The developed world no longer has a monopoly on obesity. This is now an international problem facing almost all nations. The World Health Organization has projected that, by 2015, approximately 2.3 billion adults will be overweight and 400 million will be obese. Region-by-region, the percentage of obesity in 2005 was 3–4 percent in Japan and Korea, 7–10 percent in western Europe, 14 percent in Canada, 22–23 percent in Australia and the United Kingdom, and 30 percent in the United States, the developed world’s leader.
Obesity is a leading preventable cause of death, increasing the risk of heart attack, high blood pressure and stroke, type 2 diabetes, and certain cancers. For many individuals seeking to lose weight, weight-loss drugs are a tempting shortcut. The challenge has been finding drugs that are both safe and effective.
Weight-loss drugs work in the following ways: (1) Decreasing the appetite by depressing the feeding center in the hypothalamus. Amphetamine-like drugs—the most widely used and approved for short-term use—act this way. (2) Interfering with the absorption of fats. Orlistat (Xenical, Alli) causes a very modest weight loss of 2–3 kilograms (4.4–6.6 lbs) after a year. (3) Increasing the body’s rate of metabolism. Dinitrophenol, used in the 1930s, was highly effective at this but caused cataracts and severe toxicity.
Since the 1990s, approved drugs that were effective, such as Fen-phen, Redux, and Meridia, have been withdrawn because they increase the risk of heart attacks, strokes, and heart-valve problems. Acomplia (rimonabant) was approved in the European Union in 2006 and withdrawn three years later because its use was associated with depression and increased risk of suicide. In 2012, Qsymia (a combination of phentermine and topiramate) and Belviq (lorcaserin) were both approved for long-term use. Developing suitable drugs has proven to be an elusive challenge, with potential weight-loss products failing before approval or after marketing due to abuse potential, adverse effects, or questionable effectiveness. Time will tell whether these latest drugs effectively combat the rising tide of obesity.
SEE ALSO Amphetamine (1932), Dinitrophenol (1933).
The Portrait of a Gentleman (1630) is attributed to Charles Mellin. At 47 inches x 80 inches (121 cm x 203 cm), the size of this painting exceeds the size of the subject.