Obesity and Drug Therapy

Obesity is prevalent.  It is known for 2500 years to be associated with many illnesses such as diabetes mellitus, hypertension, high cholesterol, and heart attacks.  Weight loss of 10 to 15 percent signicantly reduces these ailments.  Drug therapy, along with diet and exercises, helps obese patients lose weight. 

 
During the Middle Ages and the Renaissance obesity was misperceived as the symbol of wealth and therefore was common among the elite.


Among available drugs that are claimed to help reduce weight, FDA approves only 7 drugs that are proven to be effective and safe .  Four of these drugs are diabetic medications.   They are Metformin, Pramlintide, Exenatide, and Liraglutide.  Other two drugs, Phentermine and diethylpropion, help reduce eating by causing early fullness.  Phentermine and diethylpropion are approved for short-term use up to 12 weeks.  These two drugs are also known as "anorexiants" since they cause early satiety.  Their main adverse effects are increase in blood pressure and potential for abuse.  The last one drug, Orlistat, alters fat digestion, thereby reducing absortion of fatty food.

Many previous drugs, which once were claimed to help lose weight, were removed from market when unfavorable adverse effects were reported.  Adverse effects are usually recorded after certain drugs are used for a sufficient time.  Therefore, it is wise to follow up reported adverse effects of currently approved drugs.  Some of these drugs may fall out of favor some time in the future.

It is important to keep in mind that current drug therapy does not cure obesity; weight might be regained when drug therapy is discontinued.

Canon in D Major

Cigarette Smoking, Lung Cancer, and Statistics

It's well-known that cigarette smoking increases risk for lung cancer.  Cigarette smoking is responsible for approximately 90% of all cases of lung cancer.  The risk of a current smoker with a 40 pack-year smoking history is about 20 times that of someone who has never smoked. 

Several other factors increase the risk for lung cancer.  The combination of smoking history and asbestos exposure escalates the risk to as high as 50 to 90 times that of a never-smoker.  The presence of airway obstruction on pulmonary function testing increases the risk to a four- to sixfold.




Sigmund Freud, whose doctor assisted his suicide because of cancer caused by smoking



The most effective method for reducing current smokers' risk is to quit.  After a current smoker quits smoking, the risk for lung cancer falls steadily for about 15 years before the risk levels off.  The risk, however, remains twice that of a never-smoker.  In other words, a 15-year smoking cessation reduces the risk from 20 to 2.

California Dreaming by The Papas and The Mamas

Hereditary Nonpolyposis Colorectal Cancer

Hereditary Nonpolyposis Colorectal Cancer (HNPCC, also known as Lynch syndrome) is the most common of the hereditary colon syndromes and runs in families which are affected. 



HNPCC occurs when there are mutations of MLH1 and MLH2, which are mismatch repair genes.  This type of colon cancer may occur at unusually young age and tends to occur in the right side of the colon.  Many families with HPNCC have high risk of other cancers, especially endometrial carcinoma and ovarian cancer.

To detect this type of colon cancer at early age, annual colonoscopy is recommended to begin at age 20 to 25, or 10 years prior to the earliest age of colon cancer diagnosed in the family.  Annual screening for endometrial cancer and ovarian cancer is also recommended.