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Sibutramine was approved for use by the FDA in 1997 for the treatment of obesity in the form of Sibutramine HCl monohydrate. It was marketed under the brand names of MeridiaTM and ReductilTM in the US by Knoll Pharmaceuticals. It comes in three different strengths; 5,10 and 15mg, and is administered in the form of a creamy-white powder in a capsule (see picture) Meridia (sibutramine) inhibits the reuptake of certain neurotransmitters: Active weight normally loss occurs for 6 months, and weight loss can be maintained for a period of up to 2 years with sustained therapy. Treatment for further periods of time have not been evaluated yet. |
According to data from the 22American Obesity Association, obesity is the second largest preventable cause of death in the US after smoking. Obesity and its associated diseases can place individuals at a high risk of premature death and therefore must be treated. Lethal conditions and/or diseases that can be brought on by obesity include established coronary heart disease and other atherosclerotic diseases, type 2 diabetes and sleep apnea. Non-lethal but still serious conditions that can be brought on by obesity include osteoarthritis, gallstones, stress incontinence, and gynecological abnormalities such as amenorrhea and menorrhagia. If obesity is combined with other factors, including smoking, hypertension, a family history of cardiovascular disease, age (greater than 45 for men, greater than 55 for women) then there is an even greater risk of death.
The medical guidelines for the treatment of obesity are as follows:
For individuals with BMI > 25kg m-2, a combination of dieting, increased physical activity and behavioural therapy is recommended.
For individuals with BMI > 30kg m-2, additionally, pharmacotherapy is also recommended to further aid weight loss.
For individuals with BMI > 40kg m-2, in addition to the above, weight loss surgery may also considered, on account of the extreme risk to the individual
concerned.
There are three main factors that contribute to an individual becoming obese; genetic predisposition, environment and behaviour.
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There are certain genes in our DNA that encourage obesity. It should be noted that these genes do not cause obesity, however they do produce an increased risk of being obese. Individuals with these genes may have a particularly slow metabolism and therefore store more fat rather than burning it off. They may not be particularly inclined to spontaneous activity, such as fidgeting. They also might have bodies that are particularly efficient at turning carbohydrate into fat. There are many other genetic factors that may increase the risk of obesity - as part of the Human Genome Project, researchers are trying to find which genes are responsible for an increased risk of obesity. A summary of their work can be found at the Human Obesity Gene Map. |
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Our environment also plays a part in how people become obese. If an individual lives in an environment where they are not encouraged to exercise, they run a greater risk of becoming obese. Some factors might be being forced to drive rather than walking, not being able to play any sport or other common forms of exercise, or having fatty, rather than healthy, nutritious food available. |
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The behaviour of an individual is a major factor in becoming obese. If an individual chooses not to eat healthily, doesn't take any opportunity to exercise, or is excessively lazy, they run the risk of becoming obese. There is research to support the view that genetic factors play the biggest part in determining whether an individual becomes obese, however the individual's behaviour is still the only thing that can be easily changed to promote weight loss. |
Sibutramine primarily works by increasing feelings of satiety and reducing appetite. There is 24research to support the view that sibutramine also induces thermogenesis, either through promoting more muscular activity, increasing oxygen consumption or increasing glucose utility, however this is not widely accepted as sibutramine's primary method of operation.
More information on the clinical aspects of sibutramine can be found here