INTRODUCTION

Obesity is a dreadful disease that has been on the rise for the past few years, affecting millions of people worldwide. In the past, it only used to affect adults more commonly and rarely affected teenagers or children but nowadays, it is a global disease affecting people of all age groups with no exceptions. It is defined as a disease that occurs due to the excessive gaining of weight and fat accumulation with severe morbid complications that follow. People are classified according to BMI into four categories; Underweight, Normal, Overweight and Obese.

A person with a BMI ranging from 25 to 29.9 is NOT OBESE. A person with that range is considered overweight, while a BMI of 30 or above is considered obesity. Obesity is a major risk factor for a wide variety of chronic diseases, such as Type II Diabetes Mellitus, cardiovascular diseases, and even certain diseases such as PCOS for women. It affects the quality of life and the longevity of the person and even your health on a psychological level. That is why it is necessary to understand the causes of obesity in order to provide appropriate treatment.

Obesity is a multi-factorial disease that happens due to a change in behavior, diet, due to certain health disorders and due to physical activity changes.

Diet

A severe change has occurred in the common dietary patterns worldwide as of the past few years.

People are moving towards the harmful patterns of diet, such as sugary beverages and sugary food such as donuts, milkshakes and other drinks and foods that contribute to weight gain without providing a sense of fullness and therefore, more carbohydrates to gain.

Due to the stresses people are facing currently in the whole world, stress-eating has become a habit to many people which is not a useful habit. Frequent snacking of chips and sodas and candies has also unfortunately helped in the rise of obesity.

Physical Activity

In a world full of phones, computers, screens, easier ways of transportation and office-related jobs, sedentary lifestyle has been the norm for many people. People nowadays rarely think about brisk walking or hitting the gym.

Health Disorders

Some health disorders are linked to a sudden increase in weight in a short duration of time, such as hypothyroidism which causes severe weight gain in a short amount of time or increased intake of exogenous corticosteroids or diseases related to the adrenal gland. These diseases lead to dreadful complications if not resolved by medical treatment and evaluation by a specialist.

Obesity is a serious disease of adults and children, women and men worldwide. It’s drastic effects can cause the following complications on the long run:

Type II Diabetes Mellitus

Type II Diabetes Mellitus is the inability of the body to utilize the insulin provided by the pancreatic beta cells of Langerhans to move glucose into the cells, and therefore, the glucose stays elevated in the bloodstream, leading to more insulin being squeezed out of the pancreatic cells in order to hopefully decrease the glucose level in the bloodstream, also known as “Insulin Resistance”.

Serious long-term complications can occur due to type 2 DM, such as neuropathy which is weakness of the nerves of the body and peripheral numbness, Retinopathy which is a pathology concerning the eye, which causes diminution of eyesight later on, as well as Nephropathy which is a pathology concerning the kidneys and it may present as frothy urine with significant proteinuria on urine analysis. DM Type II is not diagnosed within the first few years and the patient remains diseased without actually knowing that he had became diabetic, therefore not controlling it especially if the diet stayed as unsuitable as before.

Respiratory issues

Obesity can also significantly impact respiratory health. Obese adults and children are at higher risk for obstructive sleep apnea, a condition where the airway becomes blocked during sleep, leading to disrupted breathing and poor-quality sleep. The reason an obese person is risked for this condition is because an obese person has a wider neck diameter with larger fat and muscles than normal, blocking the airway passages upon sleeping. This condition is associated with various health issues, including daytime sleepiness, learning difficulties, and behavioral problems especially in children of school age. The excess weight can contribute to asthma exacerbations and other respiratory complications.

PCOS

One of the complications of obesity is the disease of Polycystic Ovary Syndrome, which is a disease that happens in obese women with a certain degree of insulin resistance. The woman usually complains of hirsutism(facial hair) and interrupted periods as well as infertility, which is the inability to conceive a child. An obese woman can be free from PCOS if she decides to lose weight and can even be fertile once again.

Obesity is a hard to bear disease, especially with all of these complications piling up one on another. That’s why it is necessary to choose the appropriate regimen and diet for your body.

Dieting and regimens

Although dieting and regimens may be effective for some people, it needs consistency which may not be possible. Also, other people may not find it useful or may be searching for quicker methods to lose weight.

Methods such as dieting or doing physical activity may not be suitable for everyone, especially people above a certain weight where mobility becomes nearly impossible.

That’s why other methods started to emerge as of lately, such as medical treatments and surgical methods of treatment.

That’s why in this article, we will provide you with one of the most potent and successful drugs in decreasing your body weight by a huge number of pounds in a very short duration without the need for surgeries or insensible diets, Sibutramine.

One of the newest and most potent treatments available for obesity is Sibutramine, which has emerged in the 21^st century, changing the concepts of dieting and losing weight.

What is Sibutramine?

Sibutramine is a norepinephrine, serotonin and dopamine reuptake inhibitor indicated to assist with weight loss in obesity. It is considered a sympathomimetic drug which means that it mimics the actions of the sympathetic system, acting on the central nervous system reducing the food intake by providing a sense of fullness. Also attenuates the fall in metabolic rate associated with weight loss. It was approved by the FDA for the use as a weight loss drug which showed great efficacy.

How does Sibutramine work?

Sibutramine – as a reuptake inhibitor – inhibits the reuptake of serotonin and norepinephrine which are two neurotransmitters which are associated and involved in the process of regulating mood, appetite and energy balance. By inhibiting the reuptake of these neurotransmitters, the number of neurotransmitters available accumulate and therefore suppresses the appetite and increase the energy expenditure of the body.

It also affects the hypothalamus, which is a part of the brain which sends the signals of “Hunger” of “Thirst” to your body. Sibutramine reduces these food hunger signals.

What is the dosage of Sibutramine?

Sibutramine should be taken orally once daily with a dosage of 10mg per day. This dose can be increased up to 15mg per day depending on the patient’s medical health condition and under the supervision of a specialist.

Side effects of Sibutramine?

As previously mentioned, sibutramine is a sympatho-mimetic drug which means that it mimics your sympathetic system which is the system responsible for your “Fight or flight responses”. It can cause the following side effects:

Tachycardia
Increased blood pressure (Hypertension)
Dry mouth
Headache due to raised intracranial pressure(due to hypertension)
Being anxious
Seizures – although very rare.
Mood changes due to the alterations of the neurotransmitters of the brain.

These side effects rarely occur if the person is normal and not suffering from any complications or other diseases.

In conclusion, obesity is a multi-factorial dreadful disease that threatens the whole world that occurs due to a sedentary lifestyle and an unhealthy diet in both adults and children nowadays. Sibutramine is a great option for every obese patient looking to lose weight in a short duration of time without the need to abide to insensible diets and fasting regimens that prevent you from eating what you really like. Sibutramine is a norepinephrine and serotonin reuptake inhibitor that works on the central nervous system and regulates appetite as well as changes the signals of the hypothalamus to hunger. It is a very effective and appropriate method of losing weight and it is approved by the FDA. In case of suffering from any side effects – which is rare – consult your specialist regarding the use of sibutramine.

References

Prevalence of overweight and obesity among adults: United States, 1999. Hyattsville, Md.: National Center for Health Statistics, Health E-Stats, 2000. (Accessed December 7, 2001, at http://www.cdc.gov/ nchs/products/pubs/pubd/hestats/obese/obse99.htm
Finer N. Sibutramine: its mode of action and efficacy. Int J Obes Relat Metab Disord. 2002 Dec;26 Suppl 4:S29-33. doi: 10.1038/sj.ijo.0802216. PMID: 12457297
https://go.drugbank.com/drugs/DB01105
Alexandria Faculty of Medicine Pharmacology Textbook