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Clinical treatment of obesity: are drugs and surgery the answer?

Published online by Cambridge University Press:  07 March 2007

Peter G. Kopelman
Peter G. Kopelman
Affiliation:
Barts and the London, Queen Mary's School of Medicine & Dentistry, University of London, Turner Street, London E1 2AD, UK
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Abstract

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Obesity treatment remains a ‘Cinderella’ of all clinical management programmes, but generally without a happy ending. The great expectation for new therapeutic agents has not been fulfilled in clinical practice, whilst the restriction of eating through surgical division of the upper bowel seems strange in an age of advanced and sophisticated technology. The better understanding of the neuro-regulation of appetite, and its application as part of evidence-based clinical interventions, could lead to a more coherent approach to obesity treatment. Nevertheless, investigation of potential neuroendocrine targets for appetite suppression suggests redundancy in the systems, which make development of effective agents against single receptors impractical. Importantly, the progressive rise in the prevalence of obesity will inevitably mean that only a small proportion of afflicted patients will actually be treated by long-term drugs and surgery. Drugs and surgery are not currently the answer for the majority of obese individuals. What is required is a better way of identifying patients who may particularly benefit from such approaches. However, the major emphasis must be the development of effective population-wide interventions that halt the increase in fatness and ensure that future generations maintain and enjoy a healthy body weight.

Keywords

ObesityAnti-obesity drugsObesity surgery
Type
Plenary Lecture
Information
Proceedings of the Nutrition Society , Volume 64 , Issue 1 , February 2005 , pp. 65 - 71
Copyright
Copyright © The Nutrition Society 2005

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