La obesidad: una visita a la Historia / Obesity: a visit to the history

Intentar la redacción de una historia de la obesidad en veinte folios sería una auténtica temeridad. Sin embargo, para cumplir con el amable encargo de incluir algunos de los aspectos centrales expuestos en el III Curso Avanzado de Obesidad, organizado por la Real Academia Nacional de Farmacia en abril de 2016, no podemos sino trazar un panorama general sobre el estado de la cuestión, dividido en los siguientes cuatro epígrafes. En primer lugar, el establecimiento de un contexto general en el marco de la evolución biológica. En segundo, las bases lógicas o pre científicas -si entendemos por científicas las alcanzadas por la ciencia moderna y contemporánea- establecidas en la Historia para entender el fenómeno de la obesidad. En tercero, los aspectos sociales y estéticos sobre la gordura. Y por último, un pequeño recorrido sobre gordos ilustres (AU)

Try writing in twenty pages about obesity through history would be a genuine recklessness. However, to meet the friendly custom of including some of the central issues exposed in the III Advanced Course of Obesity, organized by the Royal Spanish Academy of Pharmacy, we cannot but draw a general picture about the State of the art, divided into the following four headings: first, the establishment of a general context in the frame of biological evolution. Second, the logics or pre scientific bases - if we mean by scientific those achieved by modern and contemporary science - established in the History to understand the phenomenon of obesity. Third, the social and aesthetic aspects of fatness. And finally, a small visit to illustrious obese people (AU)

Hasday: tratamiento de la obesidad en el siglo X / Hasday: treatment of obesity in 10th century

No disponible

Weight management in obesity - past and present.

AIMS: To describe the treatment of obesity from ancient times to present day. METHODS: Articles reporting the development of anti-obesity therapies were identified through a search for 'anti-obesity' AND 'pharmacotherapy' AND 'development' within the title or abstract on PubMed and 'obesity' in ClinicalTrials.gov. Relevant articles and related literature were selected for inclusion. RESULTS: Stone-age miniature obese female statuettes indicate the existence and cultural significance of obesity as long as 30,000 years ago. Records from Ancient Egyptian and Biblical eras through Greco-Roman to Medieval times indicate that obesity was present throughout the major periods of history, although peoples of previous centuries would probably have experienced overweight and obesity as exceptional rather than normal. Health risks of obesity were noted by the Greek physician Hippocrates (460-377 BCE) when the earliest anti-obesity recommendations on diet, exercise, lifestyle and use of emetics and cathartics were born. These recommendations remained largely unchanged until the early 20th century, when spreading urbanisation, increasingly sedentary jobs and greater availability of processed foods produced a sharp rise in obesity. This led to the need for new, more effective, ways to lose weight, to address comorbidities associated with obesity, and to attain the current cultural ideal of slimness. Drug companies of the 1940s and 1950s produced a series of anti-obesity pharmacotherapies in short succession, based largely on amphetamines. Increased regulation of drug development in the 1960s and new efficacy requirements for weight-loss drugs led to rapid reduction in anti-obesity therapies available by the early 1990s. CONCLUSION: In the last two decades, several new and emerging therapies have been approved or are in development to provide safe, long-term pharmacological agents for the treatment of obesity.

Diet pills and the cataract outbreak of 1935: reflections on the evolution of consumer protection legislation.

An outbreak of cataracts in 1935 caused by dinitrophenol (DNP), the active ingredient of popular diet pills, highlighted the inability of the U.S. Food and Drug Administration (FDA) to prevent harmful drugs from entering the marketplace. Just two years earlier, the FDA used horrific images of ocular surface injury caused by cosmetics at the World's Fair in Chicago to garner public support for legislative reform. The FDA had to walk a fine line between a public awareness campaign and lobbying Congress while lawmakers debated the need for consumer protection. The cataract outbreak of 1935 was conspicuous in the medical literature during the height of New Deal legislation, but questions persist as to how much it affected passage of the proposed Food, Drug, and Cosmetic Act (of 1938). The legislation languished in committee for years. The cataract outbreak probably had little impact on the eventual outcome, but medical opinion concerning the safety of DNP may have contributed to the voluntary withdrawal of the diet drug from the market. We review the DNP cataract outbreak and examine it in context of the challenges facing regulatory reform at that time.

[A trip through the history of obesity]. / Vom Schönheitsideal zur Krankheit - eine Reise durch die Geschichte der Adipositas.

The origins of obesity can be traced back at least 25 000 years. In the Stone Age, in the Middle Ages, and in the 17th century overweight indicated prosperity,power, and fertility, but already Hippocrates described obesity as a disease in the Antique. The first academic papers dealing with adiposity were published in the times of the Industrial Revolution.In the 19th century a pharmaceutical treatment boom against overweight emerged- people had to deal with quackery and dangerous remedies like amphetamines that flooded the market.Bariatric surgery was introduced in the 20th century- to days gold standard is the RYGB operation. Dealing with morbid obesity and its comorbidities is nowadays one of the serious problems in the field of public health.

The return of rainbow diet pills.

The US Food and Drug Administration (FDA) has recently warned consumers about the risks of weight loss supplements adulterated with multiple pharmaceutical agents. Some of these supplements combine potent anorectics, such as amphetamines derivatives, with benzodiazepines, beta-blockers, and other medications to suppress the anorectics' adverse effects. These weight loss supplements represent the most recent generation of rainbow diet pills, named for their bright and varied colors, which date back more than 70 years. Beginning in the 1940s, several US pharmaceutical firms aggressively promoted rainbow pills to physicians and patients. By the 1960s the pills had caused dozens of deaths before the FDA began removing them from the US market. We used a variety of original resources to trace these deadly pills from their origins in the United States to their popularity in Spain and Brazil to their reintroduction to the United States as weight loss dietary supplements.

Dinitrophenol and obesity: an early twentieth-century regulatory dilemma.

In the early 1930s, the industrial chemical dinitrophenol found widespread favor as a weight-loss drug, due principally to the work of Maurice Tainter, a clinical pharmacologist from Stanford University. Unfortunately the compound's therapeutic index was razor thin and it was not until thousands of people suffered irreversible harm that mainstream physicians realized that dinitrophenol's risks outweighed its benefits and abandoned its use. Yet, it took passage of the Food, Drug, and Cosmetic Act in 1938 before federal regulators had the ability to stop patent medicine men from selling dinitrophenol to Americans lured by the promise of a drug that would safely melt one's fat away.

Challenges in the discovery and development of new agents for the treatment of obesity.

New pharmacologic agents are being sought to help manage the epidemic of obesity and its consequences. Understanding the challenges of the history of obesity drugs is wise before investing in new obesity agents. Expectations of patients, physicians, and drug company executives are not consistent with characteristics of current agents or most potential new ones. Owing to the complex biology underlying body weight regulation, combinations of agents may be necessary to improve weight loss efficacy.

Pharmacotherapy of obesity.

The growing recognition of the health risks of obesity coupled with the difficulties in treating it successfully by lifestyle modification predicates a need for effective drug treatment. The history of drug treatment in the second half of the 20th century is, however, one of disappointment and concern over drug toxicity. However, the advances in our understanding of the mechanism of weight control, together with improved ways of evaluating anti-obesity drugs, has resulted in two effective compounds, sibutramine and orlistat, becoming available for clinical use. Sibutramine has actions on both energy intake and expenditure and had been shown to enhance weight loss and weight maintenance achieved by diet, in simple obesity as well as when accompanied by complications of diabetes or hypertension. About 50-80% of patients can achieve a >5% loss, significantly more than if patients receive the same lifestyle intervention with placebo. Orlistat, which acts peripherally to block the absorption of dietary fat, has had similar results in clinical trials; a recent study (XENDOS) has just reported results which show that the enhanced, albeit modest, weight loss achieved with orlistat delays the development of diabetes over a 4-year period. A number of other compounds are expected to complete or enter clinical trials over the next decade. There is considerable optimism that we will soon have the pharmacological tools needed to make the treatment of obesity feasible.