Obesity: Symptoms, Causes & Dangerous Drugs

Weight management adheres to a multi-faceted lifestyle model that’s comprised of several interrelated decisions and activities such as: eating healthy foods; understanding portion sizes, nutritional values, and macronutrient ratios; creating a holistic exercise regimen that works with your schedule, incorporates your interests, is dynamic enough to prevent burnout, and sets reasonable goals; and accessing the wealth of safe, clinically proven, prescription weight management medications that are currently available. Empower Pharmacy is dedicated to providing the resources health professionals need to aid their patients in achieving and maintaining ideal body weight goals, as they strive to improve their health-related conditions and overall quality of life.

Obesity and its many serious comorbidities exert a heavy toll in both human and economic terms. More than one-third of adults in the United States are obese, which exponentially increases their odds of hypertension, dyslipidemia, diabetes, and other cardiovascular disease risk factors.[1] Studies have demonstrated that weight loss of as little as 5% to 10% of baseline body weight, has been shown to result in lower triglyceride and blood pressure levels, and in as much as a 58% reduction in the risk of diabetes in pre-diabetic patients. [1] Unfortunately, the problem of obesity is typically exacerbated by aging, as this condition becomes even more difficult to control for older segments of the population. It is a mistake to merely think of obesity in relation to internal health conditions, because it impacts many other areas of one’s childhood, teen, adult, and especially senior life.  One study of individuals aged 65 years and older found that obese individuals had a 31% higher incidence of falling.1

Symptoms and Causes of Obesity

The definitions for being overweight and obese vary depending on the source. The National Heart, Lung, and Blood Institute describes some of the signs of being overweight and possibly obese as: clothes feeling tight and requiring larger size; the development of extra fat around the waist; and possessing a higher than normal body mass index and waist circumference.2

More specifically, with regard to defining obesity, the Mayo Clinic quantifies obesity as a body mass index (BMI) of 30 or higher. Your body mass index is calculated by dividing your weight in kilograms (kg) by your height in meters (m) squared.3

Although there are genetic components and hormonal influences, obesity occurs when you take in more calories than you burn through normal daily activities and extracurricular exercise. The body stores these excess calories as fat, which if it continues to accumulate results in obesity that can be caused by a combination of contributing factors including:

• Inactivity - a sedentary lifestyle makes it easy to overeat.
• Unhealthy diet and eating habits - frequent: high calorie meals; fast food; breakfast skipping; late night eating; drinking high calorie beverages; and eating oversized portions all contribute to weight gain.
• Pregnancy - Many women view this as a time of overindulgence, which initiates obesity, whereas others simply find this weight difficult to lose after giving birth.
• Lack of sleep - getting less than seven hours of sleep a night can cause changes in hormones that increase your appetite, and create cravings for high calorie foods.
• Certain medications - some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids, and beta blockers.
• Medical problems - specific medical diseases and conditions promote weight gain, such as Prader-Willi syndrome, Cushing's syndrome, polycystic ovary syndrome, metabolic syndrome, etc.

Dangerous Weight Loss Drugs

• Overweight and obese individuals have been seeking quick fixes for centuries. Called 'fat reducers', the first diet pills emerged in the late 1800's. Based on thyroid extract, which can increase metabolic rate, they were effective but had harsh side effects including abnormal heartbeats, increased heart rate, weakness, chest pains, high blood pressure, and fatalities. In the 1930s, a new medication (though technically a poison) called dinitrophenol became a popular for its thermogenic fat loss property (actually a symptom of phenol poisoning). Once its other poisonous symptoms (severe rashes, cataracts, peripheral neuritis, etc.) turned tragic it was removed from the market.
• A mid-1950s stimulant used in WWII to keep soldiers alert, amphetamines, promoted energy, suppressed appetite, and provided a slimming effect, but were neurologically and psychological addictive.
• 1965's obesity treatment, aminorex fumarate, triggered pulmonary hypertension.
• By the late 1960s a form of thyroid hormone was introduced, often used in conjunction with diuretics, laxatives, and amphetamines. These drugs proved too toxic.
• In the 1970s, a Danish physician used ephedrine in combination with caffeine to treat asthma, and eventually weight loss. It was soon banned by several states in the 1990s and finally the U.S. Food and Drug Administration (FDA) on December 31, 2003 for adverse cardiovascular and neurological problems, and implication in several deaths.
• Later phenylpropanolamine, an ephedra derivative, became popular as an appetite suppressant. It was also discontinued due to hemorrhagic stroke and increased hypertension.
• In 1973 the FDA approved weight loss drug fenfluramine gained popularity in 1992, when it was combined with another drug, phentermine and came to be known as Fen-Phen. Boasting over 18,000,000 sold bottles in 1996 alone, pulmonary hypertension, heart lesions, and valve abnormalities caused its removal...subsequently fenfluramine was voluntarily removed from the market in 1997.

• 1. Aust N Z J Public Health. 2014 Feb;38(1):13-8. Associations between obesity and overweight and fall risk, health status and quality of life in older people. Mitchell RJ, Lord SR, Harvey LA, Close JC.
• 2. The National Heart, Lung, and Blood Institute. July 13, 2012 What Are the Signs and Symptoms of Overweight and Obesity? http://www.nhlbi.nih.gov/health/health-topics/topics/obe/signs.html
• 3. The Mayo Clinic Diseases and Conditions. Obesity: Symptoms. http://www.mayoclinic.org/diseases-conditions/obesity/basics/symptoms/CON-20014834