Obesity

There are surgical and pharmacological treatments for obesity. The choice depends on the severity of the disease and age of the patient. In very obese adults, a radical surgical procedure of gastric banding can be used to physically restrict amounts of food that can be held in the stomach. Pharmacological treatments include appetite suppressors, inhibitors of gut absorption, drugs increasing thermogenesis (energy expenditure), modulators of fat and protein metabolism and modulators of hypothalamic activity related to weight control. Some of the therapies for obesity are controversial because they can have risks associated with them that should be carefully considered. Appetite suppressors, such as Sibutramine, cause increase in satiety and can also induce and increase in energy expenditure. In contrast, an inhibitor of intestinal lipase, Orlistat, inhibits digestion of triglycerides from diet resulting in a reduced fat absorption.

Great expectations were associated with leptin as a obesity treatment. Leptin is naturally present in the body, and is secreted by fat cells, inhibits food intake, and increases energy expenditure. Studies on obese people showed that they have high levels of leptin in their blood suggesting that their bodies do not respond to leptin (leptin insensitivity) and the clinical trial of leptin has not produced the expected results. Further research concentrates now on appetite suppressors acting on cells in the hypothalamus with a number of drugs being tried. As overweight and obesity can also be caused by the growth hormone (GH) deficiency, the number of people using GH replacement therapy is increasing in order to combat the effects of GH-deficiency or age-related reduction in GH secretion.

Current treatments of obesity are not solving the underlying problem as they are effective only when used, and after the treatment is discontinued, weight gain often occurs. Also, most treatments reduce obesity only by a few percent, which is not satisfactory for most obese patients. Developing prevention methods, therefore, remains a priority with researchers. The main areas to be targeted are proper nutrition and good eating habits. Furthermore, development of an active lifestyle is fundamentally important in the prevention of obesity.