Resumen

BAUTISTA BOHORQUEZ, FERNANDO. La Obesidad y sus Paradojas: Un problema de Peso Consecuencias del Tratamiento Farmacológico para la Obesidad. Rev.Cs.Farm. y Bioq [online]. 2013, vol.1, n.1, pp.131-139. ISSN 2310-0265.

Abstract Obesity is a disease characterized by endocrine-metabolic excessive fat accu-mulation in adipose tissue. The importance in the study and treatment of obesity, lies not only in the high incidence of this disease in recent years, but the health risk that this implies. The goal of treatment is to reverse the positive energy balance, and im-provement of co-morbidities such as diabetes mellitus, hypertension, heart disease, gallbladder disease, certain forms of cancer and psychosocial. This is very important because in recent decades, Latin America has suffered a "nutrition transition", which involved adding the various expressions of the Latin American diet features of the American diet (high in saturated fats and carbohydrates) with an increase of over-weight and obesity. Additionally, physical inactivity, increased smoking and alcohol consumption and stress presentin rapid-ly growing cities in developing countries. In the WHO epidemiological half a billion people, or 12 percent of the world popula-tion is considered obese. The highest levels are in America and the lowest in Southeast Asia. The mainstays of therapy are chang-ing behavior, diet and exercise. However, these tools are not guarantee the mainte-nance of weight loss in the long term with-out rebound. Drugs are a tool used in asso-ciation with the above and not as the sole measure. Drugs for the treatment of obe-sity is classified into those that decrease food intake (noradrenergic agents, sero-toninergic and dual), decrease absorption (orlistat) and those that increase thermo-genesis (ephedrine and caffeine). Current-ly only sibutramine and orlistat are seen as the only drugs whose safety and efficacy demonstrated its clinical application to al-low long-term (two years). Advances in the study of energy balance and its regulation have been postulated new targets for fu-ture production of more specific and effec-tive drugs as endocannabinoid receptor an-tagonists, but are still under study. Among the considerations to take into drug therapy are gastrointestinal side effects with orlistat which predominated, and included esteatorreicas stool, oily spotting and fecal urgency in 15% to 30% of patients. Fecal incontinence occurred in 7% of patients treated with orlistat compared with 1 % in the placebo group, with a number need-ed to harm of 17%. Sibutramine side effects included increases in systolic and diastolic blood pressure of 1-3 mmHg and increased heart rate of 4-5 beats per minute. Other side effects such as insomnia, dry mouth, nausea and constipation occurred in 7-20% of cases analyzed in the use of these drugs. The key is that the weight reducing drugs are useful for a few, while having significant adverse effects in many patients.

Palabras clave : Obesity; drug treatment; Consequences.

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