Anti-obesity Drugs: From Animal Models to Clinical Effi cacy

INTRODUCTION 272 CLINICAL ASPECTS OF OBESITY AND CARDIOMETABOLIC DISEASE 273 Background – Do We Need Drugs for Obesity? 273 Current Drugs for Obesity and Their Limitations 274 Other Drugs – Withdrawn or No Longer Recommended for Routine Clinical Use 275 The Need for New Drugs 275 BIOLOGY AND GENETICS OF ENERGY REGULATION AND IMPLICATIONS FOR OBESITY 276 Short-Term (Episodic) Signals 276 Meal Onset 276 Meal Termination 277 Thermogenesis 278 Long-Term (Tonic) Signals 278 CNS Integrating Pathways 279 BIOMARKERS OF ENERGY REGULATION AND OBESITY 280 Anthropometric Measures 280 Measures of Adiposity 281 Measures of Energy Expenditure 281 Risk Factors 282 Insulin Resistance and Systemic Infl ammation 282 THE PSYCHOBIOLOGY OF APPETITE EXPRESSION 283 Episodic Signals in the Regulation of Appetite Expression 283 Tonic Signals in the Regulation of Appetite Expression 283 PSYCHOLOGICAL AND BEHAVIORAL ASPECTS OF OBESITY 283 Genetics Versus Environment? 284 Obese Eating Style? 284 Underperformance of Appetite Control and Defi cits in the Specifi c Satiety Mechanisms 285 CHAPTER 8