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Obesity threatens the overall well-being of patients and is a major public health concern. It is basically a consequence of
excess adipose tissue getting accumulated in the adipocytes (fat cells). The number of adipocytes is usually constant in an
individual but when such individual become obese, the content of each cell multiplies and can increase in size up to100 times. The
body mass index, i.e., BMI, calculated as weight (kg) divided by height (m
2
), is a continuous, although imperfect, measure of body
fatness and can be readily and reliably quantified in clinical settings. The BMI correlates with total body fat (TBF) as well, which
is estimated using dual energy X-ray absorptiometry (DEXA) scanning in overweight and obese individuals. The BMI exceeds 30
kg/m
2
at any age group in case of obesity.
Anti-obesity medications or weight loss drugs are the pharmacological agents which reduce and/or control body weight.
These drugs alter one or the other fundamental processes (appetite, metabolism, absorption of calories, etc.) of the human weight
control mechanisms. Orlistat was the only anti-obesity medications approved by the FDA for long term use. It reduces intestinal
fat absorption by inhibiting pancreatic lipase. Rimonabant, a second drug, works via a specific blockade of the endocannabinoid
system. But due to safety concerns, it never got USFDA-approval. Sibutramine which acts in the brain to inhibit deactivation of
the neurotransmitters, thereby decreasing appetite was also withdrawn from the US and Canadian markets in October 2010 due
to cardiovascular risks.
Finally in last 13 years, in June?2012, US regulators approved the first drug called lorcaserin to treat obesity. Lorcaserin was
approved for obese adults who have high blood pressure, high cholesterol or type 2 diabetes, and is to be used in combination with
a low-calorie diet and exercise. Also recently in July?2012, USFDA has approved extended-release phentermine plus topiramate
(marketed as Qsymia) in the form of an add-on therapy along with low-calorie diet and exercise for the long term management of
overweight and/or obese adults. There are so many other medications (will be discussed for their present status on the conference
podium), all of which are proposed to have anti-obesity effects but because of potential side effects, it is recommended that they
should only be prescribed for obesity where it is hoped that the benefits of the treatment outweigh its risks. Another strategy to
prevent obesity explored in the dietary industry is many kinds of fat substitutes.
Because an uncontrolled diet and a lack of exercise (the most common causes of obesity) there are some fairly simple
treatments for obesity. To incorporate more natural foods into the diet, to drink more water, to cut-out junk food and to get
into the habit of exercising several times every week, we can drastically lower our weight and decrease the chances of becoming
obese. If there are some disease like hypothyroidism, specific medications are needed that can help regulate the thyroid gland and
improve the rate of metabolism. Lastly, I would say to find out the causes of obesity and then go for the treatment and prevention.
However the main treatment modalities for overweight and obese individuals remain dieting and physical exercise and not the
intake of medicines.
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