Anorectic
Encyclopedia
An anorectic or anorexic (from the Greek
an- = "without" and orexis = "appetite"), also known as anorexigenic or appetite suppressant, is a dietary supplement
and/or drug
which reduces appetite
, food
consumption
, and as a result, causes weight loss
to occur.
The following drugs listed as "centrally-acting antiobesity preparations" by ATC
:
The following are listed as appetite depressants by MeSH
.
Other compounds marked as appetite suppressants include:
s of fatal pulmonary hypertension
and heart valve
damage associated with pharmaceutical anorectic agents have led to the withdrawal of products from the market. This was the case with aminorex
in the 1960s, and again in the 1990s with fenfluramine
(see: Fen-phen
). Likewise, association of the related appetite suppressant phenylpropanolamine
with hemorrhagic
stroke
led the Food and Drug Administration
(FDA) to request its withdrawal from the market in the United States
in 2000, and similar concerns regarding ephedrine
resulted in an FDA ban on its inclusion in dietary supplements, in 2004 (a Federal judge later overturned this ban in 2005 during a challenge by supplement maker Nutraceuticals). It is also debatable as to whether the ephedrine ban had more to do with its use as a precursor
in methamphetamine
manufacture rather than legitimate health concerns.
, some appetite suppressants are also available over-the-counter
. In the United States, appetite suppressants do not have to be approved by the FDA when they are based on a 100% natural basis. There are all kinds of natural appetite suppressants (supplements) on the market, helping people to control and limit their food intake. Most common natural appetite suppressants are based on hoodia
, a genus of 13 species in the flowering plant family Apocynaceae, under the subfamily Asclepiadoideae. Also widely used as a basis is green tea
, with other plant extracts, to limit calorie intake. Several appetite suppressants are based on a mix of natural ingredients, mostly using green tea as its basis, in combination with other plant extracts such as fucoxanthin
, found naturally in seaweed. Drugs
of this class are frequently stimulant
s of the phenethylamine
family, related to amphetamine
(informally known as speed).
The German
and Finnish
militaries issued amphetamines to soldiers commonly to enhance warfare during the Second World War. Following the war, amphetamines were redirected for use on the civilian market. Indeed, amphetamine itself was sold commercially as an appetite suppressant until it was outlawed in most parts of the world in the late 1950s due to increased recreational use. Many amphetamine
s produce side effects, including addiction
, tachycardia
and hypertension
, making prolonged unsupervised use dangerous.
Greek language
Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...
an- = "without" and orexis = "appetite"), also known as anorexigenic or appetite suppressant, is a dietary supplement
Dietary supplement
A dietary supplement, also known as food supplement or nutritional supplement, is a preparation intended to supplement the diet and provide nutrients, such as vitamins, minerals, fiber, fatty acids, or amino acids, that may be missing or may not be consumed in sufficient quantities in a person's diet...
and/or drug
Drug
A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage.In pharmacology, a...
which reduces appetite
Appetite
The appetite is the desire to eat food, felt as hunger. Appetite exists in all higher life-forms, and serves to regulate adequate energy intake to maintain metabolic needs. It is regulated by a close interplay between the digestive tract, adipose tissue and the brain. Decreased desire to eat is...
, food
Food
Food is any substance consumed to provide nutritional support for the body. It is usually of plant or animal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals...
consumption
Eating
Eating is the ingestion of food to provide for all organisms their nutritional needs, particularly for energy and growth. Animals and other heterotrophs must eat in order to survive: carnivores eat other animals, herbivores eat plants, omnivores consume a mixture of both plant and animal matter,...
, and as a result, causes weight loss
Weight loss
Weight loss, in the context of medicine, health or physical fitness, is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue...
to occur.
List of anorectics
Numerous pharmaceutical compounds are marketed as appetite suppressants.The following drugs listed as "centrally-acting antiobesity preparations" by ATC
Anatomical Therapeutic Chemical Classification System
The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. It is controlled by the WHO Collaborating Centre for Drug Statistics Methodology , and was first published in 1976....
:
- PhenterminePhenterminePhentermine, a contraction of "phenyl-tertiary-butylamine", is a psychostimulant drug of the phenethylamine class, chemically related to amphetamine. It is used medically as an appetite suppressant....
(Fastin, Adipex, Ionamin, etc.) - Diethylpropion (Tenuate)
- RimonabantRimonabantRimonabant is an anorectic antiobesity drug that has been withdrawn from the market. It is an inverse agonist for the cannabinoid receptor CB1...
(Acomplia) - SibutramineSibutramineSibutramine is an oral anorexiant. Until 2010 it was marketed and prescribed as an adjunct in the treatment of exogenous obesity along with diet and exercise...
(Meridia, Reductil)
The following are listed as appetite depressants by MeSH
Medical Subject Headings
Medical Subject Headings is a comprehensive controlled vocabulary for the purpose of indexing journal articles and books in the life sciences; it can also serve as a thesaurus that facilitates searching...
.
- BenfluorexBenfluorexBenfluorex is an anorectic and hypolipidemic agent that is structurally related to fenfluramine. Two clinical studies have shown it may improve glycemic control and decrease insulin resistance in people with poorly controlled type 2 diabetes; However Servier is suspected of having marketed Mediator...
- ButenolideButenolideButenolides are a class of lactones with a four-carbon heterocyclic ring structure. They are sometimes considered oxidized derivatives of furan. The simplest butenolide is 2-furanone, which is a common component of larger natural products and is sometimes referred to as simply "butenolide". A...
- CathineCathineCathine, also known as d-norpseudoephedrine, is a psychoactive drug of the phenethylamine and amphetamine chemical classes which acts as a stimulant...
- Diethylpropion
- FG-7142
- PhenmetrazinePhenmetrazinePhenmetrazine is a stimulant drug of the morpholine chemical class that was previously used as an appetite suppressant, but has since been withdrawn from the market...
- PhenterminePhenterminePhentermine, a contraction of "phenyl-tertiary-butylamine", is a psychostimulant drug of the phenethylamine class, chemically related to amphetamine. It is used medically as an appetite suppressant....
- PhenylpropanolaminePhenylpropanolaminePhenylpropanolamine , also known as the stereoisomers norephedrine and norpseudoephedrine, is a psychoactive drug of the phenethylamine and amphetamine chemical classes which is used as a stimulant, decongestant, and anorectic agent. It is commonly used in prescription and over-the-counter cough...
- Pyroglutamyl-histidyl-glycinePyroglutamyl-histidyl-glycinePyroglutamyl-histidyl-glycine is an anorectic....
- SibutramineSibutramineSibutramine is an oral anorexiant. Until 2010 it was marketed and prescribed as an adjunct in the treatment of exogenous obesity along with diet and exercise...
Other compounds marked as appetite suppressants include:
- AmphetamineAmphetamineAmphetamine or amfetamine is a psychostimulant drug of the phenethylamine class which produces increased wakefulness and focus in association with decreased fatigue and appetite.Brand names of medications that contain, or metabolize into, amphetamine include Adderall, Dexedrine, Dextrostat,...
- BenzphetamineBenzphetamineBenzphetamine is an anorectic drug marketed under this brand in the USA by Pharmacia. Benzphetamine is used as a short term adjunct in management of exogenous obesity. It is closely related to amphetamine.- Pharmacology :...
(Didrex) - DexmethylphenidateDexmethylphenidateDexmethylphenidate, otherwise known as d-threo-methylphenidate , is the dextrorotatory enantiomer of methylphenidate. It is a norepinephrine-dopamine reuptake inhibitor and releasing agent and thus a psychostimulant, which affects the CNS...
(Focalin) - DextroamphetamineDextroamphetamineDextroamphetamine is a psychostimulant drug which is known to produce increased wakefulness and focus as well as decreased fatigue and decreased appetite....
(Dexedrine) - GlucagonGlucagonGlucagon, a hormone secreted by the pancreas, raises blood glucose levels. Its effect is opposite that of insulin, which lowers blood glucose levels. The pancreas releases glucagon when blood sugar levels fall too low. Glucagon causes the liver to convert stored glycogen into glucose, which is...
(GlucaGen) - MethamphetamineMethamphetamineMethamphetamine is a psychostimulant of the phenethylamine and amphetamine class of psychoactive drugs...
(Desoxyn) - MethylphenidateMethylphenidateMethylphenidate is a psychostimulant drug approved for treatment of attention-deficit hyperactivity disorder, postural orthostatic tachycardia syndrome and narcolepsy. It may also be prescribed for off-label use in treatment-resistant cases of lethargy, depression, neural insult and obesity...
(Ritalin, Concerta) - PhendimetrazinePhendimetrazinePhendimetrazine is a stimulant drug of the morpholine chemical class used as an appetite suppressant....
(Bontril) - PhenethylaminePhenethylaminePhenylethylamine or phenethylamine is a natural monoamine alkaloid, trace amine, and also the name of a class of chemicals with many members well known for psychoactive drug and stimulant effects. Studies suggest that phenylethylamine functions as a neuromodulator or neurotransmitter in the...
Public health concerns
EpidemicEpidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...
s of fatal pulmonary hypertension
Pulmonary hypertension
In medicine, pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion...
and heart valve
Heart valve
A heart valve normally allows blood flow in only one direction through the heart. The four valves commonly represented in a mammalian heart determine the pathway of blood flow through the heart...
damage associated with pharmaceutical anorectic agents have led to the withdrawal of products from the market. This was the case with aminorex
Aminorex
Aminorex is an anorectic stimulant drug of the 2-amino-5-aryl oxazoline class developed by a team at McNeil in 1962. It is closely related to 4-methylaminorex. Aminorex has been shown to have locomotor stimulant effects, lying midway between dextroamphetamine and methamphetamine...
in the 1960s, and again in the 1990s with fenfluramine
Fenfluramine
Fenfluramine is a drug that was part of the Fen-Phen anti-obesity medication . Fenfluramine was introduced on the U.S. market in 1973. It is the racemic mixture of two enantiomers, dextrofenfluramine and levofenfluramine...
(see: Fen-phen
Fen-phen
The drug combination fenfluramine/phentermine, usually called fen-phen, is an anti-obesity treatment that utilizes two anorectics. Fenfluramine, its S-enantiomer dexfenfluramine, and a few other serotonin agonists were shown to cause potentially fatal pulmonary hypertension and heart valve...
). Likewise, association of the related appetite suppressant phenylpropanolamine
Phenylpropanolamine
Phenylpropanolamine , also known as the stereoisomers norephedrine and norpseudoephedrine, is a psychoactive drug of the phenethylamine and amphetamine chemical classes which is used as a stimulant, decongestant, and anorectic agent. It is commonly used in prescription and over-the-counter cough...
with hemorrhagic
Bleeding
Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
led the Food and Drug Administration
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
(FDA) to request its withdrawal from the market in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
in 2000, and similar concerns regarding ephedrine
Ephedrine
Ephedrine is a sympathomimetic amine commonly used as a stimulant, appetite suppressant, concentration aid, decongestant, and to treat hypotension associated with anaesthesia....
resulted in an FDA ban on its inclusion in dietary supplements, in 2004 (a Federal judge later overturned this ban in 2005 during a challenge by supplement maker Nutraceuticals). It is also debatable as to whether the ephedrine ban had more to do with its use as a precursor
Precursor (chemistry)
In chemistry, a precursor is a compound that participates in the chemical reaction that produces another compound. In biochemistry, the term "precursor" is used more specifically to refer to a chemical compound preceding another in a metabolic pathway....
in methamphetamine
Methamphetamine
Methamphetamine is a psychostimulant of the phenethylamine and amphetamine class of psychoactive drugs...
manufacture rather than legitimate health concerns.
History and initial uses
Used on a short-term basis clinically to treat obesityObesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
, some appetite suppressants are also available over-the-counter
Over-the-counter drug
Over-the-counter drugs are medicines that may be sold directly to a consumer without a prescription from a healthcare professional, as compared to prescription drugs, which may be sold only to consumers possessing a valid prescription...
. In the United States, appetite suppressants do not have to be approved by the FDA when they are based on a 100% natural basis. There are all kinds of natural appetite suppressants (supplements) on the market, helping people to control and limit their food intake. Most common natural appetite suppressants are based on hoodia
Hoodia
Hoodia is a genus of 13 species in the flowering plant family Apocynaceae, under the subfamily Asclepiadoideae. They are stem succulents, described as "cactiform" because of their remarkable similarity to the unrelated cactus family...
, a genus of 13 species in the flowering plant family Apocynaceae, under the subfamily Asclepiadoideae. Also widely used as a basis is green tea
Green tea
Green tea is made solely from the leaves of Camellia sinensis that have undergone minimal oxidation during processing. Green tea originates from China and has become associated with many cultures throughout Asia. It has recently become more widespread in the West, where black tea is traditionally...
, with other plant extracts, to limit calorie intake. Several appetite suppressants are based on a mix of natural ingredients, mostly using green tea as its basis, in combination with other plant extracts such as fucoxanthin
Fucoxanthin
Fucoxanthin is a xanthophyll, with formula C42H58O6. It is found as an accessory pigment in the chloroplasts of brown algae and most other heterokonts, giving them a brown or olive-green color...
, found naturally in seaweed. Drugs
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
of this class are frequently stimulant
Stimulant
Stimulants are psychoactive drugs which induce temporary improvements in either mental or physical function or both. Examples of these kinds of effects may include enhanced alertness, wakefulness, and locomotion, among others...
s of the phenethylamine
Phenethylamine
Phenylethylamine or phenethylamine is a natural monoamine alkaloid, trace amine, and also the name of a class of chemicals with many members well known for psychoactive drug and stimulant effects. Studies suggest that phenylethylamine functions as a neuromodulator or neurotransmitter in the...
family, related to amphetamine
Amphetamine
Amphetamine or amfetamine is a psychostimulant drug of the phenethylamine class which produces increased wakefulness and focus in association with decreased fatigue and appetite.Brand names of medications that contain, or metabolize into, amphetamine include Adderall, Dexedrine, Dextrostat,...
(informally known as speed).
The German
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
and Finnish
Finland
Finland , officially the Republic of Finland, is a Nordic country situated in the Fennoscandian region of Northern Europe. It is bordered by Sweden in the west, Norway in the north and Russia in the east, while Estonia lies to its south across the Gulf of Finland.Around 5.4 million people reside...
militaries issued amphetamines to soldiers commonly to enhance warfare during the Second World War. Following the war, amphetamines were redirected for use on the civilian market. Indeed, amphetamine itself was sold commercially as an appetite suppressant until it was outlawed in most parts of the world in the late 1950s due to increased recreational use. Many amphetamine
Amphetamine
Amphetamine or amfetamine is a psychostimulant drug of the phenethylamine class which produces increased wakefulness and focus in association with decreased fatigue and appetite.Brand names of medications that contain, or metabolize into, amphetamine include Adderall, Dexedrine, Dextrostat,...
s produce side effects, including addiction
Substance dependence
The section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:...
, tachycardia
Tachycardia
Tachycardia comes from the Greek words tachys and kardia . Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate...
and hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
, making prolonged unsupervised use dangerous.
See also
- AmphetamineAmphetamineAmphetamine or amfetamine is a psychostimulant drug of the phenethylamine class which produces increased wakefulness and focus in association with decreased fatigue and appetite.Brand names of medications that contain, or metabolize into, amphetamine include Adderall, Dexedrine, Dextrostat,...
- AminorexAminorexAminorex is an anorectic stimulant drug of the 2-amino-5-aryl oxazoline class developed by a team at McNeil in 1962. It is closely related to 4-methylaminorex. Aminorex has been shown to have locomotor stimulant effects, lying midway between dextroamphetamine and methamphetamine...
- AppetiteAppetiteThe appetite is the desire to eat food, felt as hunger. Appetite exists in all higher life-forms, and serves to regulate adequate energy intake to maintain metabolic needs. It is regulated by a close interplay between the digestive tract, adipose tissue and the brain. Decreased desire to eat is...
- ChlorphentermineChlorphentermineChlorphentermine is an appetite suppressant of the phenethylamine class. Developed in 1962, it is the 4-chloro derivative of the better known appetite suppressant phentermine, which is still in current use.Chlorphentermine itself is a relatively weak stimulant with little abuse potential, but is...
- Eating disorderEating disorderEating disorders refer to a group of conditions defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual's physical and mental health. Bulimia nervosa, anorexia nervosa, and binge eating disorder are the most common specific...
- EphedrineEphedrineEphedrine is a sympathomimetic amine commonly used as a stimulant, appetite suppressant, concentration aid, decongestant, and to treat hypotension associated with anaesthesia....
- FenfluramineFenfluramineFenfluramine is a drug that was part of the Fen-Phen anti-obesity medication . Fenfluramine was introduced on the U.S. market in 1973. It is the racemic mixture of two enantiomers, dextrofenfluramine and levofenfluramine...
- KhatKhatKhat, qat, gat or Waquish Spoken from true Yemeni, is a flowering plant native to tropical East Africa and the Arabian Peninsula....
- ObesityObesityObesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
- OrexigenicOrexigenicAn orexigenic is a drug or hormone that increases appetite. This can be a naturally occurring neuropeptide hormone such as ghrelin, orexin or neuropeptide Y, or a medication which increases hunger and therefore enhances food consumption...
- PhenterminePhenterminePhentermine, a contraction of "phenyl-tertiary-butylamine", is a psychostimulant drug of the phenethylamine class, chemically related to amphetamine. It is used medically as an appetite suppressant....
- StimulantStimulantStimulants are psychoactive drugs which induce temporary improvements in either mental or physical function or both. Examples of these kinds of effects may include enhanced alertness, wakefulness, and locomotion, among others...
External links
- Questions and Answers about appetite suppressant medication treatment from the Medical College of WisconsinMedical College of WisconsinMedical College of Wisconsin is a private, freestanding medical school and graduate school located in Milwaukee, Wisconsin, United States. It was formerly affiliated with Marquette University....