Obesity: Molecular Mechanisms, Epidemiology, Complications and Pharmacotherapy

Obesity is a common disorder affecting millions of people worldwide. The number of overweightOverweight 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 adipocytokinesAdipocytokines, resulting in chronic inflammationChronic inflammation. The obesity-induced chronic inflammationInflammation paves the way for a large variety of systemic complicationsComplications including but not limited to diabetesDiabetes mellitus, hyperlipidemia, atherosclerotic lesions, cardiovascular diseasesCardiovascular disease tissue and malignancy. In addition, other obesity-inducers, such as increased insulin growth factor 1, insulin resistanceInsulin resistance, and increased tissue level of leptinLeptin and low concentration of adiponectinAdiponectin may lead to the development of tissue malignancy. Increased physical activityPhysical activity coupled with a healthy food intakeFood intake is crucial to the managementManagement of obesity. Anti-obesity drugs such as sibutramine, qsymia (a combination of phentermine and topiramate), and orlistatOrlistat have been used to treat obesity with variable degrees of efficacy. Bariatric surgeryBariatric surgery becomes a choice in severe cases when physical activity and pharmacotherapyPharmacotherapy fail. In the obese patient with diabetesDiabetes mellitus, the choice of hypoglycemic agent is important. MetforminMetformin, 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.