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Drug treatment of obesity in the cardiovascular patient

Charakida, Mariettaa; Tousoulis, Dimitrisb; Finer, Nicholasc

doi: 10.1097/HCO.0b013e3283642a4c
PREVENTION: Edited by Andrew Pipe

Purpose of review The incidence of obesity and its associated comorbidities have significantly increased over the years with adverse health and financial consequences for society. Lifestyle changes are essential for the prevention and treatment of obesity but their benefit appears limited as inadequate and nonsustained weight loss results have been reported. Pharmacotherapy is frequently advocated as part of a weight loss strategy. In this review, we will discuss the antiobesity drugs with Food and Drug Administration approval and their cardiovascular implications.

Recent findings Orlistat (Xenical) remains the single monotherapy that has approval in Europe. Topiramate (Topamax) and phentermine have long been approved in the United States, whereas lorcaserin and the extended release combination of phentermine with topiramate have recently gained approval. The development of single peptides targeting gut hormones or other host signals related to obesity may represent promising therapeutic options.

Summary Despite the recent failures of a number of antiobesity drugs, the pharmacotherapy of obesity is progressing rapidly. Treating the obese cardiovascular patient has proven challenging. Efficacy, safety and the sustainability of weight loss are key areas of focus in drug development strategies.

aVascular Physiology Unit, Institute of Child Health, London, UK

bA Cardiology Unit, Hippokration hospital, Athens, Greece

cDepartment of Medicine, University College London, London, UK

Correspondence to Marietta Charakida, Vascular Physiology Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. Fax: +44 0 20 7831 0488; e-mail:

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