Present and future pharmacological approaches.

There is evidence that drugs altering food intake such as dexfenfluramine, sibutramine and orlistat have useful therapeutic effects, with an acceptable side effect profile. 'Thermogenic' drugs, such as ephedrine and caffeine, are also effective, but less well tolerated and may, in any case, work by producing anorexia. The state of drug treatment for obesity now is similar to the early days of antihypertensive treatment in the 1960s when reserpine, ganglion blockers and nonselective adrenergic blocker were all that was available. There is considerable reason for optimism that the next 10 years will bring better treatments for the obese.