Obesity drugs: appetite suppression or satiety?

 

There is often disagreement among researchers and industry participants about the categorization of drugs and devices with regard to affecting satiety or suppressing the appetite. The reason for this is the differing definitions of satiety and appetite suppression. (From a practical standpoint, the mode of action is less significant than whether an obesity drug's side effects are low enough to be acceptable.)

In Mosby’s Medical Dictionary, satiety is defined as ‘a state of being satisfied, as in the feeling of being full after eating,’ while appetite suppression is defined as ‘an agent that diminishes the desire for eating.’ On the other hand, appetite suppressants may be defined as drugs that promote weight loss by decreasing appetite or increasing the sensation of fullness (satiety): hence the confusion. 

Generally:

  • An appetite suppressant is a medication or device which works prior to eating, and decreases the desire to eat. 
  • A drug or device which produces weight loss through satiety works during the eating of a meal and causes the individual to feel full and to therefore stop eating earlier than usual.

By these definitions, there is no prescription satiety drug on the market at this time. NeuroSearch is developing tesofensine, an Appetite Suppressant drug, which this report predicts may be approved for the US market in 2014. Shionogi is also working on an appetite suppression candidate, velneperit (S-2367). Shionogi is aiming for market launch of velneperit in 2016.

Combination drugs are defined as pharmaceuticals consisting of two or more compounds. Frequently this means that each compound has been approved on its own for an indication other than obesity.
 
The primary example of a obesity drug consisting of two or more compounds is Orexigen’s Contrave (naltrexone SR plus bupropion SR). Another is Orexigen’s Empatic, which is a combination of zonisamide SR and bupropion SR.
 

For full review of drugs on the market and in development (and similarly for devices) for the treatment of obesity, see Report #S835 from MedMarket Diligence.
 

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