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Review
. 2004 Jul;53(7):1044-53.
doi: 10.1136/gut.2003.021816.

New thoughts on managing obesity

P G Kopelman  1 , C Grace
Affiliations
Review

New thoughts on managing obesity

P G Kopelman et al. Gut. 2004 Jul.
No abstract available

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Figures

Figure 1
Figure 1
A diagrammatic representation of the complex interrelationship between peripheral and central (hypothalamic) neuropeptides for regulation of feeding. Stimulation by orexigenic pathways results in food intake; stimulation of anorexigenic pathways leads to satiety. Continuous lines represent stimulating pathways, broken lines indicate suppressive actions. NPY, neuropeptide Y; AgRP, argouti related peptide; POMC, pro-opiomelanocortin; PYY, peptide YY; Y21, Y2R, postsynaptic NPY receptors; Cart, cocaine amphetamine regulated transcript; MC3R, MC4R, melanocortin receptor 3 and 4; MCH, melanin concentrating hormone; GLP-1, glucagon-like peptide.
Figure 2
Figure 2
A management pathway for the appropriate prescription of an antiobesity drug. The firstline of treatment is dietary and physical activity interventions with some form of behaviour management. If at 12 weeks after starting such treatment, an overweight or obese patient considered at medical risk from their fatness has not achieved an appropriate weight loss goal (5–10% of their presenting weight), then drug therapy may be considered. Drug therapy must be monitored regularly and discontinued if a patient begins to regain weight despite the drug—the duration of drug treatment should not exceed that determined by the drug’s product licence (with acknowledgment to the Royal College of Physicians of London).
Figure 3
Figure 3
Three surgical procedures for reducing gastric volume as a method for inducing weight loss: gastric restriction and gastric bypass operations, and biliopancreatic diversion.
See this image and copyright information in PMC

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