Exam 4: Pharmacotherapy in the Management of
Obesity
The weight loss goal - correct answer ✔✔5-10% weight loss improves many medical
complications of obesity and prevents new obesity-related illnesses
*Do not have to lose much for health benefit!*
diabetes - correct answer ✔✔what can modest weight loss (5%) prevent in risk risk
populations?
New treatment Paradigm - correct answer ✔✔treat obesity first, then Co-morbidities
Drug therapy - correct answer ✔✔should not be the 1st option
- BMI >27 with established co-morbidities
-OR those with BMI >30
-not all patients respond well to this type of therapy
Diet, exercise & behavior modifications - correct answer ✔✔should be first line of therapy for all
obese patients
requirements for good drugs - correct answer ✔✔-persistently effective (>10% weight loss)
-safe
-cheap
, Duration of phase 3 trails - correct answer ✔✔-first year placebo-controlled: demonstrate
efficacy
-second year open-label: demonstrate durable efficacy and safety in long-term use
Efficacy: year 1 - correct answer ✔✔-placebo-subtracted weight loss >5%
-proportion losing >5% wt. is more with drug
-changes in diabetes, lipid, BP control
Efficacy: year 2 - correct answer ✔✔mean loss of 5.0kg vs. placebo
Safety - correct answer ✔✔1500 patients for 1 year
-200-500 patients completing year 2
Fen- Phen - correct answer ✔✔appetite suppressant found to cause brain damage in monkeys
in 1970's
-found to increase risk of cardiac events in 1996
reduce food intake - correct answer ✔✔-increase satiety signals
-decrease appetite signals (intestine, brain)
Block nutrient absorption - correct answer ✔✔fat or carbohydrates (intestine)
Increase thermogenesis - correct answer ✔✔-increase metabolism and dissipate energy as heat
OR
-increase energy use through increased physical activity (muscle, adipose)
Modulate fat storage - correct answer ✔✔regulate fat synthesis/breakdown (adipose)
Obesity
The weight loss goal - correct answer ✔✔5-10% weight loss improves many medical
complications of obesity and prevents new obesity-related illnesses
*Do not have to lose much for health benefit!*
diabetes - correct answer ✔✔what can modest weight loss (5%) prevent in risk risk
populations?
New treatment Paradigm - correct answer ✔✔treat obesity first, then Co-morbidities
Drug therapy - correct answer ✔✔should not be the 1st option
- BMI >27 with established co-morbidities
-OR those with BMI >30
-not all patients respond well to this type of therapy
Diet, exercise & behavior modifications - correct answer ✔✔should be first line of therapy for all
obese patients
requirements for good drugs - correct answer ✔✔-persistently effective (>10% weight loss)
-safe
-cheap
, Duration of phase 3 trails - correct answer ✔✔-first year placebo-controlled: demonstrate
efficacy
-second year open-label: demonstrate durable efficacy and safety in long-term use
Efficacy: year 1 - correct answer ✔✔-placebo-subtracted weight loss >5%
-proportion losing >5% wt. is more with drug
-changes in diabetes, lipid, BP control
Efficacy: year 2 - correct answer ✔✔mean loss of 5.0kg vs. placebo
Safety - correct answer ✔✔1500 patients for 1 year
-200-500 patients completing year 2
Fen- Phen - correct answer ✔✔appetite suppressant found to cause brain damage in monkeys
in 1970's
-found to increase risk of cardiac events in 1996
reduce food intake - correct answer ✔✔-increase satiety signals
-decrease appetite signals (intestine, brain)
Block nutrient absorption - correct answer ✔✔fat or carbohydrates (intestine)
Increase thermogenesis - correct answer ✔✔-increase metabolism and dissipate energy as heat
OR
-increase energy use through increased physical activity (muscle, adipose)
Modulate fat storage - correct answer ✔✔regulate fat synthesis/breakdown (adipose)
