orlistat and Substance-Related-Disorders

Abuse of widely available, over-the-counter drugs and supplements such as laxatives and diet pills for weight control by youths is well documented in the epidemiological literature. Many such products are not medically recommended for healthy weight control or are especially susceptible to abuse, and their misuse can result in serious health consequences. We analyzed the government's role in regulating these products to protect public health. We examined federal and state regulatory authority, and referred to international examples to inform our analysis. Several legal interventions are indicated to protect youths, including increased warnings and restrictions on access through behind-the-counter placement or age verification. We suggest future directions for governments internationally to address this pervasive public health problem.

Topics: Adolescent; Anti-Obesity Agents; Behind-the-Counter Drugs; Drug and Narcotic Control; Female; Health Planning Guidelines; Humans; Lactones; Laxatives; Male; Nonprescription Drugs; Orlistat; Overweight; Pilot Projects; Substance-Related Disorders; United States; United States Food and Drug Administration

Rates of pediatric obesity have increased dramatically over the past decade. This trend is especially alarming because obesity is associated with significant medical and psychosocial consequences. It may contribute to cardiovascular, metabolic, and hepatic complications, as well as to psychiatric difficulties. The development of obesity appears to be influenced by a complex array of genetic, metabolic, and neural frameworks, along with behavior, eating habits, and physical activity. Numerous parallels exist between obesity and addictive behaviors, including genetic predisposition, personality, environmental risk factors, and common neurobiological pathways in the brain. Typical treatments for pediatric obesity include behavioral interventions targeting diet or exercise. These treatments have yielded mixed results and typically have been examined in specialty clinic populations, limiting their generalizability. There are limited medication options for overweight children and adolescents, and no approved medical intervention in children younger than 16 years old. Bariatric surgery may be an option for some adolescents, but due to the risks of surgery, it is often seen as a last resort. The parallels between addiction and obesity aid in developing novel interventions for pediatric obesity. Motivational enhancement and cognitive-behavioral strategies used in addiction treatment may prove to be beneficial.

Topics: Adolescent; Anti-Obesity Agents; Appetite Depressants; Bariatric Surgery; Behavior Therapy; Child; Cognitive Behavioral Therapy; Cross-Sectional Studies; Diet, Reducing; Exercise; Humans; Hypoglycemic Agents; Lactones; Metformin; Motivation; Obesity; Orlistat; Prognosis; Risk Factors; Substance-Related Disorders

Topics: Anti-Obesity Agents; Bulimia; Comorbidity; Female; Humans; Lactones; Middle Aged; Orlistat; Substance-Related Disorders