Abstract
“Disease will always be with us, but we may look forward confidently to a time when epidemics shall be no more” (Osler, 1891). Such an optimistic attitude has carried the world forward through many epidemics and likely will also help us prevail in the case of obesity. An important component of the effort is the development of improved pharmaceutical therapy for obesity. Ideally, this should have a widespread use, being available from overweight to morbidly obese people, at a lower cost and with fewer side effects than bariatric surgery. In this chapter, we review the latest pharmaceutical approaches to treat obesity through therapies targeting the control of eating. The energy input refers to the regulation of an adequate and readily available supply of energy metabolites in the circulation. Differences between energy input and output are buffered by the control of adipose-tissue mass, which is the major energy store. These are among the most important biological functions of any living organism. These aspects of energy homeostasis are linked to the control of eating. Eating, however, not only is under the control of physiological processes but is also affected by social stimuli, experience, learning, and a multitude of other exogenous factors. From a physiological standpoint, understanding the controls of eating remains an unsolved problem in behavioral neuroscience that is a prerequisite to the development of specific and more effective obesity therapy.
Lutz, Thomas A