What are the three reasons why resistance to leptin arises?
- decreasing sensitivity of leptin receptor in hypothalamus
- secondary message signals less sensitive
- transport system reduce sensitivity - less leptin in the brain
What are six conditions that excess body fat predispose people to?
Type 2 Diabetes
Coronary Heart Disease, Hypertension
What happens after a high fat meal when on Orlistat?
Describe the circadian rhythm of leptin
High at midday
Low in midnight
What is the mechanism of function of phentermine?
Act in the brain to increase NA, serotonin and dopamine to cause reduced food intake
Which drug can’t you use with phentermine?
MAO inhibitors (anti-depressant)
What are the weight loss effects of topiramate?
Increase energy expenditure
(Reduce insulin resistance)
What are the side effects of phentermine?
Increased BP, HR
What is the function of amylin?
Inhibit glucagon release
Delay gastric emptying
Inhibit food intake
Why doesn’t targeting single neuropeptides work in reducing appetite?
Because there are multiple so others will compensate
What is the advantage of Centilistat?
Less side effects cf to orlistat with the same general function
What are target general strategies to target excess weight?
Reduce food intake
Reduce fat absorption
How does leptin pass the BBB?
A specific channel
Why can you only use phentermine for 3 weeks?
How much does Orlistat reduce fat absorption?
How must diet be altered while on Orlistats?
Low fat diet required
Which drug is used for obesity off label?
Topiramate - an epilepsy drug
What is the mechanism of action of Orlistat?
Inhibit gastric and pancreatic lipases > prevents breakdown of TAG to FAs > less TAGs absorbed
What is the major draw back with phentermine?
Can only used it for 3 weeks
Plasma leptin level is proportional to what?
BMI and Fat
What are pramlinitide and metreleptin?
Analogues of amylin and leptin
When is Orlistat taken?