New molecular targets in the pathophysiology of obesity and available treatment options under investigation

Authors

  • G. Valsamakis,

    Corresponding author
    1. Endocrine Unit, 2nd Department of Obs and Gynae, Areteeion University Hospital, Athens Medical School National and Kapodistrian University of Athens, Athens, Greece
    2. WISDEM Centre for Diabetes, Endocrinology and Metabolism, Warwick Medical School, University of Warwick, Coventry, UK
    • Address for correspondence: Dr Georgios Valsamakis, 2nd Department Obs and Gynae, Endocrine Unit, Areteion University Hospital, 37A Leoforos Pendelis Ave, Vrilissia/Athens 15235, Greece. E-mail: gedvalsamakis@yahoo.com

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  • K. Lois,

    1. Endocrine Unit, 2nd Department of Obs and Gynae, Areteeion University Hospital, Athens Medical School National and Kapodistrian University of Athens, Athens, Greece
    2. WISDEM Centre for Diabetes, Endocrinology and Metabolism, Warwick Medical School, University of Warwick, Coventry, UK
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  • S. Kumar,

    1. WISDEM Centre for Diabetes, Endocrinology and Metabolism, Warwick Medical School, University of Warwick, Coventry, UK
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  • G. Mastorakos

    1. Endocrine Unit, 2nd Department of Obs and Gynae, Areteeion University Hospital, Athens Medical School National and Kapodistrian University of Athens, Athens, Greece
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Summary

The pharmacotherapy of obesity has historically recorded an overall poor safety and efficacy profile largely because of the complex mechanisms involved in the pathophysiology of obesity. It is hoped that a better understanding of the regulation of body weight will lead us to the development of effective and safer drugs. Recent advances in our understanding of the regulation of energy homeostasis has allowed the design of novel anti-obesity drugs targeting specific molecules crucial for the modulation of energy balance, including drugs that induce satiety, modulate nutrient absorption or influence metabolism or lipogenesis. Almost a decade after the Food and Drug Administration approved the first weight loss medication, it recently approved two novel anti-obesity drugs Belviq (lorcaserin) and Qsymia (topiramate and phentermine), thus signalling the beginning of a new era in the pharmacotherapy of obesity. It is believed that the next generation of weight-loss drugs will be based on combination treatments with gut hormones in a manner that mimics the changes underlying surgically induced weight loss thus introducing the so called ‘bariatric pharmacotherapy’. An in-depth understanding of the interrelated physiological and behavioural effects of these new molecules together with the development of new treatment paradigms is needed so that future disappointments in the field of obesity pharmacotherapy may be avoided.

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