What Is Bariatric Medicine?

Slimming pills are medicines that have the effect of losing weight. With the change of aesthetic concepts, a kind of medicine that can make people achieve weight loss is derived. Because it can make the body lose weight faster and thinner, it is loved by those who want to lose weight. The market is full of counterfeit and inferior weight-loss pills, which deceives many obese people. Only one type of weight-loss pills approved by the State Food and Drug Administration is Orlistat.

Slimming pills are medicines that have the effect of losing weight. With the change of aesthetic concepts, a kind of medicine that can make people achieve weight loss is derived. Because it can make the body lose weight faster and thinner, it is loved by those who want to lose weight. The market is full of counterfeit and inferior weight-loss pills, which deceives many obese people. Only one type of weight-loss pills approved by the State Food and Drug Administration is Orlistat.

Chinese name

Weight loss pills

Foreign name

orlistat

Function

lose weight

Development history of slimming pills

Obesity has become a serious global medical and social problem. The incidence of overweight and obesity in China from 1992 to 2002 increased from 14.6% to 21.8% according to WHO standards. In 2006, obesity has affected the health of more than 200 million Chinese, and it is expected that the number of obese people in China will rise rapidly in the coming decades. Obesity is usually a high risk factor for diseases such as hyperlipidemia, type 2 diabetes, fatty liver, hypertension, cardiovascular disease, and cancer. About 3 million people die each year globally as a result. The clinical weight-loss drugs have not made significant progress compared to 10 years ago because of the discovery of serious adverse reactions. For a considerable period of time, "holding your mouth and spreading your legs" is the best way to lose weight.
The only long-term weight loss drugs approved by the FDA are the lipase inhibitor orlistat, and the serotonin 2C receptor agonist lorcaserin and Qsymia ( (Sustained release agent containing phentermine and topiramate). All four new drugs declared to the FDA in 2010 were rejected for safety. Therefore, safety has become the biggest challenge in the development of weight-loss drugs, and it must also be overcome.
There are two major classes of weight loss drugs on the market today, pancreatic lipase inhibitors and appetite suppressants that act on the central nervous system. Appetite suppressants are restricted in use because they can cause adverse reactions in the nervous system. Pancreatic lipase inhibitor orlistat inhibits pancreatic lipase activity, thereby inhibiting the decomposition and absorption of fats in food to reduce weight. But because it can cause steatorrhea, it can cause deficiency of fat-soluble vitamins. It has also recently been reported to cause liver damage. Although the central nervous system appetite inhibitors lorcaserin and Qsymia became the first weight-loss drugs approved by the FDA in 13 years, there are still safety uncertainties in the central nervous system and the cardiovascular system. There are only a handful of options in the weight loss market. If there is a weight loss medicine with good curative effect and low adverse reaction, its market will be significantly expanded.

Difficulties in the development of weight-loss drugs have led to few new drugs on the market for many years. Although lorcaserin and Qsymia have been marketed after years of R & D and repeated FDA reviews, they still face the test of drug safety. There are currently a number of weight loss drugs in clinical trials or experimental studies.

Applicable people for diet pills

There are two types of people who must not use diet pills.

One group is young people under the age of 18, and the other group is old people over the age of 70.

The organs of adolescents under the age of 18 are not yet mature, and it is easy to cause body damage by taking weight loss pills;

In the elderly over 70 years old, the organs have begun to degenerate, and the drugs are not well absorbed. There may be serious consequences when taking weight-loss pills.

In addition, people with heart disease or other diseases should also actively stay away from diet pills.

Price of diet pills

Every June and July is the golden season for the sale of weight-loss products. This summer, the weight loss market around the country is still full of smoke. Hundreds of weight-loss products are entangled in slaughter and struggles, leading to a state of struggle.

For a long time, the price gap in the weight loss market is very obvious, ranging from thousands to tens of yuan. Such a large gap has left consumers confused when choosing: Is it more expensive the better or cheaper the better?

After a long-term investigation and analysis of the weight loss drug market by foreign authoritative institutions, it has been found that the change in sales and price of the weight loss drug market is directly proportional to the rise and fall of the economic bubble, that is, the larger the bubble of economic growth, the more sales of the weight loss drug market, the price The higher, and vice versa.

In today's market conditions where the domestic economic development is gradually maturing and the bubble economy is gradually disappearing, the high price and high profit of weight-loss medicines cannot be sustained for a long time. Instead, they have fallen sharply as market competition intensified, gradually moving towards the social average. profit.

Classification of diet pills

Diet pills granular

It is to make something containing weight loss ingredients into weight loss particles, and then achieve the effect of weight loss through oral administration. Generally, there are many granules with diarrhea and anti-eating effect. Such drugs are against the principle of health.

Slimming Tea

From the medical principle, it is the sum of tea with the effects of detoxification and beauty. Tea to reduce obesity. Their prescriptions are different, and some Chinese herbal medicines are added, which are said to have the effects of reducing fat, cholesterol, and fatigue.

Slimming pills

Slimming paste is a slimming product that absorbs pharmaceutical ingredients into the human blood through the skin or acupuncture points. Its active ingredients have anti-eating effect and diarrhea effect. In fact, the medicine absorbed by the stomach and intestines is realized by external use, and the fat consumption is accelerated.

Classification of diet pills

1.It is an appetite suppressant;

2.Energy consumption enhancer;

3, is to prevent digestion and absorption of drugs;

4.It is a drug that affects lipid metabolism;

5, is other drugs.

Weight Loss Pills

(1) Lose weight and maintain a reduced weight without rebounding; ^[1]

(2) Selectively lose fat without consuming protein; ^[1]

(3) Improve metabolic disorders in obese patients; ^[1]

(4) Safety, small adverse reactions, no possibility of addiction. ^[1]

Use diet pills with caution

Despite the existence of the above five major weight loss drugs, we are still very cautious about using western medicine to lose weight, and it is necessary to strictly grasp the indications for the use of drug treatment.

1. Use drugs to suppress appetite to ensure that patients endure diet control.

2, diet control for six months to one year, who still gain weight.

3. Patients who refuse diet control can try drug treatment.

4. For some people with bad moods or those with peptic ulcers, when dietary treatment is difficult, drugs should be added as a temporary solution.

5, usually develop good eating habits, develop the habit of going to bed early and getting up early!

6, must eat three meals a day on time, develop a regular pattern!

Three misunderstandings of diet pills

Misunderstanding of weight loss pills

Weight loss pills are effective

The principle of most weight loss pills is the same: that is to burn fat, accelerate metabolism, and increase fat burning rate. Therefore, diet pills are not always effective.

Weight loss pills to lose weight is to lose weight successfully

Weight loss is the standard by which most weight-lossers measure success, but in fact, fat accumulation is the real cause. The scales obscured the fact that everything was happening. Diet pills containing "diuretics" will remove 70% of the body's water from the body and quickly lose weight. Diet pills containing diarrhea such as rhubarb and senna are the same principle. However, these two types of drugs can only be used for a short time. Once stopped, drink water to eat, the weight rebounded like a bamboo shoot.

Diet pills are naturally safe

Whether it's medicine or health products, once you play the trump card of "natural", there will always be no disadvantage. Natural = safe? Actually not. Regardless of the raw materials used or the processing technology, once the drug interferes with metabolism and affects absorption and digestion, the effect is the same as that of chemicals. Pay attention to the three misunderstandings of taking weight-loss pills. It is not that all weight-loss pills are effective, and it is impossible to reduce the volume or to lose weight. It must be approved by the relevant national authorities before it can be safe.

Precautions for diet pills

Slimming pills are not health products. As medicines, they have certain side effects and adverse reactions. People who want to achieve weight loss through slimming pills must take them for a long time to produce weight loss effects. However, long-term consumption of slimming pills can cause gastrointestinal disorders in the body. Indigestion occurs in the light, and a series of gastrointestinal diseases may occur in the severe. Some weight-loss drugs are even harmful to the human body. For example, the diuretic component in weight-loss drugs, if taken for a long time, will cause kidney function to deteriorate, which will cause various disease. Women taking weight loss pills can also cause infertility, which is very bad for every woman and will be a regret in life. In fact, the most important thing to lose weight is to have a normal diet, a balanced diet, and more importantly, exercise. This is the best way to lose weight. Therefore, for the health of women, you still want to lose weight scientifically.

If you get over-excited after taking weight-loss pills and can't sleep at night, then you should be wary that your pills may contain amphetamines. At the beginning of taking this medicine, the effect of weight loss may be obvious, but with the development of body resistance, symptoms such as emotional instability, delusion, hallucinations, and sleep disturbances will appear. And amphetamines are as addictive as drugs. Once they are addicted, the process of quitting is very painful, and may even cause symptoms such as anxiety, depression, fatigue, lethargy, and overeating. Experts advise that this medicine must never be taken lightly.

Current status and safety issues of weight loss pills

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The approval of new weight-loss drugs must adhere to both efficacy and safety. In terms of efficacy, the weight-loss drugs on the market all meet the FDA's evaluation criteria for weight-loss drugs: (1) After taking the weight-loss drugs and placebo for 1 year, the difference in weight loss between the two groups of subjects should not be less than 5%. (2) The proportion of subjects with a weight loss of more than 5% in the drug treatment group is not less than 35%, and the proportion should be twice that of the placebo group. However, while weight-loss drugs bring good weight-loss effects, there are serious safety issues. The most notorious of these are appetite suppressants, amphetamine analogs, fenfluramine and phentermine, which were widely used in the 1990s for their appetite suppressant effects, but caused pulmonary hypertension and heart valves due to their appetite suppression effects. Sick and had to leave the market. Other amphetamine analogs and sympathomimetic drugs also have serious risks such as addiction, myocardial toxicity, and sudden death. The mortality rate of chronic pulmonary hypertension caused by aminorex is 50%. Phenylpro-panolamine can cause intracranial hemorrhage and stroke. Ephedrine can cause heart disease, high blood pressure, palpitations, stroke, and sudden death. Sibutramine can cause an increase in cardiovascular disease.

Rimonabant is an endogenous cannabis receptor CBL antagonist that can cause increased depression and suicide. These unsafe drugs have all been withdrawn from the market. At present, there are still 5 kinds of weight-loss drugs in clinical use, including orlistat capsules approved in 1999, lorcaserin and phentermine and topstilbate (qsymia) slow-release agents approved in 2012 Capsules and naltrexone hydrochloride and bupropion hydrochloride compound sustained-release tablets and liraglutide injections approved in 2014.

Diet pills in clinical use

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1 orlistat Diet pills 1, orlistat

In 1987, the pancreatic lipase inhibitor lipstatin was isolated from Streptomyces, but because the structure contains two unstable cis double bonds, Roche passed the premise of retaining its basic structure. Hydrogen reduction has resulted in a more stable orlistat and was approved by the US FDA for the treatment of obesity in 1999. In addition to having a good weight loss effect, it can also improve the blood pressure of hypertension patients who are difficult to control with conventional antihypertensive drugs. In addition, orlistat can control blood sugar while reducing weight and reduce the incidence of diabetes. Orlistat as a gastrointestinal esterase inhibitor, partially inhibits gastric lipase, pancreatic lipase and carboxyester lipase, prevents the gastrointestinal mucosal cells from absorbing fatty acids and glyceryl monostearate, thereby reducing the absorption of 30% of fat intake , Increase the excretion of feces, to achieve the purpose of weight loss. Orlistat at high doses of 800mg · d (normal dose of 360mg · d) does not affect the whole body, so it mainly manifests as adverse reactions to the intestine, such as diarrhea, flatulence, urgency and urinary incontinence However, these adverse reactions can be reduced by reducing the fat content in the diet. While reducing fat absorption, orlistat also reduces the absorption of fat-soluble vitamins (vitamin A / D / E), mineral elements (calcium and potassium), and certain drugs [warfarin, amiodarone] , Cyclosporin (ciclosporin), lamotrigine, valproic acid, vigabatrin, gabapentin, thyroxine, etc.]. In addition, there are reports in 2010 that orlistat can cause severe liver injury, acute pancreatitis, acute kidney injury, and precancerous lesions of colon cancer. In short, the limited efficacy of weight loss and serious adverse reactions highlight the shortcomings of orlistat. Therefore, there is still an urgency for the development of new weight-loss drugs with high efficiency and low toxicity.

2 lorcaserin Diet pills 2, lorcaserin

Dexfenfluramine, the first weight-loss drug approved by the FDA for long-term treatment of obesity in 1996, has a good weight-loss effect, but it is not selective for 5-HT2B and 5-HT2C receptors, leading to Severe heart valve disease was removed from the market in 1997. In order to avoid heart valve adverse reactions caused by 5-HT2B excitement, Arena Pharmaceutical Company structurally modified fenfluramine to form the phenyl ring at the C-1 and C-6 positions of the phenyl ring. The chloro-type mother nucleus was substituted with trifluoromethyl at the C-3 position to increase its selectivity to 5-HT2C to obtain lorcaserin. This product was approved by the US FDA in June 2012 for adjuvant treatment of overweight or obese patients with a body mass index (BMI) 27 and suffering from at least one obesity complication. Iorcaserin reduces appetite and increases satiety by selectively activating the 5-HT2C receptors in the hypothalamus, which avoids the adverse reactions of stimulating 5-HT2B to heart valves and enhances drug safety. When used alone, the most common adverse reactions in non-diabetic patients are headache, dizziness, fatigue, nausea, retching and constipation; the most common adverse reactions in diabetic patients include hypoglycemia, headache, back pain, cough and fatigue.

3 qsymia Diet pills 3, qsymia

Phentermine was first approved for short-term weight management in 1956. It is an amphetamine analogue, which mainly suppresses appetite and induces food loss by inducing the release of norepinephrine from the central nervous system. The most common adverse reactions are insomnia, dry mouth, and constipation. Because of its stimulant properties, it has contraindications such as cardiovascular disease, hyperthyroidism, glaucoma, restlessness, and drug abuse. The study found that topiramate, which was first approved for the treatment of epilepsy in 1996, can increase satiety and reduce energy intake, but its weight loss mechanism is still unclear. The most common adverse reactions are paresthesia (numbness in the legs and feet) and taste disorders. Because topiramate is mainly metabolized by the kidney, it can cause kidney stones, metabolic acidosis and acute angle-closure glaucoma in some patients. Vivus used phentermine in combination with topiramate and found that it has a stronger weight loss effect. At the same time, it achieves the same therapeutic effect with lower doses and fewer adverse reactions, but it increases patient tolerance to the drug. The US FDA approved qsymia as a new compound weight loss drug for appetite suppression in 2012, and believes that the drug outweighs the disadvantages in the long-term application of overweight and obese people.

4 contrave Diet pills 4, contrave

Bupropion is a selective norepinephrine and dopamine reuptake inhibitor, and is used clinically as an antidepressant and a smoking cessation drug. Studies have found that bupropion has an appetite-suppressing activity, and this activity is related to the stimulation of hypothalamic opioid-melanocyte-procortinogen (POMC) -releasing neurons (procortinogen). These neurons release a-melanocyte stimulating hormone (a-MSH), reducing food intake and increasing energy expenditure. However, in clinical studies, the effect of weight loss using bupropion alone is not obvious. Therefore, the FDA has not approved its marketing as a weight loss drug alone. Studies have also found that taking naltrexone while taking bupropion enhances appetite suppressant activity and enhances weight loss efficacy. As a result, the U.S. FDA approved the marketing of the compound weight loss drug contrave developed by Takeda and Orexigen in October 2014 for obese adult patients with a BMI 30 kg · m, or BMI 27 kg · m and suffered from at least one complication such as hypertension , Adult patients with type 2 diabetes or high cholesterol (dyslipidemia). Because contrave contains bupropion, the compound has a black box warning to remind health care professionals and patients that this drug can increase suicidal thoughts and behaviors related to antidepressants.

5 liraglutide Diet pills 5, liraglutide

liraglutide is a human glucagon-like peptide-1 (GLP-1) analog, developed by Novo Nordisk, first marketed in the European Union in July 2009, and in China in October 2011. Treatment of type 2 diabetes. In December 2014, liraglutide was approved by the US FDA as a long-term weight loss drug in the United States. It is suitable for adult obese patients with BMI 30kg · m or BMI 27kg · m but with obesity-related complications such as diabetes or hypertension. Liraglutide comes with a black box warning that studies have shown that liraglutide increases the risk of thyroid C-cell tumors when used in rodents, and the above risks are uncertain for humans. Therefore, liraglutide should not be used in patients with a family or personal history of medullary thyroid carcinoma (MTC), and in patients with multiple endocrine tumor syndrome type 2 (a disease with more than one adenoma, which can easily induce MTC). Serious adverse reactions during liraglutide treatment have been reported to include pancreatitis, gallbladder disease, renal dysfunction, and suicidal tendencies. Liraglutide can also increase heart rate, and patients should stop taking medication if their resting heart rate continues to increase. In clinical trials, the most common adverse reactions in patients treated with liraglutide included nausea, diarrhea, constipation, vomiting, hypoglycemia, and decreased appetite. This product is a subcutaneous injection.