Obesity causes treatment by drugs Effects on health and Pathophysiology

Obesity   

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight by the square of the person's height, is over 30 kg/m2, with the range 25–30 kg/m2 defined as overweight. Obesity increases the likelihood

of various diseases.                                          

other disease caused from obesity  

obesity cause many other disorder but most common are the following. particularly heart disease, type 2 diabetes, obstructive sleep apnea, some types of cancer, and osteoarthritis .

Obesity causes is most commonly caused by a combination of excessive food intake, lack of physical activity, and genetic susceptibility

A few cases are caused primarily by genes, endocrine disorders, medications, or mental illness.The view that obese people eat little yet gain weight due to a slow metabolism is not generally supported.

prevention from obesity .  

Obesity is mostly preventable through a combination of social changes and personal choices Changes to diet and exercising are the main treatments. Diet quality can be improved by reducing the consumption of energy-dense foods, such as those high in fat and sugars, and by increasing the intake of dietary fiber. Medications may be taken, along with a suitable diet, to reduce appetite or decrease fat absorption 

risk from obesity 

Obesity is a leading preventable cause of death worldwide, with increasing rates in adults and children.

Effects on health

Excessive body weight is associated with various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, osteoarthritis. and asthma.As a result, obesity has been found to reduce life expectancy

treatment of obesity by drugs

the following drugs are most commonly used for obesity 

anti-obesity drugs

Orlistat.
Lorcaserin.
Sibutramine.
Rimonabant.
Metformin.
Exenatide / Liraglutide.
Pramlintide.
Phentermine/topiramate

Pathophysiology

                                                                                                                                                                                                    The  mechanisms    of   obesity    are    poorly     understood. At                            

a  simplistic   level   weight   gain   results   when   the. energy

intake exceeds expenditure   ; however, both intake and

expenditure are controlled in complex physiological systems.

Women tend to gain excess weight after puberty,

precipitated by events such as pregnancy, use of the oral

contraceptive therapy and the menopause. Changes in

lifestyle in men during the third and fourth decade lead

to reduced physical activity and henceweight gain, which

continues until the sixth decade. The quantity, type and

pattern of food intake have all been implicated in the

development of obesity. Both the appetite and the sensation

of satiety (fullness) are implicated.Central adiposity

(waist-to-hip ratio measurements >0.9 inmenand >0.84

in women) increases the risk of many health problems

such as diabetes and hyperinsulinaemia.

The control system is complex, it is regulated by a control

centre thought to be located in the hypothalamus.

Afferent signals to the control centremay include nerves,

hormones and nutrients:

Leptin production correlates with body fat mass; a

leptin receptor has been identified in the ventromedial

region of the hypothalamus.

Gastric distention signals satiety.

Hormonal signals including cholecystokinin and

glucagon-related peptides inhibit food intake; neuropeptide

Y is a potent stimulus for appetite. Monoamines,

including noradrenaline and serotonin, also

modulate the hypothalamic control centre.

The efferent of the control is energy expenditure. Approximately

70% of energy expenditure is for resting

metabolic processes such as temperature control and

physiological function. A further 10% of energy expenditure

is related to the thermic responses to food.

Catecholamine-stimulated lipolysis is mediated via β3

receptors, and low receptor activity decreases thermogenesis.

The remaining 20% of energy expenditure is due

to physical activity and exercise.

used include the following:

Behaviour modification including examining the

background of the individual, the eating behaviour

and the consequences of the behaviour, usually conducted

by psychologists.

Dietary manipulation: Reducing the calorie intake

to below expenditure results in weight loss; however,

food diaries are recognised to be inaccurate as

all patients underestimate their intake. Diets include

balanced low-calorie diets, low-fat diets and lowcarbohydrate

diets, which are ketogenic possibly inducing

calcium loss and tend to be high in saturated

fat.

controlment of obesity  

1 Sibutramine is a noradrenaline and serotonin reuptake

inhibitor and promotes a feeling of satiety. It

should be prescribed only as part of an overall treatment

plan for management of obesity in patients

aged 18–65 years who have a BMI of 27.0 kg/m2 or

more in the presence of significant co-morbidities

or a BMI of 30.0 kg/m2.

2 Orlistat inhibits pancreatic lipases so that ingested

fat is not completely hydrolysed or absorbed. NICE

guidelines dictate that Orlistat should only be prescribed

for patients aged 18–75 years who have lost

at least 2.5 kg in weight by dietary control and

increased physical activity in the month prior to

the first prescription. They must have a BMI of

28 kg/m2 or more in the presence of significant comorbidities

or a BMI of 30 kg/m2. Treatment is reviewed

at 4 and 6 months to confirm that weight

continues to be lost and should stop at 12 months

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