Control of feeding and the psychopharmacology of anorexic drugs

Part of the Current Status of Modern Therapy book series (CSMT, volume 2)


If pharmacological agents have a role in the treatment of obesity then their efficacy must be considered in the light of information about the systems controlling feeding behaviour and the mechanisms involved in the aetiology of obesity. In the past most pharmacological research relevant to obesity has been directed toward the development of anorexic drugs — appetite suppressants — on the understanding that a primary cause of obesity was the overeating which resulted from an excessive hunger1. Accordingly, the most obvious way to counter obesity was by drugs which inhibited hunger. However, the relationship between hunger, overeating and obesity is far from simple and it is widely recognized that human obesity does not arise from a single causal factor. Moreover, certain of the conditions important for the development of obesity may exist beyond the generally recognized boundaries of a physiological system and within the domain of psychological interactions. It follows that there is no simple policy available to guide the development of drugs to treat obesity, and one researcher has referred to the use of drugs in obesity as tantamount to quackery2. Indeed, it must be admitted that the overall advantage to weight loss brought about by drug administration is often small3. Consequently, these issues raise a number of questions regarding the use of drugs for the treatment of obesity:
  1. (a)

    What should be the primary objective of pharmacological treatment — restriction of food intake or loss of body weight?

  2. (b)

    Should different drugs be prescribed for different types of fat people whose condition may arise from quite different causal processes?

  3. (c)

    Should drugs be administered as the sole form of treatment?



Food Intake Food Consumption Brain Serotonin Hypothalamic Lesion Ventromedial Nucleus 
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