Obesity Current Research and Future Hope

Rehan Haider; Asghar Mehdi; Geetha Kumari

doi:10.55927/cjas.v2i2.9573

Authors

Rehan Haider Department of Pharmacy University of Karachi
Asghar Mehdi Fazaia Ruth Pfau Medical College Air University,Karachi
Geetha Kumari GD Pharmaceutical Inc OPJS University Rajasthan

DOI:

https://doi.org/10.55927/cjas.v2i2.9573

Keywords:

Obesity, Current Research, Genetics, Environment, Therapeutic Interventions, Personalized Medicine

Abstract

Obesity is a broad-based public health issue that is defined by excessive consumption of body fat, which is associated with more negative health impacts than positive ones, such as diabetes, cancer, and cardiovascular disease. This abstract backs up a brief overview of the approaches being used in the fight against obesity today and in the future.The goal of current research efforts is to comprehend the intricate interplay of behavioral, environmental, and historical factors that contribute to corpulence. Genetic research has uncovered a large number of vulnerable genes, removing the inherited components of obesity. In the meanwhile, material factors like fattening diets and indolent habits warrant more study.Approaches to behavior qualification and novel healing attacks are being energetically investigated. Strategies include expanding anti-corpulence medications, bariatric surgery, and targeting gut bacteria. In the areas of precision, treatment, customized digestive approvals, plant structure, and customized absorption, encouraging results are emerging.The integration of scientific and mathematical strength techniques holds the key to future success in the battle against obesity. Innovative approaches to tracking and managing obesity are provided by wearable technology, mobile devices, and telehealth manifestos. Healthcare providers and situations can benefit from the large dossier science of logical analysis and artificial intelligence in generating thoughtful remedies for individualized burden administration

Downloads

Download data is not yet available.

References

Wigand R, Gelderblom H, and Wall G New human adenovirus ( candidate Adenovirus 36), a novel member of subgroup D Arch viral 1980, 64(3)225-33

Atkinson RL,Viruses as an etiology of obesity.Mayo clin proc 2007, 82(10), 1292–8.

Atkinson RL, Dhuran dher NV, Allison DB, Bowen RI, Israel BA, Albu JB,et.al.Human adenovirus 36 is associated with increased body weight and paradoxical reduction of serum lipids.int J obes (land)2005-29(3)281-6

Rogers PM, Fusiniki KA, Rathod MA, Loiler SA, Passarica M, Show MK, et al. Human adenovirus Ad-36 reduces adipogenesis via its E4 or f -1 gene Int J obes (Land) 2008, 32(3), 397–406.

KraJmalnik Brown R, IIkhan ZE, KangDW, Diabaise JK, Effect of gut microbes on nutrient absorption and energy regulation Nutr clin Pract 2012, 27(2), 201–14

Casazza F, Brown A, Astrop A,BertzF,Baum C, Bohan Brown M, et al., weighing the evidence of common beliefs in obesity research, Crit Rev Food sci Nutr 2015, 55(14), 2014-53

Casazza K ,Pate R, Allison. DB, Myths, Presumptions and facts about Obesity, N Engl J Med 2013, 368(23) 2236-7

Casazza K, Fontaine KR, Asstrup A, Birch LL, Brown AW, Jonathan Brown MM, et al., myths, presumptionsand facts about obesity .N Engl J Med 2013.368(5)446-64

Shefer G, Marcus Y., Stern N.: Is obesity a brain disease ? Neurosci Biobehav Rev. 2013, 37 (10 pts), 2489–503.

Thaler,JP,YiCX Schur EA,Guyenol 8J,Hwang BH,Dietrich MO, et al. Obesity is associated with hypothalamus injury in rodents and humans J clin invest 2012,122(1)153-62

Horvath TL, Sarman B, Garcia-Caceres C, Enrtori PJ, Sotonyl P, Shana brought M et al. Synaptic input organization of the melanocortin system predicts diet-induced hypothalamic reactive gliosis and obesity.Proc Natl Acad sci USA 2010 107(33) 14875-80

Heilbronn LK,DejongaL,Frisard MI,DelanyJP,Larson-Meyer MeyerDE,RoodJ, et al. Effect of 6-month calorie restriction on biomarkers of longevity, metabolic adaptation, and oxidative stress in overweight individuals randomized controlled trials.JAMA 2006.295(13)1539-48

Astrup A, Dietary composition,Substrate balance and body fat in subjects with a predisposition to obesity, int J obes Relat Metab Disord. 1993; 17 suppl 3: 532-6 Discussion S41-2

Knowler WC, Barrett-Connor-E, Fowler SE, Hammah RF,LachinJM,walker EA,et.al.Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin N Engl J Med 2002: 346(6) 393-403

Tuomilehto J, Lindstrom J, Eriksson JG, ValleTT, Hamalainen H, Ilanne-Parikka P, et al. prevention of type 2 diabetes mellitus by change in lifestyle among subjects with impaired glucose tolerance .N Engl J Med 2001, 344(18), 1343–50.

clinical Guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report National Institute of Health Obesity Red 1998, 6 Suppl. 2 515-2095

Hamman RF,wing RR, Edelstein, Lachin JM, BrayGA, Delahanty L, et al. Effect of weight loss with lifestyle intervention on risk of diabetes,Diabetes Care 2006, 29(9), 102–7.

Hesh kas, Anderson JW, Atkinson RL, Greenway FL, Hill Jo, Phinney, et al.

Weight loss with self-help compared with a structured commercial program A randomized trial JAMA 2003,289(14)1792-8

Rock CL, Flatt SW, Sherwood NE, Karanja N, Pakiz B, Thompson CA Effect of a free prepared meal and incentivized weight loss program on weight loss weight loss maintenance in obese and overweight women: A randomized controlled trials JAMA 2010,304,(16) 1803-10

Pavlou KN, Krey S, Stefee, WP,Exercise as an adjunct to weight loss and maintenance in moderately obese subjects AmJ clin Nutr 1989, 49, 5 suppl: 1115–23

Church T,EarnestC,Blair S, Dietary over compensation across different doses of exercise obesity, 2007; 15Suppl : A17

Shai.I.,Schwarzfuchs D.,Henkin Y.,Shahar DR.,Witkow S.,Greenberg L., et al.,HenkinY,Shahar Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat fat (2008), 359(3), 229–41.

Sacks FM,Bray GA,Carey VJ, smith SR, Ryan DH,Anton SD, et al. comparison of fat, protein, and carbohydrates N Engl JMed. 2009; 360(9): 859–73.

Cornier MA, Donahao WT, Preira R, Gurevich l, Westergren R, Enerback S, et al. Insulin sensitivity determines the effectiveness of dietary macronutrient composition on weight loss in obese women obes Res 2005:13(4) 703-9

Foster GD, Wyett HR, Hill JO, Meguekvi BG, Brill C, Mohammed BS, et al. A randomized trial of a low-carbohydrate diet for obesity Engl J Med 2003: 348(21) 2082–90

Ebbeling CB, Leidig MM, Fieldman HA, Lovesky MM, and Ludwig DS: Effect of a low glycemic load vs low - fat diet in obese young adults A randomized trial JAMA 2007, 297(19), 2092–102

Orentreich N, Motias JR, Defelice A, and Zimmerman JA: Low methionine Ingestion by rats extend life span J Nutr 1993,123(2)269-74

Hasek BE, Stewart LK, and Henegan TM Bondreau A, Leonard NR, Black C, et al. dietary methionine restriction enhances metabolic flexibility and increases uncoupled respiration in both fed and fasted states AmJ Physiol Regul Intercomp Physiol 2010.299(3) R 728-39

Epner DE,Morrow S, Wilcox M, and Houghton JL.Nutrient intake and nutritional indexes in adults with metastatic breast cancer: phase 1 clinical trials of dietary methionine restriction Nuts Cancer 2002, 42(2)158-66

Plaisonnae ER, Green way Fl, Boudreau A, Hill Kl, Johnson WD, Krejaik RA, et al.Dietary methionine restriction increases fat oxidation in obese adults with metabolic syndrome .JCbin Endocrinol Metab 2011,96(5) E836-40

Perrone CE, Mattocks DA, Plummer JD,chittus SV, Money R, Vignola2 K et al. Genomic and metabolic responses to methionine-resistant cysteine Supplemented diets in Fischer 344 rats: inguinal adipose tissues liver, and quadriceps muscle Nutrigent Nutrigenomics, 2012, 5(3), 132–57

Wadden TA, BerKowitz RI,womble LG, Warmer DB, Phelan S, Cara RK, et al., randomized trial of life style modification and pharmaco therapy for obesity Engl J Med 2005, 353(20) 2111-20

Lichtman SW, Pisar Ska K, Bergman ER, Pestone M, Dowling H, Offenbacher E, et al. Discrepancy between self - reported and actual calorie intake and exercise in obese.Subjects N Engl J Med 1992,327(27)1893-8

Martin CK, Nicklas T, Gunturk B, Correa JB, Allen HR, and Champagne C Measuring food intake with digital photography J Hum Nutr Diet 2014,27,suppl 1: 72–81 81

Martin CK, Cortes J B, Han H, Allen HR, Room JC, Champagne CM, et al. validity of the remote food photography method ( RFPM) for estimating energy and nutrient intake in near-real-time obesity (Silver Spring) 2012, 20(4), 891–9.

Thomas DM, Martin CK, Heyesfield S,Redman LM, Schoeller DA, Levina JA,A simple model predicting individual weight change in humans, J Biol Dyn 2011; 5(6): 579–99

Thomas DM,Martin CK,Lettieri S,Bredlau C,Kaiser K,church T, et al., can a weight loss of one pound a week be achieved with a 3500-kcal deficit? Commentary on a commonly accepted rule Int J obes ( Lond) 2013, 37(12), 1611–13

Hall KD,Wang YC, Gortmaker SL.Sacks G, ChandraMohan D, Chow CC, et al Qualifications of the effect of energy imbalance on body weight, Lancet 2011, 378(9793), 826–37.

Zhang K, Pi-Sunyer FX, Boozer CN,improving energy expenditure in healthy adults Med sci sports Exerc 2004, 36, (5) 883-9

Ryan J, Gordon J., An evaluation of energy expenditure estimation by three activity monitor Eur J Sport sci 2013, 13(6) 681–8

johannsen DL, Calabro MA, Stewart J, Franke W, Road JC, and Werk GJ,Accuracy of armband monitor for measuring daily energy expenditure in healthy adults Med sci sports Exerc 2010 42 (11) 2134-40

US FDA Dietary supplement Health and Education Act of 1994.http w.w.w.fda gov/regulatory information / legislation/ Federal food drug and cosmetic act fd&c act/u cm 148003htm

Congressional hearing investigates Dr. 'Oz's'miracle' weight loss claims 2014.http://www.CNN.com/2014/06/17/health/senate grills-Dr-0z/ accessed December 8, 2014

Author retract green coffee bean diet paper touted by Dr Oz, 2014,2014 http.tetra action watch.com 2014/10/20 authors: retract green coffee bean diet paper touted by Dr. Oz, accessed December 8, 2014

Greenway FL.The safety and efficacy ephedrine use as a weight loss agent (Obes Rev 2001, 2(3), 199–211)

Cocky CD, Ephedra banned Awhonn lifelines 2004, 8(1) 19-25

Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttor MJ, et al. Efficacy and safety of Ephedra and Ephedrine for weight loss and athletic Performance A meta-analysis JAMA 2003, 289(12), 1537–45

United States Drug Enforcement Administration 2014 http://www.justice-gov/dea/druginfo/concern-the baine html

Maeda H, Tsukui T, Sashimi T, Hosokawa M, Miyashita K, and seaweed carotenoid fucoxanthin as a multi-functional nutrient. Asia pac J clin Nutr, 2008: 17 suppl 1: 196–9.

Abidov M, Ramezanov Z, Seifulla R, Grachev S. The effects of xanthigen in the weight management of obese premenopausal women with non-alcoholic fatty liver disease and normal liver fat Diabetes Obesity Metab 2010: 12(1) 72–81

Maeda H.,Hosokawa M.,Sashima T.,Funeyama K.,Miyashita K.,Effect of medium-chain triacylglycerols on the anti-obesity effect of fucoxanthin J oleo Sci., 2007, 56(12):615–21.

Maeda H, Hosokawa M, Sashima T, and Miyashita K. Dietary combination of fucoxanthin and fish oil attenuates the weight gain of white adipose tissues and decreased blood glucose in obese and diabetic KKay-Nice nice J Agric Food Chem. .2007; 55(19): 7701-6

MacLean DB, Lou LG, increased ATP content or production in the hypothalamus may be a signal for energy sensing and safety.studies of the anorectic mechanism of a plant steroidal glycoside Brain Res 2004, 1020(1-2) 1-11

Blom WA, Abrahamse SL, Bedford R, Duchateau GS, Theis W, Orsi A, et al. Effects of 15-d repeated consumption of Hoodia gordonii purified extract on safety, ad libitum energy intake, and body weight in healthy, overweight women; A randomized controlled trial, AmJ J Clin Nutr, 2011:94(5) 1171–81.

ObenJ, KuateD, Agbor G, Momo C, and Talla X. The use of a cissus quadrangularis formulation in the management of weight loss and metabolic syndrome, Lipid Health Dis 2006: 5: 24

Oben JE, Enyegue DM, Fomekong GI, Soukontoua YB, and Agbor GA.The effect of cissus quadrangularis ( CQR-300) and a cissus formulation ( CORE) on obesity and obesity-induced oxidative stress Lipids Health Dis 2007:6:4

Oven JE, Ngordi JL, MomoCN, Agbor GA, Sobgui CS,The use of a Cissus quadranuralis/Irrungia gabonensis combination in the management of weight loss was a double-blind placebo-controlled study. Lipids Health Did 2008, 7:12

Sullivan AC, inhibition et al. Factors influencing the Invivo rates of lipogenesis in fat liver J Nutr: 1971: 101: 265-272

Sullivan AC inhibition of lipogenesis in rats liver by (-) hydroxycitrate, Arch Biochemistry Biophys 1972; 150(1): 183–190

Sullivan AC, et al. Effect of (-) hydroxycitrate upon the accumulation of lipik in the rats, lipogenesis Lipids 1974: 8(2) 121–128

Sullivan AC et al. Effect of (-) hydroxy citrate upon the accumulation of lipik in the rats Appetite : Lipids 1974:9: (2) 129-134

Heymsfield SB Allison DB, Vasselli JR, Pietrobelli A, Greenfield D, Nunez C, Garcinia Cambogia ( hydroxy citric acid) as a potential anti-obesity agent: A randomized controlled trials. JAMA 1998, 280(18), 1596–600

Preuss HG,Garis RI,Bramble JD, Bagchi M,Rao CV, et al.Efficacy of a novel Calcium / Potassium salt of (-) hydroxy citric acid in weight control, int J clin pharmacol Res 2005, 25(3), 133–44

Stern JS, Person J, Mishra AT, Sadasiva, Rao MV, Rajeswari KP,Efficacy and tolerability of a novel herbal formulation for weight management and obesity (Silver Spring) 2013: 21(5) 921–7

Keenan MJ,Zhou J,Mccutcheon KL,Raggio AM,Bateman HG,Todd E, et al. Effects of resistant starch, a non - digestible fermentable fiber, on reducing body fat.obesity (silver spring) 2006, 14(9), 1523–34

Zhou J, Hegsted M, McCcutcheon KL, Keenan MJ, XIX,RaggioAM, et al. peptide YY and proglucagon mRNA expression patterns and regulation in the gut. Obesity (Silver Spring) 2006; 14(4): 688–9.

GreenwayF,O' Neil CE,StewartL,RoodJ,KeenanM,MartinR,Fourteen weeks of treatment with Viscofiber increased fasting levels of glucagon-like peptide -1 and peptide-2.

Rudkowaka I, Roynette CE, Demontyl,VanstoneCA,JewS, Jones PJ,Diacylglycerol,Efficacy and mechanism of action of an anti-obesity agent. Obes Res 2005; 13(11): 1864–76

Taguchi H, Nagao T, Watenabe H, Onizawa K., Matsua N.,Tokimitsul et al. energy value and digestibility of dietary oil containing mainly 1,3-diacylglycerol are similar to those of triacylyglycerol.Lipids 2000: 36(4) 379–82

KamphuisMM,MelaDJ, Westerterp-Plantenga MS, Diacylglycerols affect substrate oxidation and appetite in humans, clin Nutr 2003, 77(5), 1133–9.

MatsuyamaT,ShojiK,watanableH,shimizvH,ScotomeY,NagaoT,et.al. Effect of diacylglycerol oil on adiposity in obese children ; initial communication J peditr Endocrinol Metab 2006; 19(6): 795-804

Chorvat RJ, Berbaum J, Seriacki K, McElroy JF, 5006 and JD-5037: peripherally restricted (Pr) connabimoid-receptor blocker related to SLV-319 319(ibipinabant) as metabolic disorder therapeutics devoid of CNS liabilities.Bioorg Med Chen LeH, 2012, 22(19) 6173-80

Chorvat RJ, peripherally restricted Cb1 receptor blockers, Bioorg Med chem Lett. 2013;23(17):4751–60.

Fitzgerald LW,Burn TC, PA, role of valvular serotonin 5 ht (2b) receptor in the cardiopathy associated with fenfluramine Mol pharmacol 2000; 57(1) 75–81 81

Smith SR, Weissman NJ, Anderson CM, Sanchez M, Chuang, Studbes, et al. Multi-center, placebo-controlled trial of lorcaserin for weight management NEngl J Med 2010, 363(3): 245–56

clinical trials Gov.A multi-center Pilot study of 12 weeks duration to assess the

short-term safety and tolerability of lorcaserin plus two doses of an immediate-release phentermine-HCl compound with lorcaserin alone in over weight and obese adults (2013). http://clinicaltrials.gov.C+2/ results? term=lorcaserin and + phentermine & search= search.

Kopelman P,Bryson A,HicklingR,RissanenA,RossnerS,ToubroS, Cetilistat(ATL- al., Cetilistat (ATL-962), a novel lipase inhibitor: A 12-week randomized, placebo - controlled study of weight reduction in obese patients, int J obes (Lond) 2007:31(3)494-9

Astrup A, Meier DH, Mikkelsen BO,villumsen JS, and LorsenTM. Weight loss produced by testofensine in patients with Parkinson's or Alzheimer's disease obesity (Silver Spring) 2008; 16(6): 1363–9.

SJodinA, Gareyger C,Nielsen A,-LH, Mods Beds, Breum L, Krostrup JP, et al. examined the effect of tesofensine on body composition in obese subjects.Into J obes.2008: 32 suppl 2: S83

Astrup A, Mods bed S, Breum L, Jensen TJ, Krostrup JP, Larsen T, Effect of ™

Effect of Tesofensine on body weight loss body composition, and quality of life in obese patient: A randomized, double-blind placebo-controlled trial Lancet, 2008, 372(9653):1906–13

Greenway FL,Fujioka K, Plakowski RA, Mudaliar S, Gutta Dauria M,EricksonJ,et.al.Effect of overweight and obese adult (CORE-1) A multi center randomized double-blind placebo-controlled phase 3 trial, Lancet, Lancet,2010,376(9741)595-605

Greenway FL,Anderson, JW, Atkinson RL, et al., Bupropion and Zonisamide for the treatment of Obesity Res 2006: 14 Supplement AM.

Gadde B, Allison DB., Ryan DH., Peterson CA., et al. Effect of low-dose controlled release of phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adult ( conquer) A randomized placebo-controlled phase3 trial Lancet, 2011: 377(9774) 1341–52

Astrup A,Rossner S, VanGaal L, et al. Effect of liraglutide in the treatment of obesity A randomized, double-blind, placebo-controlled study .Lancet.2009,374(9701) 1606-16

FDA committee Recommends approval for liraglutide as antiobesity Drug http// formulary Journal modern Medicine.com/ Formulary Journal/content/tags/ liraglutide/ FDA committee recommends approval Liraglutide Antiobesity? Page = Full accessed Dec 8, 2014

Fierce biotech zafgen announces initial result from phase Z study of Beloranib in patient with prader-willi syndrome (2014). http://fiercebiotech.com/pressrelease/zafgen Announced: initial result; phase za study; Beloranib, patient leader

Businesswire Research and Markets obesity velneperit (S-2367): Forecast and Market analysis to 2022 http://businesswire.com/news/home/2014 404030056502367- forecast

Sjostrom L,Narbro K, Sjostrom CD, et al. Effect of bariatric surgery on mortality in Swedish obese subjects Engl J Med 2007, 357(3) 741–52

Chang SH, Stoll CR, Song J, and Egon CJ.The effectiveness and risks of bariatric surgery .An updated systematic review and meta-analysis 2003, 2012, JAMASURG 2014: 149(3), 275–87

Stimac D, Majanovic SK.The position of endoscopic procedures in the treatment of obesity.Curr clin Pharmacol 2013:8(3) 238–46

WebMD .FDA Panel Backs Appetite-Curtaining Implants for Severe Obesity 2014.http://www.WebMD.com/diet/news/20140617/Felaconsider-Appetite-Curtainment-Implants-for-Severely Obese? Page 2

Obalon .com The obalon balloon .The power of innovation applied to weight loss (2014) http://www.obelon.com/ HCP/En/

Society of American Gastrointestinal & endoscopic Surgeons, 2014, http://www.sages.org/meeting/abstract.Archive/ First clinical experience with the Trans-Pyloric Shuttle (TPS) Device A non-surgical Endoscopic treatment for obesity result from A-3 months and 6 months: study

PatelSR,MasonJ,Hakim N, The duodenal jejunal bypass sleeve (endobarrier-Castro intestinal liner) for weight loss and treatment of type II diabetes .Indian J surg 2012.74(4) : 275-7

Golden RL, William Osler, at 150.An overview of life JAMA 1999,282(23)2252-8

Health implications of obesity National Institute of Health consensus Development conference statement Ann Intern Med1985; 103(1): 147–51

The New York Times.A M.A recognizes obesity As a disease 2013 http://www.NYTimes.com/2013/06/19/Business/Ama.Recognize Obesity as a Disease HTML.R=0

Banting FG,Pancreatic extract in the treatment of diabetes mellitus .preliminary report Can Med Assoc J 1922: 12(3) :141-6

Kempner Treatment of hypertensive disease with a Rice Diet, 1948, 3: 545

Platt R, Gilbert R,wilson C, Cooke W, Discussion on sympathectomy in hypertension, Br Heart J 1948; 10(4):293–7.

Gliedman ML, Tellis VA, soberman R, and Rifkin H. Long-term effects of pancreatic transplant function in patient with advanced juvenile-onset diabetes. Diabetes Care 1978:1(1):1-9

song YB, on YK, Kim JH,shin DH, Kim JS, SungJ, et al. The effect of atorvastatin on the occurrence of postoperative atrial fibrillation after off-pump coronary artery bypass grafting surgery.Am Heart J 2008; 156(2) 373-E-9-16

Karamana KasSN,Vagenas, KalferentzoSF,Alexandrides TK, weight loss, appetite suppression and change in fasting and postprandial ghrelin and peptide-YY-level after Roux-en-Y- gastric bypass and sleeve gastrectomy A prospective double-blind study.Ann surg 2008; 247(3) 40–7

Dequattro V, Lid, and Sympatholytic Therapy in primary hypertension: A User-Friendly Role for the future.J Hum Hypertens 2002:16 suppl 1:S118-23

Rapoport A, Evans BM, and Wang H. found some short-term metabolic effect of chlorothiazide in hypertension on a rice diet.Can Med Assoc J 1959,81,984-90

McMahon FG, Efficacy of an antihypertensive agent .comparison of methyldopa and hydrochlorothiazide in combination and singly JAMA 1975; 231(2) : 155-8

Putnam cases of myxoedema and acromegalia treatment and benefits by sheeps thyroid Am J Med sci: 1893; 106(2)125–48

Gardner DF,KaplanMM,stanley CA, and Utiger RD, effect of triiodothyronine replacement on the metabolic and pituitary responses to Starvation Engl J Med 1979, 300(11), 579–84

Masserman J, Dinitrophenol's therapeutic and toxic action in certain types of psychobiological under activity JAMA 1934 : 102:523

Coleman E, Dinitrophenol and obesity An early twentieth-century regulatory dilemma Regul Toxicol pharmacol 2007: 48(2) 115–17

Bartholomew AA,Amphetamine addiction Med J Aust 1970; 1(24): 1209–14

Kramer MS, Lane DA, Aminorex,dexfenfluramine, and Primary Pulmonary Hypertension, J clin Epidemiol, 1998, 5(4), 361-4

Connolly HM, Crary JL, MeGoon MD, Hensrud DD, Edward BS, et al. valvular heart disease associated with fenfluramine. Phentermine N Engl J Med 1997: 337(9): 581–8.

Kernan WN,Viscoli CM,Bress LM,Broderick JP,Feldman E, et al. Phenylpropanolamine and the risk of hemorrhagic stroke, N Engl J Med 2000, 343(25), 1826–32.

James WP,CatersonID, Colinno W, Finner N,vanGaabLF,Maggion AP,et.al.Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects NEngl J Med 2010, 363(10): 905–17

Sharma AM, Kumar RF, A proposed clinical staging system for obesity, Int J obes (Land) 2009, 33(3), 289–95.

Pedal RS, Pawewski NM,Allison DB, and Sharma AM, using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity CMAJ 2011:183(14); E1059-66

Stafford RS, Raley DC, and national trends in anti-obesity medication use . Arch intern Med 2003; 163(9) 1046–50

Andres R, Muller D.C., and Sorkin J.D., long-term effects of change in body weight on all cause mortality .A review, Ann intern Med 1993: 119(7pt 2), 737–43

Pi-sunyer FX,A review of long-term effects of change in body weight loss in ameliorating disorders associated with obesity.clin Ther. 1996, 18(6): 1006-35, discussion 5

Allison DB,Zanolli,FaithMS,HeoM,Pietrobelli A,Vanitellie TB, et al. found that weight loss increases and fat loss decreases all - cause mortality rate.Result from two independent cohort studies.Int J. Obes Relat Me tab disord, 1999, 23(6) 603–11.

Troiano RP, Frongillo EA, Jr.Sobel J, and Levitsky DA, The relationship between body weight and mortality: A quantitative analysis of combined information from existing studies Int J obes Relat Metab Disord. 1996,20(1)63-75

Kisses AH,Krakower GR, Regional adiposity and morbidity physiol Rev 1994, 75(4), 761–811.

Coleman DL, Hummel KP, Effect of parabiosis of normal with genetically diabetes mice.AmJ Physiol 1969, 217(5), 1298–304

Halaas JL,GajiwalaKS,Maffei M,CohenSL,ChaitBT,Rabinowitz D,et al., "Weightreducing effect of the plasma protein encoded by the obese gene, Science 1995,269(5223):543-6

Cone RD, Cowley MA, Butler AA, FanW, Meyers DL, LowMJ,.The Arcuate nucleus is a conduit for diverse signals relevant to energy homeostasis.Int J obes Relat Metab Disord 2001:25 suppl 5: S 63–7

Greenway FL,whitehouse MJ, Guttadauria M, Anderson JW, Atkinson RL, Fujioka K,et.al.Rational design of a combination medication for the treatment of obesity (silver spring) 2009, 17(1)30-9

Manolio TA,BrooksLD,Collins FS, A hapmap harvest of insight into the genetics of common disease J clin invest 2008, 118(5), 1590–605.