New approaches in the pharmacological treatment of obesity

Many new substances are currently being investigated for their usefulness i n the pharmacotherapy of obesity. Most drugs interfere with monoamine neuro transmitter (serotonin, noradrenalin, dopamine and histamine) effects and a ct as an appetite suppressant. Other approaches are to primarily increase t hermogenesis (e.g. beta(3)-adrenoceptor agonists), or to decrease fat absor ption by inhibiting the pancreatic lipase (orlistat). New promising agents are substances that increase the effect of corticotropin releasing factor ( CRF) or urocortin in the brain (CRF-binding protein ligand inhibitor) and a neuropeptide Y (NPY) Y-5 receptor antagonist. The clinical relevance of le ptin in the therapy of obesity is probably limited, but can not be fully ev aluated at the moment. As obesity has a multifactorial basis, all these sub stances have in common the fact that they can not cure obesity. They should only be used as an adjunct to classical strategies like diet and exercise in severe obesity. For developing new, perhaps even more specific pharmacol ogical agents, further research is needed to understand the individually di fferent genetic and physiological basis of obesity.