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2. Case Report
Extra health benefits
Sibutril is not suitable for people who:
• High blood pressure leading to anxiety and vision blurred
Obesity is a chronic disease that can be defined as an excessive accumulation of body fat [1 ]. Its prevalence is increasing worldwide and nowadays more than 300 million individuals are obese and an additional 800 million are pre-obese or overweight. Obesity, particularly central obesity, increases the risk of cardiovascular (CDV) and cancer mortality, thereby reducing life expectancy [2 ]. Lack of effective weight-loss treatments based solely on lifestyle modifications (diet and physical exercise), promoted the development of anti-obesity drugs as an adjunctive treatment. Patients with a body mass index (BMI) persistently exceeding 30 kg/m 2 or with a BMI ≥ 27kg/m 2 with concomitant obesity-related co-morbidities (e.g. coronary heart disease, hypertension, type 2 diabetes, dyslipidemia or obstructive sleep apnea), are eligible for anti-obesity drug treatment [3 , 4 ]. The mechanisms of action of anti-obesity drugs that lead to weight loss include: (a) a reduction of food intake and appetite by amplifying anorexigenic (i.e. suppressors of food intake) or blocking orexigenic (i.e. stimulators of food intake) afferent and efferent central nervous system (CNS) signals, (b) a decrement of body weight reference value (body weight set point) determined by the hypothalamic areas that control energy homeostasis, (c) an increase in energy expenditure, (d) a decrease in nutrient (especially fat and carbohydrates) digestion and intestinal absorption, and (e) a reduction of fat storage and/or increase of hydrolysis of triglycerides in adipose tissue [1 , 4 , 5 ]. During the last 50 years, CNS energy regulatory mechanisms that control appetite, food intake and energy expenditure have been the target of most of the developed anti-obesity drugs [6 ]. Sibutramine, is one of these drugs. So, the aim of this review is to summarize the effects of sibutramine upon the mechanisms controlling energy homeostasis, which are responsible for its weight reduction potential. Additionally, sibutramine long-term effectiveness and side effects will be briefly described.