Anoreksici as drugs for the treatment of obesity.
It’s hard to say what is considered the term obesity. Obesity or obesity is a condition of excessive accumulation of fat in the body. Of course, one should include the cultural and sociological factors in the whole story.

Obesity in one part of the world is obesity in another, obesity in a social environment is considered to be normalized, while the second is absolutely unacceptable (even in the Pannonian region there is a saying “nice and thick”). We should also remember that time is not the same. The ideal of beauty in the history of the implied higher proportion of fat than it is today when it’s actually anoreksičnost ideal of beauty.
The etiology of obesity is complex and includes genetic factors, lifestyle factors, psychological factors, but clearly that one of the key role of a poor diet. Fats are a significant source of calories that are stored in the body in the form of fat, a typical composition of human food containing more than 40% fat, although it is recommended that the proportion of fat content of up to 30%. This of course depends on the climate where we speak – eg. Slavonia traditional food is richer in calories than, for example in the coastal region of Dalmatia. Thickness is not a problem that occurs suddenly, he develops a certain period of ticks. In the opinion of the World Health Organization, obesity has become an epidemic proportions and is becoming a leading public health issue. Due to the increased body weight caused a number of clinical complications that reduce quality of life, work ability and life expectancy of patients. Direct and indirect medical costs of obesity are a great burden for zdravstvenie systems. Because of modern life in which we are available to many foods, and thus little need for physical activity, more people than ever before caught in the trap of excessive weight gain. More than half of adult Europeans are overweight. Almost one in five of them health is in danger. The situation is much worse in the U.S. where, according to some statistics, 60% of the population is overweight.
The question is – what causes this condition? One thing is certain – today’s diet is not suitable for human beings. Specifically, physiology and anatomy of man is not changed in the past 10 000 years, but greatly changed diet. Last physiological modifications people have experienced at the time of the original community, and then the food was not enough – the food was scarce and was based on plant fruits, pokojoj caught the animal and the like. The entire digestive system and metabolism of man and still is “tuned” to the original food, but few who are now feeding such as feeding people 10 000 years ago. Also, now people are much less range, less physical work and the daily need for calories greatly reduced. However, 200 years ago the food was much healthier. Today, we in the developed world are faced with large quantities of industrially processed foods visokorafinisane. For example, black wholemeal bread was once the food is poor, while the rich aristocracy eating bread made from refined flour. Today it is called. black bread to white paradoxical expensive. Some foods are in turn largely expelled from the human food supply (eg, buckwheat), while they were once one of the most important. White crystal sugar is a modern creation – in history there was only honey, a white crystalline sugar was the privilege of the rich bourgeoisie and aristocracy, and come with advances in technology. There is a theory that the problem of obesity a wide section of the population is actually on the shelves of modern discount hypermarkets that offer almost exclusively – industrially grown and processed, canned food and for relatively little money. Although at first glance it seems that food is more available than ever – and now has parts of the world where children die of hunger.
Of course, obesity is sometimes a consequence of metabolic disorders, ie. hormonal diseases such as diabetes, lack of thyroxin or disorder glucocorticoids or sex hormones.
The question is – why are young people, on average less pretilni of the elderly population? There are many theories and speculation, but most likely is that of growth hormone. Growth hormone secreting pituitary gland and on, among other things has a lipolytic effect – reducing the amount of fat stored in fat cells and causes their rapid combustion. Before 30 years of growth hormone has in large amounts until after thirty years of its volume is significantly reduced. Without it (and with nesmanjivanje calories) fat deposits begin to flourish, and dieting attempts are getting harder and harder. We should not underestimate the role of sex hormones in women – hormonal changes during pregnancy strongly encourage appetite and pregnant women are usually more than ugoji needs.
How to lose weight? The issue becomes a real quest for the holy grail of modern times. It is a question that concerns both sexes (although males tend to admit) and some weight loss has developed an entire industry that includes producers of food and drugs, fashion industry, media, doctors, nadrilekar, religious movements and kvazireligijske food, lots of books, trainers and gyms, beauty salons, cosmetic surgeons, swindlers, etc.. Throughout the industry a year to reverse the big money.
All in all, looking for less weight people search for many things – younger people want to look like their favorite media star (younger girls are often stuck in the mud of anorexia), more mature people try to keep as much as slender line, and older people are trying to restore youthful beauty. Only a tiny number of people trying to lose weight – for health. Today’s modern society imposes on thinness as a great aesthetic ideal, the thickness of the anatemizira and declared unacceptable behavior, and pretilne people are discriminated in all segments of society. It is clear that in the world a huge number of people doing everything to lose weight at any cost.
For a person lost weight, it is clear that it must consume more calories than you entered. This implies a permanent (not temporary) change in diet and increased physical activity permanently. Change of diet is not only in quality and quantity, but should first pay attention to during a meal schedule and quality. However, the most important is breakfast, and dinner should contain by far the lowest part of the total calories. A majority of people deliberately skipped breakfast and main meal becomes dinner.
Therefore, resorting to a number of diets (of which little is that based on scientifically established facts) and physical activity (jogging, aerobics, cycling, etc.).. When it comes to your child one thing is certain – any low-calorie diet that is limited in time (from 1 to 3 months) at the end always brings an even greater gain in body weight than the time before the start dieting.
What food is the main problem? Usually points a finger in fat and are considered to be the very greatest evil in the diet. But one should bear in mind that the most common major problem in the intake of carbohydrates. And not only the simple sugars (sucrose) that are the most dangerous but also starches. Bread, rice, pasta – that’s where lies the real danger, no matter what the official team store of nutrition precisely predetermined lead in the diet.
But many people in pharmacology often turns into just the desire to solve their problems with weight.

Almost every day it happens to overweight people entering a pharmacy with the request “Give me the pills”. The pharmacist is then located on a big trouble, in part because of the huge variety of dietary products offered very dubious effectiveness, but also due to a simple principle: that which is not harmful, it is usually not efficient enough, and what is effective, it is usually very dangerous and harmful to health . If we exclude those pharmacological agents that could be harmful is nothing but the funds that are highly suspicious of efficiency, ie. without proven scientific foundation.

The most common ingredients of OTC products for weight loss
These are ingredients that are not harmful, but their efficacy is ambiguous. They’re available at drugstores without a prescription, they often have a high price.

L-Carnitine
L-carnitine is the preferred means of weight loss in recreational athletes. It is an amino acid normally present a number of tissues, but most of it is in muscle tissue. Its biochemical role is to transport fatty acids from citozola cells the mitochondria where fatty acids are broken down into simpler molecules that enter the production of energy. Without L-carnitine has no burning of fatty acids. Disorders of the transmission associated with the deposition of lipids in muscle and concluded that the increase in muscle carnitine content used increased the reduction of fat deposits. The theory sounds good, but in practice it’s different.
1. Preparations of L-carnitine can increase the value of L-carnitine in the blood, but there is no evidence that its concentration increases in muscle.
2. Research-based studies have shown that L-carnitine can increase fat burning only in patients with the rare anomaly of the lack of L-carnitine in the muscles, but not in those people who have enough L-carnitine in the muscles, and such person is by far the greatest number. Basically, there is no solid evidence that preparations of L-carnitine can increase loss of body weight and must be wondering what is the justification for taking such products due to their high cost.

Chitosan
Chitosan is a polymer of glucosamine that is derived from chitin, an ingredient shell crab, shrimp, lobster and related arthropods. Chitosan binds fat and it is assumed that in this way reduces fat absorption from the gastro-intestinal tract. Careful scientific research has not completely failed to prove the effectiveness of chitosan in a recent study showed no statistically significant differences in body weight of 30 obese subjects who took chitosan or a placebo. Taking products based on chitosan is hardly justified.

Conjugated linoleic acid – CLA
Conjugated linoleic acid (CLA) is a natural polyunsaturated fatty acids, and is located in the meat and dairy products. CLA stimulates glucose effects on energy supply and build muscle instead of turning into fat. Because of this effect argues that CLA supports fat loss. Most of the research done on animals and really show that CLA reduces fat, increases metabolism and reduces energy intake, but no evidence of its efficacy in obese patients.

Fiber
Different sources of fiber, like bran, pectin and psilija, are used as ingredients for weight loss resources. It is assumed that the mechanism of their action increasing satiety, reducing energy intake. But there is no evidence that such preparations cause means substantial weight loss over the long term.

Hidroksilimunska acid (HCA)
Hidroksilimunska acid is a molecule that is located in Indian plants Garcinia cambogia and Garcinia indica. These ingredients are plant resources for weight loss because it is considered that the decrease lipogenesis (creation of lipids), curb food intake and reduce weight gain. Reducing the generation of lipid actually been proven in animal experiments, but the question is whether this can be applied to humans. Numerous studies have been controversial, some argue that HCA really helps in reducing body weight, but they are deficient and no professional reviews. The latest studies show that HCA helps weight loss but that loss was not statistically significant. Decision to take a preparation based on the HCA on each person individually.

Guarana
Guarana is an herb that contains higher amounts of caffeine. Caffeine is a thermogenic substance, encourages the consumption of calories. Scientific research products based on guarana prove that it is effective but only in the long run. But it must be taken into account the effects of caffeine – primarily a negative effect on the cardiovascular system, ie. heart and blood pressure.

Sibutramine
Sibutramine belongs to a group of drugs to treat obesity that act centrally. Inhibits re-entry (reuptake) monoamines (especially serotonin and norepinephrine), and in vivo effects mediated by the action of groups of metabolites of primary and secondary amines. It is believed that the effects Sibutramina his influential food intake, ie. the feeling of satiety, but it probably contributes to increased thermogenesis. Although chemically similar to amphetamines and similar acts, sibutramine not so strong central action, or causes the typical side effects like amphetamines. However, the drug does not smieu take people who have thyroid problems, cardiovascular system, liver, kidney and mental disorders. Sibutramine is indicated as an aid in the treatment program for obesity:
– Patients whose obesity is caused by diet, and have a body mass index (BMI = body mass index) 30 kg/m2 or greater
– Patients whose obesity is caused by diet, and with a BMI of 27 kg/m2 or greater, have additional risk factors such as diabetes mellitus type II and dyslipidemia.
The drug can be given only to those patients who do not respond sufficiently to the appropriate measures to reduce body weight, ie. those for three months lost more than 5 kg. Treatment should be undertaken only as part of a complex therapeutic program to reduce body weight under the control of specialists to treat obesity. Appropriate therapeutic approach includes dietary measures and behavior change and increased physical activity. Such a complex approach to pre-condition for continuing use of dietary habits and behavior, which is necessary for the maintenance of reduced body weight after treatment. Duration of treatment should be limited in time. Side effects include loss of appetite, constipation, dry mouth, insomnia.

Orlistat
Orlistat is a representative of an entirely new group of therapeutic inhibitors of pancreatic lipase. By blocking lipase prevents the absorption of 30% fat from foods and so provides long-term control and regulation of body weight. Increased excretion of fat continues to chair the 24 to 48 hours after the first dose and returned to normal at the latest after 72 hours of last dose. In addition to the food absorb a sufficient amount of fat and fat-soluble substances (70%).
Orlistat is active only in the stomach and small intestine, it is absorbed in a negligible percentage and does not cause any systemic effects.
Orlistat is used with simultaneous mild hipokaloričnu diet in the treatment of obesity in people whose body mass index (BMI) 30 kg / m or 28 kg / m with presence of risk factors (elevated pressure, lipids, sugar).
Treatment of orlistat should be discontinued after 12 weeks, if no loss of at least 5% of body weight measured at the start of therapy. Side effects are gastrointestinal nature: frequent, urgent diarrhea, fatty stools, oily stains from the rectum, gases. They occur when the fat intake of food is higher than recommended, and are associated with the start of therapy and reduce the length of therapy.

Dangerous and harmful products for weight loss
Below listed ingredients are effective, but their application is permanently banned because of the very dangerous side effects. Their use for weight loss is considered an abuse and playing with their own lives!

Amphetamines
Amphetamines as a means of weight loss are used for many years. However, due to very bad side effects that lead to severe health threat to all the less used. The best-known amphetamine for weight loss is certainly phentermine. It is a substance that leads to increased metabolism, increased glucose utilization, lipolysis, and greater use of fat as fuel. but above all phentermine cancels hunger and creates a feeling of fullness. However, the fact is that phentermine has the same side effects as well as all amphetamines – severe sleep disturbances, nausea, vomiting, diarrhea, intermittent breath, feeling of panic and anxiety, aggressive and violent behavior, paranoia, severe depression and suicidal tendency. Long-term effects may be disorders of the kidneys and lungs with fatal outcome, with different degrees of brain damage, permanent psychological problems, reduced resistance to disease, liver damage, heart attack and stroke. It is clear that such a preparatory not be a solution for the treatment of obesity.

Ephedrine
Ephedrine is an alkaloid from the plant Ephedra sinica, and belongs to the sympathomimetics. By its action is the alpha and beta adrenergic agonists. Ephedrine in principle increases the excretion of noradrenaline, but also acts directly. The effect of this substance is very similar to the effect of the natural secretion of adrenaline. Medical use of ephedrine is usually limited to use as a nasal vasoconstrictor in case of fever. Ephedrine increases the force of muscle contraction, metabolism, increases your heart rate, cause heart arrhythmias, also acts slowly antidepressant (but causes depression after use), increased blood pressure, slows the digestive tract, causing dry mouth and others. The use of ephedrine as a means of weight loss, until recently, was very widespread. Specifically, it contained products such as Ripped Fuel, Xenadrine, etc.. Ephedrine in these preparations was actually extract of Ma Huang (Ephedra sinica) with a large proportion of ephedrine. The purpose of weight loss ephedrine is used in combination with caffeine and aspirin – the famous “EKA” combination. This mixture proved to be very effective as an excellent thermo device having a double effect – increasing the metabolism and body temperature stimulates the release of triglycerides from fat cells. In addition, the extremely reduced appetite. Abuse of ephedrine has many adverse short and long term consequences. Since ephedrine is very similar to amphetamines, it is expected side effects that are similar to taking amphetamines but milder. This could result in trembling hand, trembling, sweating, rapid heartbeat and high blood pressure, dizziness, nausea, vomiting, irritability and a sense of inner turmoil. Those suffering from high blood pressure, irregularities in heart failure, prostatic hypertrophy may be in danger if you take this substance for weight loss. Also, like amphetamines, ephedrine can in the long run cause a stroke. And an extremely unpleasant side effects – in males causes impotence.

Dinitrofenol (DNP)
Of all the means of weight loss 2.4 dinitrofenol the most poisonous and lethal product that people have ever tried to use for weight loss. The basic purpose of this preparation as a means of detonation of TNT explosives, as well as rat poison and insecticide. DNP-property and that causes weight loss was first observed by chance. Specifically, obese workers in factories producing munitions for the U.S. Army in World War I many inexplicably lose weight in short periods of time. Subsequent investigation showed that the DNP, with whom workers come into contact, was the main culprit for this unusual phenomenon. Although at that time there was no explanation for this phenomenon began to be widely recommend as an excellent tool for weight loss. So in the 30s of the last century has become extremely popular. However, because of health threats, after a few years ago was withdrawn from sale. Many users are a very serious side effects experienced occurrence of cataract in the eyes. Often were the deaths due to overdose.
DNP, or any similar chemical compound can not be found in any living organism, and is therefore considered that its use is absurd. Nevertheless, DNP has recently become incredibly popular among bodybuilders and fitness freaks, especially in the U.S..
DNP increases calorie burning by increasing body temperature by blocking oxidative phosphorylation in mitochondria of cells. DNP prevents the ATP used as energy. There is no doubt that DNP increases metabolism like no prreparat so far. Even at relatively low doses of 3-5 mg per kilogram of body weight per day, DNP metabolism by 30%. If the product is used continuously, this percentage increases up to 50%. At this pace can burn up to 0.5 kg of body fat a day. Of course, with such an extraordinary action comes to great danger. Quadruple the amount of those recommended certainly cause death. DNP with higher dose raises the body temperature so it can lead to coagulation proteins, which primarily damages the brain. Simply put, DNP can “burn” the brain. Also, there is irreversible damage to liver and kidney. All in all, taking a DNP is one of najsuludijih pharmacological adventures that man ever tried.