Obesity

1
Obesity

• By
• Jewels Morgan
• Medicinal Chemistry
• March 14, 2007

2
What is obesity?

• Body Mass Index (kg/m2)
• Normal BMI is 18 to 25
• Overweight 25-29.9
• Obese 30
• Combination of height/weight/waist circumference
• National Institutes of Health (NIH)
• 20 or more above ideal body weight is when
  excess weight becomes a health risk.

3
What Causes Obesity?

• Over eating
• Genetics
• Environment
• Metabolism rate
• Eating disorders
• Some medical conditions and medications
• Underlying causes are not well known

4
Who is at risk for obesity?

• Certain ethnic groups
• Children
• People with less active lifestyle
• Single Mothers
• Low-income individuals
• Suburban life

5
Symptoms of Obesity

• No specific symptoms
• Contributes to other major health problems
• High blood pressure
• Type 2 diabetes
• Heart disease
• Arthritis
• Sleep Apnea
• Stroke
• Gallbladder disease

6
Obesity Statistics in the US

• Steady increase from 1970s
• 2005 study
• 2003-2004 estimated 66 US Adults obese
• Food drink portions
• 80s-12oz
• 90s-16oz
• 2000s-32oz

www.cdc.org
7
Treatment options

• Pharmaceutical options
• Surgery options
• Dieting/Exercising options

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Pharmaceutical treatment options Orlistat

• Orlistat Oral (Xenical)
• Mechanism of action blocks fat absorption
• Saturated derivative of Lipstatin
• Isolated from Streptomyces toxytricini
• Inhibits pancreatic lipases
• Dosage
• 120mg/three times daily

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Orlistat Cont.

• Costs 49 to 600, depends of number of pills
• Side effects
• Loose or oily stool
• Increased flatulence
• Increased or urgent bowel movements
• Lack of absorption of fat soluble vitamins
• Taken until weight loss goal reach
• Method of delivery Orally
• Treatment doesnt cure disease

www.meds.com
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Orlistat Cont.

• FDA approved for over the Counter Sales in Summer
  2007
• Alli at 60mg
• First non-prescription diet pill on the market
• http//www.myalli.com/Default.aspx
• Used in combination with diet/exercise program

www.myalli.com
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Sibutramine (Meridia)

• Neurotransmitter reuptake inhibitor
• Serotonin, norepinephrine, dopamine
• Has no antidepressant qualities
• Increases neurotransmitter level in brain
• Gives full sensation sooner
• Administered orally
• 10mg/daily (am)
• Related to amphetamines

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Sibutramine Cont.

• Pharmokinetics
• Absorbed in GI tract
• First pass metabolism
• Metabolized by Cytochrom P450
• FDA approved 1997
• Cost 90-100/month
• Side effects
• Increased Blood Pressure
• Increased Heart Rate
• Headache
• Dry mouth
• Constipation
• Sleeping problems

www.drugs.com
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New Anti-Obesity Drugs??

• Rimonabant Selective Cannabinoid-1 receptor
  antagonist
• Shows significant weight loss
• 20mg/daily
• In animal studies, decreased appetite food
  intake
• Drug-drug, Drug-food, Drug-disease interactions

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New Anti-Obesity Drugs??

• Side effects
• Nausea
• Dizziness
• Diarrhea
• Back pain
• Anxiety
• Depression
• Safe for 2 years of use
• Further research needed

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Pharmacology gone wrong.

• Fen-Phen (Fenfluramine and Phentermine)
• Caused Valvular heart disease
• Pulmonary hypertension
• FDA withdrew in 1997

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Surgery Methods for Obesity Treatment

• Gastric bypass surgery
• Lap-Band

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Diet and Exercise

• Weight Watchers
• Jenny Craig
• NutriSystem

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Need more research..

• Interview bariatric doctor
• Over the counter diet supplements and their
  mechanism of action