Obesity: Molecular Mechanisms, Epidemiology, Complications and Pharmacotherapy

Abstract

Obesity is a common disorder affecting millions of people worldwide. The number of overweight and obese subjects, globally, is currently 2 billion and 800 million, respectively. Projected estimates show that the number of overweight citizens will approach 60% of the world’s population by the year 2030. Oxidative stress facilitates the development of obesity by stimulating pre-adipocyte differentiation and eventual adipose accumulation. Large deposits of fat release excessive quantities of adipocytokines, resulting in chronic inflammation. The obesity-induced chronic inflammation paves the way for a large variety of systemic complications including but not limited to diabetes mellitus, hyperlipidemia, atherosclerotic lesions, cardiovascular diseases tissue and malignancy. In addition, other obesity-inducers, such as increased insulin growth factor 1, insulin resistance, and increased tissue level of leptin and low concentration of adiponectin may lead to the development of tissue malignancy. Increased physical activity coupled with a healthy food intake is crucial to the management of obesity. Anti-obesity drugs such as sibutramine, qsymia (a combination of phentermine and topiramate), and orlistat have been used to treat obesity with variable degrees of efficacy. Bariatric surgery becomes a choice in severe cases when physical activity and pharmacotherapy fail. In the obese patient with diabetes mellitus, the choice of hypoglycemic agent is important. Metformin, and sodium glucose cotransporters 2 (SGLT2) inhibitors, a new set of antidiabetic drugs can significantly reduce body weight and improve cardiorenal function. SGLT2 inhibitors, thus belong to a class of potential drugs that can be used to treat obesity. In conclusion, obesity is a “deadly” condition that can predispose individuals to many life threatening health conditions.