Chuť i míra hladu, ale i rychlost metabolizmu jsou geneticky determinovány a regulace probíhá na třech úrovních v mozku a také ve střevě, a to pomocí střevních hormonů a neuromodulátorů. Hubnutí není fyziologický proces, tělo je nastaveno tak, že bychom měli neustále přibírat až na hmotnost, která je nám zřejmě geneticky předurčena. Poslední roky se objevují nové moderní a velmi bezpečné léky na hubnutí a na léčbu obezity jako nemoci. Začíná převládat názor, že obezitu je třeba léčit doživotně, za pomoci nejen změny životního stylu, ale také za použití léků nebo postupů bariatrické chirurgie.
Appetite and hunger, as well as metabolic rate, are genetically determined and regulated at three levels in the brain and also in the bowel by bowel hormones and neuromodulators. Weight loss is not a physiological process, the body is set up to enable continuous weigh gaining up to the weight that is probably genetically predetermined for us. In recent years, new modern and very safe drugs are emerging for weight loss and for treating obesity as a disease. The opinion that obesity should be treated for life, not only with lifestyle changes but also with drugs or bariatric surgery procedures, is becoming predominant.
- MeSH
- Bupropion therapeutic use MeSH
- Phentermine therapeutic use MeSH
- Glucagon-Like Peptide 1 therapeutic use MeSH
- Anti-Obesity Agents administration & dosage therapeutic use MeSH
- Liraglutide therapeutic use MeSH
- Overweight etiology drug therapy genetics psychology therapy MeSH
- Naltrexone therapeutic use MeSH
- Obesity etiology drug therapy genetics psychology therapy MeSH
- Orlistat therapeutic use MeSH
- MeSH
- Bariatric Surgery MeSH
- Diabetes Mellitus * drug therapy therapy MeSH
- Phentermine administration & dosage pharmacology therapeutic use MeSH
- Glucagon-Like Peptides administration & dosage pharmacology therapeutic use MeSH
- Incretins administration & dosage pharmacology therapeutic use MeSH
- Anti-Obesity Agents administration & dosage pharmacology therapeutic use MeSH
- Humans MeSH
- Obesity * surgery drug therapy MeSH
- Check Tag
- Humans MeSH
- Keywords
- dulaglutid,
- MeSH
- Bupropion therapeutic use MeSH
- Phentermine adverse effects therapeutic use MeSH
- Glucagon-Like Peptide 1 analogs & derivatives MeSH
- Hypoglycemic Agents administration & dosage therapeutic use MeSH
- Humans MeSH
- Liraglutide administration & dosage therapeutic use MeSH
- Naltrexone administration & dosage therapeutic use MeSH
- Obesity * drug therapy complications therapy MeSH
- Orlistat therapeutic use MeSH
- Diet, Reducing methods MeSH
- Heart Disease Risk Factors MeSH
- Check Tag
- Humans MeSH
Farmakoterapie obezity u mnoha pacientů vede k významnému a dlouhodobě udržitelnému poklesu tělesné hmotnosti a tím i zlepšení komorbidit a celkové prognózy. V současné době jsou v ČR dostupné pro terapii obezity celkem 4 léky: fentermin, orlistat, liraglutid a bupropion/naltrexon. Ve sdělení se podrobněji věnujeme především relativně recentně registrovaným léčivům (liraglutid a bupropion/naltrexon). Krátce zmiňujeme i léky recentně stažené z trhu (lorkaserin a rimonabant) a uvádíme nejslibnější molekuly v klinickém vývoji (tesofensin a bimagrumab). Při nastavování terapie na míru konkrétnímu pacientovi trpícímu obezitou bychom pro terapii přidružených onemocnění (diabetes, deprese) měli volit léky, které nezvyšují tělesnou hmotnost, a naopak léky, které používáme k terapii obezity, by měly být vybrány tak, aby nezhoršovaly další choroby, kterými pacienti trpí.
Obesity pharmacotherapy helps many patients to achieve significant and sustainable body weight reduction and improvement in comorbidities and overall prognosis. Four drugs to treat obesity are currently available in the Czech Republic: phentermine, orlistat, liraglutide and bupropion/naltrexone. Recently approved drugs (liraglutide and bupropion/naltrexone) are discussed in detail. Drugs recently withdrawn (lorcaserin and rimonabant) and most promising drugs in clinical studies (tesofensin and bimagrumab) are mentioned in brief. When tailoring the therapy for obese patient, drugs to treat comorbidities (e. g. depression, diabetes) should be carefully chosen so that they do not increase the body weight as a side effect. On the other hand pharmacotherapeutic modality for obesity treatment should be appropriately chosen so that it does not worsen any other disease of the patient as a side effect.
- MeSH
- Bupropion administration & dosage pharmacology therapeutic use MeSH
- Phentermine administration & dosage therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Liraglutide administration & dosage therapeutic use MeSH
- Naltrexone administration & dosage pharmacology therapeutic use MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- Obesity * drug therapy therapy MeSH
- Orlistat administration & dosage therapeutic use MeSH
- Check Tag
- Humans MeSH
- MeSH
- Bupropion therapeutic use MeSH
- Diabetes Mellitus, Type 2 drug therapy prevention & control MeSH
- Phentermine therapeutic use MeSH
- Incretins administration & dosage therapeutic use MeSH
- Anti-Obesity Agents * administration & dosage pharmacology therapeutic use MeSH
- Humans MeSH
- Naltrexone therapeutic use MeSH
- Obesity * drug therapy MeSH
- Orlistat therapeutic use MeSH
- Check Tag
- Humans MeSH
- Keywords
- Adipex (fentermin), Mysimba (naltrexon + bupropion), Saxenda (liraglutid), Ozempic (semaglutid),
- MeSH
- Bariatric Surgery MeSH
- Bupropion MeSH
- Phentermine therapeutic use MeSH
- Anti-Obesity Agents economics therapeutic use MeSH
- Obesity Management * economics methods MeSH
- Prescriptions economics MeSH
- Humans MeSH
- Liraglutide therapeutic use MeSH
- Drug Costs MeSH
- Naltrexone therapeutic use MeSH
- Orlistat therapeutic use MeSH
- Check Tag
- Humans MeSH
- MeSH
- Dopamine Agonists therapeutic use MeSH
- Bariatric Surgery MeSH
- Bromocriptine therapeutic use MeSH
- Phentermine administration & dosage adverse effects therapeutic use MeSH
- Prenatal Nutritional Physiological Phenomena MeSH
- Sodium-Glucose Transporter 2 Inhibitors MeSH
- Glucagon-Like Peptide 1 analogs & derivatives therapeutic use MeSH
- Pregnancy Complications * MeSH
- Lactones administration & dosage pharmacology therapeutic use MeSH
- Anti-Obesity Agents * pharmacology therapeutic use MeSH
- Humans MeSH
- Obesity * complications physiopathology therapy MeSH
- Orlistat MeSH
- Diet, Reducing MeSH
- Pregnancy MeSH
- Sodium-Glucose Transport Proteins therapeutic use MeSH
- Infertility, Female etiology MeSH
- Check Tag
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Review MeSH
Vzhledem k novým znalostem o roli hypothalamu a neurohormonů v léčbě obezity se zdá, že antiobezitika se postupně stanou velmi důležitou a běžnou podporou při redukci tělesné hmotnosti. I když americký Úřad pro kontrolu potravin a léčiv je ve schvalování antiobezitik mnohem pružnější, také v České republice byly uvedeny v posledních letech na trh nové látky určené k redukci hmotnosti a zdá se, že další budou následovat. Moderní farmaka v léčbě obezity jsou účinnější než dříve a měla by být hlavně bezpečná. V článku jsou probrána jednotlivá antiobezitika dostupná v České republice a také antidiabetika s pozitivním vlivem na hmotnost pacienta.
Given the new knowledge of the role of hypothalamus and neurohormones in the treatment of obesity, anti-obesity drugs seem to gradually become very important and common support in weight loss. Although the Food and Drug Administration is much more flexible in the approval of anti-obesity drugs, new weight reduction agents have been launched in the Czech Republic in recent years and others appear to follow. Modern drugs in the treatment of obesity are more effective than before and should be mainly safe. The article discusses individual antiobesity drugs in the Czech Republic and also antidiabetics with a positive effect on the patient's weight.
- MeSH
- Antidepressive Agents therapeutic use MeSH
- Bupropion administration & dosage adverse effects therapeutic use MeSH
- Phentermine adverse effects therapeutic use MeSH
- Sodium-Glucose Transporter 2 Inhibitors therapeutic use MeSH
- Glucagon-Like Peptide 1 analogs & derivatives therapeutic use MeSH
- Hypothalamus physiopathology MeSH
- Body Mass Index MeSH
- Anti-Obesity Agents * classification adverse effects therapeutic use MeSH
- Humans MeSH
- Liraglutide administration & dosage adverse effects therapeutic use MeSH
- Naltrexone administration & dosage adverse effects therapeutic use MeSH
- Obesity * epidemiology drug therapy physiopathology MeSH
- Orlistat therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Bupropion pharmacology therapeutic use MeSH
- Diabetes Mellitus, Type 2 drug therapy prevention & control MeSH
- Phentermine pharmacology therapeutic use MeSH
- Anti-Obesity Agents * administration & dosage pharmacology therapeutic use MeSH
- Humans MeSH
- Liraglutide pharmacology therapeutic use MeSH
- Naltrexone pharmacology therapeutic use MeSH
- Obesity pathology MeSH
- Orlistat pharmacology therapeutic use MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
