Enfoque diagnóstico y terapéutico del paciente con obesidad
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La obesidad es un problema de salud pública, con prevalencia creciente en todo el mundo, que acarrea una importante morbimortalidad, lo cual ha llevado a su reconocimiento como entidad nosológica independiente. Colombia no escapa a esta situación y reporta una prevalencia de adultos obesos del 51.2% en 2010. Varios elementos influyen en el comportamiento epidemiológico del sobrepeso y la obesidad: aspectos genéticos, étnicos, metabólicos, ambientales, políticos y rasgos socioculturales, entre otros. La asociación de la obesidad con múltiples patologías es cada vez más evidente, no sólo porque aumenta de forma considerable el riesgo cardiovascular, sino, también, porque causa afecciones pulmonares, gastrointestinales y osteoarticulares. A la fecha, el índice de masa corporal es el parámetro que permiten la definición y clasificación del sobrepeso y la obesidad. Medidas alternas, como la circunferencia abdominal, se han planteado como predictores de morbilidad independientes. Teniendo en cuenta la alta prevalencia de la obesidad y la imprecisión de los métodos clasificatorios para estimar el riesgo cardiovascular e identificar el paciente candidato a tratamiento, es una decisión clínica importante. El enfoque terapéutico del paciente con obesidad debe dirigirse a la intervención de los factores de riesgo modificables y está basado fundamentalmente en los cambios en el estilo de vida, complementado con la farmacoterapia en algunos pacientes, sin desconocer la opción quirúrgica en pacientes que cumplan ciertos criterios. Sin embargo, sólo será la prevención multidimensional lo que combatirá la conversión de la obesidad en una verdadera pandemia.
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Kushner RF. Clinical assessment and management of adult obesity. Circulation. 2012; 126(24): 2870-7.
Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA. 2012; 307(5): 483-90.
Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012; 307(5): 491-7.
Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013; 309(1): 71-82.
Cirilo B. Epidemiological aspects about obesity in Latin America: challenges for the future. Medwave. 2012 Ene;12(1):e5289.
Instituto Colombiano de Bienestar Familiar. Encuesta nacional de la situación nutricional en Colombia 2010 ENSIN. Bogotá: ICBF; 2011.
Álvarez-Castaño LS, Mancilla LP, González-Zapata LI, Arboleda LM, Isaza UA. Perfil alimentario y nutricional de Medellín: 2010. Medellín: Alcaldía de Medellín; 2010.
Velásquez JD, Tirado F, Ramírez A, Valencia M. Abordaje multidisciplinario en cirugía bariátrica: descripción de un grupo de 525 pacientes. Rev Perú Epidemiol. 2012; 16 (2): 02.
Ley 1355 de 2009. Diario Oficial, no. 47.502, (Octubre 14, 2009).
Berthoud HR, Morrison C. The brain, appetite, and obesity. Annu Rev Psychol. 2008; 59: 55-92.
Rankinen T, Pérusse L, Weisnagel SJ, Snyder EE, Chagnon YC, Bouchard C. The human obesity gene map: the 2001 update. Obes Res. 2002; 10(3): 196-243.
Licinio J, Caglayan S, Ozata M, Yildiz BO, de Miranda PB, O’Kirwan F, et al. Phenotypic effects of leptin replacement on morbid obesity, diabetes mellitus, hypogonadism, and behavior in leptin-deficient adults. Proc Natl Acad Sci U S A. 2004; 101(13): 4531-6.
Wardle J, Carnell S, Haworth CM, Plomin R. Evidence for a strong genetic influence on childhood adiposity despite the force of the obesogenic environment. Am J Clin Nutr. 2008; 87(2): 398-404.
Pérusse L, Rankinen T, Zuberi A, Chagnon YC, Weisnagel SJ, Argyropoulos G, et al. The human obesity gene map: the 2004 update. Obes Res. 2005; 13(3): 381-490.
Power C, Jefferis BJ. Fetal environment and subsequent obesity: a study of maternal smoking. Int J Epidemiol. 2002; 31(2): 413-9.
Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir MM, et al. Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships. Diabetes. 2000; 49(12): 2208-11.
Hediger ML, Overpeck MD, Kuczmarski RJ, Ruan WJ. Association between infant breastfeeding and overweight in young children. JAMA. 2001; 285(19): 2453-60.
Gillman MW, Rifas-Shiman SL, Camargo CA Jr, Berkey CS, Frazier AL, Rockett HR, et al. Risk of overweight among adolescents who were breastfed as infants. JAMA. 2001; 285(19): 2461-7.
Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity.N Engl J Med. 1997; 337(13): 869-73.
Mossberg HO. 40-year follow-up of overweight children. Lancet. 1989; 2(8661): 491-3.
The NS, Suchindran C, North KE, Popkin BM, Gordon-Larsen P. Association of adolescent obesity with risk of severe obesity in adulthood. JAMA. 2010; 304(18): 2042-7.
Wing RR. Changing diet and exercise behaviors in individuals at risk for weight gain. Obes Res. 1995;3 (Suppl 2): 277s-282s.
Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med. 1992; 327(19): 1350-5.
Kromhout D. Changes in energy and macronutrients in 871 middle-aged men during 10 years of follow-up (the Zutphen study). Am J Clin Nutr. 1983; 37(2): 287-94.
Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med. 2007; 357(4): 370-9.
Lawson OJ, Williamson DA, Champagne CM, DeLany JP, Brooks ER, Howat PM, et al. The association of body weight, dietary intake, and energy expenditure with dietary restraint and disinhibition. Obes Res. 1995; 3(2): 153-61.
Bouchard C, Tremblay A, Després JP, Nadeau A, Lupien PJ, Thériault G, et al. The response to long-term overfeeding in identical twins. N Engl J Med. 1990; 322(21): 1477-82.
Jenkins DJ, Wolever TM, Vuksan V, Brighenti F, Cunnane SC, Rao AV, et al. Nibbling versus gorging: metabolic advantages of increased meal frequency. N Engl J Med. 1989; 321(14): 929-34.
Bray GA, Popkin BM. Dietary fat intake does affect obesity! Am J Clin Nutr. 1998; 68(6): 1157-73.
Pereira MA, Kartashov AI, Ebbeling CB, Van Horn L, Slattery ML, Jacobs DR Jr, et al. Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 2005; 365(9453): 36-42.
Fernstrom MH. Drugs that cause weight gain. Obes Res. 1995; 3 (Suppl 4): 435S-439S.
Leslie WS, Hankey CR, Lean ME. Weight gain as an adverse effect of some commonly prescribed drugs: a systematic review. QJM. 2007; 100(7): 395-404.
Allison DB, Mentore JL, Heo M, Chandler LP, Cappelleri JC, Infante MC, et al. Antipsychoticinduced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999; 156(11): 1686-96.
National Sleep Foundation. Sleep in America Poll. Washington, DC: National Sleep Foundation;2002.
Flegal KM, Troiano RP, Pamuk ER, Kuczmarski RJ, Campbell SM. The influence of smoking cessation on the prevalence of overweight in the United States. N Engl J Med. 1995; 333(18): 1165-70.
Atkinson RL, Dhurandhar NV, Allison DB, Bowen RL, Israel BA, Albu JB, et al. Human adenovirus-36 is associated with increased body weight and paradoxical reduction of serum lipids. Int J Obes (Lond). 2005; 29(3): 281-6.
Jay P, Rougeulle C, Massacrier A, Moncla A, Mattei MG, Malzac P, et al. The human necdin gene, NDN, is maternally imprinted and located in the Prader-Willi syndrome chromosomal region. Nat Genet. 1997; 17(3): 357-61.
Bray GA, Gallagher TF Jr. Manifestations of hypothalamic obesity in man: a comprehensive investigation of eight patients and a reveiw of the literature. Medicine (Baltimore). 1975; 54(4): 301-30.
Wajchenberg BL, Bosco A, Marone MM, Levin S, Rocha M, Lerário AC, et al. Estimation of body fat and lean tissue distribution by dual energy X-ray absorptiometry and abdominal body fat evaluation by computed tomography in Cushing’s disease. J Clin Endocrinol Metab. 1995; 80(9): 2791-4.
Knudsen N, Laurberg P, Rasmussen LB, Bülow I, Perrild H, Ovesen L, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005; 90(7): 4019-24.
Ades PA, Savage PD. The obesity paradox: perception vs knowledge. Mayo Clin Proc. 2010; 85(2): 112-4.
Romero-Corral A, Montori VM, Somers VK, Korinek J, Thomas RJ, Allison TG, et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet. 2006; 368(9536): 666-78.
Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006; 23(5): 469-80.
Aschner P, Buendía R, Brajkovich I, González A, Figueredo R, Juarez XE, et al. Determination of the cutoff point for waist circumference that establishes the presence of abdominal obesity in Latin American men and women. Diabetes Res Clin Pract. 2011; 93(2): 243-7.
Wildman RP, Muntner P, Reynolds K, McGinn AP, Rajpathak S, Wylie-Rosett J, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med. 2008; 168(15): 1617-24.
Wilson PW, D’Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med. 2002; 162(16): 1867-72.
Sharma AM, Kushner RF. A proposed clinical staging system for obesity. Int J Obes (Lond). 2009; 33(3): 289-95.
Padwal RS, Pajewski NM, Allison DB, Sharma Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. CMAJ. 2011; 183(14): E1059-66.
Kuk JL, Ardern CI, Church TS, Sharma AM, Padwal R, Sui X, et al. Edmonton Obesity Staging System: association with weight history and mortality risk. Appl Physiol Nutr Metab. 2011; 36(4): 570-6.
Dubnov-Raz G, Berry EM. The dietary treatment of obesity. Med Clin North Am. 2011; 95(5): 939-52.
U.S. Department of Agriculture; U.S. Department of Health and Human Services. Dietary guidelines for americans, 2010. 7. ed. Washington, DC: Government Printing Office; 2010.
Jakicic JM. The effect of physical activity on body weight. Obesity (Silver Spring). 2009; 17 (Suppl 3): S34-8.
Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK, et al. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009; 41(2): 459-71.
Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009; 360(9): 859-73.
Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001; 344(1): 3-10.
Eckel RH. Clinical practice. Nonsurgical management of obesity in adults. N Engl J Med. 2008; 358(18): 1941-50.
Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009; 120(16): 1640-5.
Anderson JW, Konz EC, Frederich RC, Wood CL. Long-term weight-loss maintenance: a metaanalysis of US studies. Am J Clin Nutr. 2001; 74(5): 579-84.
Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A to Z Weight Loss Study: a randomized trial. JAMA. 2007; 297(9): 969-77.
Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005; 293(1): 43-53.
Truby H, Baic S, deLooy A, Fox KR, Livingstone MB, Logan CM, et al. Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC “diet trials”. BMJ. 2006; 332(7553): 1309-14.
Nordmann AJ, Nordmann A, Briel M, Keller U, Yancy WS Jr, Brehm BJ, et al. Effects of lowcarbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med. 2006; 166(3): 285-93.
Jenkins DJ, Wolever TM, Taylor RH, Barker H, Fielden H, Baldwin JM, et al. Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J ClinNutr. 1981; 34(3): 362-6.
Brand-Miller JC, Holt SH, Pawlak DB, McMillan J. Glycemic index and obesity. Am J Clin Nutr. 2002; 76(1): 281S-5S.
Lee S, Kuk JL, Davidson LE, Hudson R, Kilpatrick K, Graham TE. et al. Exercise without weight loss is an effective strategy for obesity reduction in obese individuals with and without Type 2 diabetes. J Appl Physiol. 2005; 99(3): 1220-5.
Wilmore JH, Després JP, Stanforth PR, Mandel S, Rice T, Gagnon J, et al. Alterations in body weight and composition consequent to 20 wk of endurance training: the Heritage Family Study. Am J Clin Nutr. 1999; 70(3): 346-52.
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007; 116(9): 1081-93.
Dubnov G, Berry EM. Physical activity and mood: the endocrine connection. En: Warren MP, Constantini NW, editors. Sports Endocrinology (Contemporary Endocrinology). Totowa, NJ: Humana Press; 2010. p. 421–32.
American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. 8. ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010.
Williamson DF, Madans J, Anda RF, Kleinman JC, Kahn HS, Byers T. Recreational physical activity and ten-year weight change in a US national cohort. Int J Obes Relat Metab Disord. 1993; 17(5): 279-86
Hankinson AL, Daviglus ML, Bouchard C, Carnethon M, Lewis CE, Schreiner PJ, et al. Maintaining a high physical activity level over 20 years and weight gain. JAMA. 2010;304(23): 2603-10.
Lee IM, Djoussé L, Sesso HD, Wang L, Buring JE. Physical activity and weight gain prevention. JAMA. 2010; 303(12): 1173-9.
Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc. 2009; 41(5): 998-1005.
Swinburn B, Shelly A. Effects of TV time and other sedentary pursuits. Int J Obes (Lond). 2008;32Suppl 7: S132-6.
Robinson TN. Reducing children’s television viewing to prevent obesity: a randomized controlled trial. JAMA. 1999; 282(16): 1561-7.
Hu G, Rico-Sanz J, Lakka TA, Tuomilehto J. Exercise, genetics and prevention of type 2 diabetes. Essays Biochem. 2006; 42: 177-92.
Ioachimescu AG, Brennan DM, Hoar BM, Hoogwerf BJ. The lipid accumulation product and all-cause mortality in patients at high cardiovascular risk: a PreCIS database study. Obesity (Silver Spring). 2010; 18(9): 1836-44.
Sui X, LaMonte MJ, Laditka JN, Hardin JW, Chase N, Hooker SP, et al. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. JAMA. 2007;298(21): 2507-16.
Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009; 301(19): 2024-35.
Fogelholm M. Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review. Obes Rev. 2010; 11(3): 202-21.
Slentz CA, Duscha BD, Johnson JL, Ketchum K, Aiken LB, Samsa GP, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study. Arch Intern Med. 2004; 164(1): 31-9.
Lee L, Kumar S, Leong LC. The impact of five-month basic military training on the body weight and body fat of 197 moderately to severely obese Singaporean males aged 17 to 19 years. Int J Obes Relat Metab Disord. 1994; 18(2): 105-9.
Raatz SK, Torkelson CJ, Redmon JB, Reck KP, Kwong CA, Swanson JE, et al. Reduced glycemic index and glycemic load diets do not increase the effects of energy restriction on weight loss and insulin sensitivity in obese men and women. J Nutr. 2005; 135(10): 2387-91.
Irwin ML, Yasui Y, Ulrich CM, Bowen D, Rudolph RE, Schwartz RS, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA. 2003; 289(3): 323-30.
Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord. 1997; 21(10): 941-7.
Jakicic JM, Marcus BH, Gallagher KI, Napolitano M, Lang W. Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. JAMA. 2003; 290(10): 1323-30.
Goodpaster BH, Delany JP, Otto AD, Kuller L, Vockley J, South-Paul JE, et al. Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults: a randomized trial. JAMA. 2010; 304(16): 1795-802.
Andersen RE, Wadden TA, Bartlett SJ, Zemel B, Verde TJ, Franckowiak SC. Effects of lifestyle activity vs structured aerobic exercise in obese women: a randomized trial. JAMA. 1999; 281(4): 335-40.
Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation. 2002; 106(14): 1883-92.
Poston WS 2nd, Foreyt JP. Successful management of the obese patient. Am Fam Physician. 2000; 61(12): 3615-22.
Wadden TA, Butryn ML. Behavioral treatment of obesity. Endocrinol Metab Clin North Am. 2003; 32(4): 981-1003.
Bray GA, Ryan DH. Medical therapy for the patient with obesity. Circulation. 2012; 125(13): 1695-703.
Munro JF, MacCuish AC, Wilson EM, Duncan LJ. Comparison of continuous and intermittent anorectic therapy in obesity. Br Med J. 1968; 1(5588): 352-4.
Kernan WN, Viscoli CM, Brass LM, Broderick JP, Brott T, Feldmann E, et al. Phenylpropanolamine and the risk of hemorrhagic stroke. N Engl J Med. 2000; 343(25): 1826-32.
Smith SR, Prosser WA, Donahue DJ, Morgan ME, Anderson CM, Shanahan WR, et al. Lorcaserin (APD356), a selective 5-HT(2C) agonist, reduces body weight in obese men and women. Obesity (Silver Spring). 2009; 17(3): 494-503.
Smith SR, Weissman NJ, Anderson CM, Sanchez M, Chuang E, Stubbe S, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. N Engl J Med. 2010; 363(3): 245-56.
Fidler MC, Sanchez M, Raether B, Weissman NJ, Smith SR, Shanahan WR, et al. A one-year randomized trial of lorcaserin for weight loss in obese and overweight adults: the BLOSSOM trial. J Clin Endocrinol Metab. 2011; 96(10): 3067-77.
O’Neil PM, Smith SR, Weissman NJ, Fidler MC, Sanchez M, Zhang J, et al. Randomized placebocontrolled clinical trial of lorcaserin for weight loss in type 2 diabetes mellitus: the Bloom-DM study. Obesity (Silver Spring). 2012; 20(7): 1426-36.
US Food and Drug Administration. FDA Highlights of Prescribing Information: Belviq (lorcaserin hydrochloride) tablets, for oral use [monografía en Internet]. Silver Spring, MD : FDA; 2012[citado 2013 Jun 23]. Disponible en: http://www.accessdata.fda.gov/drugsatfda_docs/ label/2012/022529lbl.pdf.
Li Z, Maglione M, Tu W, Mojica W, Arterburn D, Shugarman LR, et al. Meta-analysis: pharmacologic treatment of obesity. Ann Intern Med. 2005; 142(7): 532-46.
Bray GA, Hollander P, Klein S, Kushner R, Levy B, Fitchet M, et al. A 6-month randomized, placebo-controlled, dose-ranging trial of topiramate for weight loss in obesity. Obes Res. 2003; 11(6): 722-33.
Astrup A, Caterson I, Zelissen P, Guy-Grand B, Carruba M, Levy B, et al. Topiramate: long-term maintenance of weight loss induced by a low-calorie diet in obese subjects. Obes Res. 2004; 12(10): 1658-69.
Gadde KM, Allison DB, Ryan DH, Peterson CA, Troupin B, Schwiers ML, et al. Effects of lowdose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet. 2011; 377(9774): 1341-52.
Garvey WT, Ryan DH, Look M, Gadde KM, Allison DB, Peterson CA, et al. Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. Am J Clin Nutr. 2012; 95(2): 297-308.
Two new drugs for weight loss. Med Lett Drugs Ther. 2012; 54(1398): 69-71.
US Food and Drug Administration. FDA Drug Safety Communication: FDA Recommends against the continued use of Meridia (sibutramine) [monografía en Internet]. Silver Spring, MD: FDA; 2010 [citado 2013 Jun 23]. Disponible en: http://www.fda.gov/Drugs/DrugSafety/ucm228746. htm#Additional_Information_for_Patients.
Sjöström L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, et al. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European MulticentreOrlistat Study Group. Lancet. 1998; 352(9123): 167-72.
Chanoine JP, Hampl S, Jensen C, Boldrin M, Hauptman J. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA. 2005; 293(23): 2873-83.
Davidson MH, Hauptman J, DiGirolamo M, Foreyt JP, Halsted CH, Heber D, et al. Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. JAMA. 1999; 281(3): 235-42.
Kelley DE, Bray GA, Pi-Sunyer FX, Klein S, Hill J, Miles J, et al. Clinical efficacy of orlistat therapy in overweight and obese patients with insulin-treated type 2 diabetes: A 1-year randomized controlled trial. Diabetes Care. 2002; 25(6): 1033-41.
Padwal R, Li SK, Lau DC. Long-term pharmacotherapy for obesity and overweight. Cochrane Database Syst Rev. 2004; (3):CD004094.
US Food and Drug Administration. FDA Drug Safety Communication: completed safety review of Xenical/Alli (orlistat) and severe liver injury [monografía en Internet]. Silver Spring, MD: FDA; 2010 [citado 2013 Jun 23]. Disponible en: http://www.fda.gov/Drugs/DrugSafety/ PostmarketDrugSafetyInformationforPatientsandProviders/ucm213038.htm.
Stein MR, Julis RE, Peck CC, Hinshaw W, Sawicki JE, Deller JJ Jr. Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study. Am J Clin Nutr. 1976; 29(9): 940-8.
Greenway FL, Bray GA. Human chorionic gonadotropin (HCG) in the treatment of obesity: a critical assessment of the Simeons method. West J Med. 1977; 127(6): 461-3.
Bosch B, Venter I, Stewart RI, Bertram SR. Human chorionic gonadotrophin and weight loss. A double-blind, placebo-controlled trial. S Afr Med J. 1990; 77(4): 185-9.
Lijesen GK, Theeuwen I, Assendelft WJ, Van Der Wal G. The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteriabased meta-analysis. Br J Clin Pharmacol. 1995; 40(3): 237-43.
Goldstein DJ, Rampey AH Jr, Enas GG, Potvin JH, Fludzinski LA, Levine LR. Fluoxetine: a randomized clinical trial in the treatment of obesity. Int J Obes Relat Metab Disord. 1994; 18(3): 129-35.
Gadde KM, Parker CB, Maner LG, Wagner HR 2nd, Logue EJ, Drezner MK, et al. Bupropion for weight loss: an investigation of efficacy and tolerability in overweight and obese women. Obes Res. 2001; 9(9): 544-51.
Anderson JW, Greenway FL, Fujioka K, Gadde KM, McKenney J, O’Neil PM. Bupropion SR enhances weight loss: a 48-week double-blind, placebo- controlled trial. Obes Res. 2002; 10(7): 633-41.
Greenway FL, Fujioka K, Plodkowski RA, Mudaliar S, Guttadauria M, Erickson J, et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2010; 376(9741): 595-605.
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346(6): 393-403.
Fontbonne A, Charles MA, Juhan-Vague I, Bard JM, André P, Isnard F, et al. The effect of metformin on the metabolic abnormalities associated with upper-body fat distribution. BIGPRO Study Group. Diabetes Care. 1996; 19(9): 920-6.
Astrup A, Rössner S, Van Gaal L, Rissanen A, Niskanen L, Al Hakim M, et al. Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study. Lancet. 2009; 374(9701): 1606-16.
Kunos G, Bátkai S. Novel physiologic functions of endocannabinoids as revealed through the use of mutant mice. Neurochem Res. 2001; 26(8-9): 1015-21.
Di Marzo V, Goparaju SK, Wang L, Liu J, Bátkai S, Járai Z, et al. Leptin-regulated endocannabinoids are involved in maintaining food intake. Nature. 2001; 410(6830): 822-5.
Van Gaal LF, Rissanen AM, Scheen AJ, Ziegler O, Rössner S; RIO-Europe Study Group. Effects of the cannabinoid-1 receptor blocker rimonabant on weight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study. Lancet. 2005; 365(9468): 1389-97.
Scheen AJ, Finer N, Hollander P, Jensen MD, Van Gaal LF; RIO-Diabetes Study Group. Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a randomised controlled study. Lancet. 2006; 368(9548): 1660-72.
Rosenstock J, Hollander P, Chevalier S, Iranmanesh A; Serenade Study Group. SERENADE: the Study Evaluating Rimonabant Efficacy in Drug-naive Diabetic Patients: effects of monotherapy with rimonabant, the first selective CB1 receptor antagonist, on glycemic control, body weight, and lipid profile in drug-naive type 2 diabetes. Diabetes Care. 2008; 31(11): 2169-76.
Pittler MH, Ernst E. Guar gum for body weight reduction: meta-analysis of randomized trials. Am J Med. 2001; 110(9): 724-30.
Saper RB, Eisenberg DM, Phillips RS. Common dietary supplements for weight loss. Am Fam Physician. 2004; 70(9): 1731-8.
Mhurchu CN, Poppitt SD, McGill AT, Leahy FE, Bennett DA, Lin RB, et al. The effect of the dietary supplement, Chitosan, on body weight: a randomised controlled trial in 250 overweight and obese adults. Int J Obes Relat Metab Disord. 2004 Sep; 28(9):1149-56.
Heymsfield SB, Allison DB, Vasselli JR, Pietrobelli A, Greenfield D, Nunez C. Garciniacambogia (hydroxycitric acid) as a potential antiobesity agent: a randomized controlled trial. JAMA. 1998; 280(18): 1596-600.
Rader JI, Delmonte P, Trucksess MW. Recent studies on selected botanical dietary supplement ingredients. Anal Bioanal Chem. 2007; 389(1): 27-35
Cohen PA, McCormick D, Casey C, Dawson GF, Hacker KA. Imported compounded diet pill use among Brazilian women immigrants in the United States. J Immigr Minor Health. 2009; 11(3): 229-36.
Davies KM, Heaney RP, Recker RR, Lappe JM, Barger-Lux MJ, Rafferty K, et al. Calcium intake and body weight. J Clin Endocrinol Metab. 2000; 85(12): 4635-8.
Reid IR, Horne A, Mason B, Ames R, Bava U, Gamble GD. Effects of calcium supplementation on body weight and blood pressure in normal older women: a randomized controlled trial. J Clin Endocrinol Metab. 2005; 90(7): 3824-9.
Yanovski JA, Parikh SJ, Yanoff LB, Denkinger BI, Calis KA, Reynolds JC, et al. Effects of calcium supplementation on body weight and adiposity in overweight and obese adults: a randomized trial. Ann Intern Med. 2009;150(12): 821-9, W145-6.
Mechanick JI, Kushner RF, Sugerman HJ, Gonzalez-Campoy JM, Collazo-Clavell ML, Spitz AF, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity (Silver Spring). 2009; 17 Suppl 1: S1-70.
Casazza K, Fontaine KR, Astrup A, Birch LL, Brown AW, Bohan Brown MM, et al. Myths, presumptions,and facts about obesity. N Engl J Med. 2013 Jan 31;368(5):446-454.