problems. During the past decade, understanding of the hypothalamus functions that control food intake has increased considerably. Different factors like meal termination, meal initiation and overconsumption of highly rewarding and palatable foods are modulated by different neuroanatomical structures. Integration of the action of many signaling chemicals like hormones, neurotransmitters and neuropeptides is central to feeding behavior. Currently available drugs and ongoing research act on somewhat overlapping systems that manage food intake8. Phentermine increases the serotonin levels, noradrenalin and dopamine in the brain, although its anti-obesity activity is thought to occur mainly by increasing noradrenalin levels in the hypothalamus, thereby leading to an increased sympathetic activity. Orlistat is a long time solution for obese person, permitted by US Food and Drug Administration. In the intestinal mucosa, orlistat binds to and blocks the activity of lipase enzyme, released by the pancreas in response to fat intake, thereby inhibiting the breakdown of fat molecules and their absorption. Sibutramine blocks serotonin noradrenalin re-uptake in the synapse. Rimonabant, a cannabinoid 1 (CB1) receptor inverse agonist, obstructs the signaling of endogenous cannabinoids (such as 2-arachidonoylglycerol (2-AG))9.

Structure of some commonly talked about anti obesity drugs10



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