Medikamentose therapie der adipositas

Abstract

Overweight and obesity are tightly associated with type 2 diabetes, cardiovascular disease and other causes of increased morbidity and mortality. Diet, exercise and behavioural training are the major elements in the treatment of obese patients, with often unsatisfactory longterm results. An additional therapeutic alternative comes from the recent approval of two drugs which are characterized by distinct ways to influence energy metabolism. Orlistat binds to gastrointestinal lipases and causes a partial inhibition of fat resorption from the gut. In contrast, sibutramine causes a centrally mediated increase in safety and energy expenditure. When combined with a hypocaloric diet, both drugs lead to a moderate additional weight loss of approximately 2-6 kg within 6 months. Some cardiovascular risk factors associated with obesity are improved during therapy. However, possible longterm benefits of pharmacologic weight reduction have yet to be proven.