Obesity treatment in metabolic syndrome patients

Česká verzia

Authors: Š. Svačina
Authors place of work: III. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
Published in the journal: Vnitř Lék 2009; 55(7-8): 622-625
Category: 134th Internal Medicine Day - 23rd Vanysek's Day Brno 2009 - Vanysek's Lecture

Summary

Fat accumulation is an important pathogenetic factor in metabolic syndrome. Weight reduction, at the same time, has a positive effect on metabolic syndrome components. Lifestyle changes are important in the treatment of obesity although they are usually unlikely to provide permanent effect. At present, bariatric surgery and pharmacotherapy represent easily accessible and effective treatment options. In addition, bariatric surgery often results in full remission of type 2 diabetes. Unlike older anti-obesity agents, currently available anti-obesitics sibutramine and orlistat might be taken long-term for years, allowing avoidance of the typical weight increase following treatment completion phenomenon. Furthermore, both agents provide broad therapeutic effect as they affect all components of metabolic syndrome. The weigh of obese patients with impaired glucose tolerance and increased fasting glycaemia might be reduced with metformin. A range of other substances is in development, of which incretin analogues, expected to be used in obese non-diabetic patients, appear the most promising. Bariatric surgery decreases significantly mortality of obese patients with metabolic syndrome. It is likely that mortality reduction following the use of anti-obesity agents will soon be proven as well.

Key words:
obesity – sibutramine – orlistat – SGLT2 inhibitors – incretin mimetics – metabolic surgery – bariatric surgery

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