FOOD ADDICTION (A MEULE, SECTION EDITOR)
Pharmacological Interventions for Obesity: Current and Future Targets
Miriam E. Bocarsly
Published online: 7 May 2018
Springer International Publishing AG, part of Springer Nature 2018
Purpose of Review Obesity in the USA has been on a constant rise since the Center for Disease Control and
Prevention (CDC) began tracking it over 50 years ago. Despite focused attention on this epidemic, pharmacological
treatments aimed at obesity are lacking. Here, we briefly give perspective on the central and peripheral mechanisms
underlying feeding behaviors and describe the existing pharmacological treatments for obesity. With this lens, I
suggest future targets for the treatment of obesity.
Recent Findings Given the development of genetic and molecular tools, understanding of how energy expenditure is modulated
is becoming more nuanced. There is growing evidence for a link between obesity and addiction, which should be utilized in the
development of new pharmacological treatments.
Summary More focus is needed on identifying targets for anti-obesity pharmacology. In doing so, research should include
intensive investigation of the brain’srewardcircuitry.
In the USA, rates of obesity have nearly tripled since the
Center for Disease Control and Prevention (CDC) first
began tracking them in 1960 , with approximately
38% of adults meeting the qualifications for obesity .
It is among the leading causes of preventable, premature
death, due to its high comorbidity with conditions such as
cardiovascular disease, diabetes, some forms of cancer,
and stroke . It has been estimated that obesity accounts
for $150 billion dollars of healthcare costs in the USA ,
as well as the economic burden of lost work days, lower
productivity at work, mortality and permanent disability
. Given the great personal, societal, and economic
burden, obesity has taken center stage as a national health
concern. However, despite focused efforts, obesity rates
remain unaffected in the USA .
Historically, obesity has been considered a lifestyle or
behavioral disorder, and as a result, most treatment has
been reliant on lifestyle changes. However, recent under-
standing points to the complexity of the disease, which
results from a variety of contributing factors, including
behavior, genetics, development, and environment.
Weight loss based on behavioral changes can be difficult
to achieve, and more so to maintain, especially once the
body has undergone adaptive biological responses .
The use of pharmacological agents has been suggested,
in combination with behavioral changes, in individuals
with obesity. However, there are very few pharmacolog-
ical agents available to assist in weight loss efforts.
The control of energy intake and expenditure are com-
plex facets, dependent on bidirectional interactions be-
tween the periphery and the brain. Understanding the
mechanisms that regulate energy balance will allow for
the identification of novel pharmacotherapy targets. The
current review will briefly outline important brain re-
gions and neuronal substrates regulating energy balance,
discuss available pharmacological agents, and suggest
future targets that could provide useful in the treatment
This article is part of the Topical Collection on Food Addiction
* Miriam E. Bocarsly
National Institute on Alcohol Abuse and Alcoholism, NIH Intramural
Research Program, 5625 Fishers Lane, TS-32,
Bethesda, MD 20892-9411, USA
National Institute of General Medical Sciences, NIH Intramural
Research Program, Bethesda, MD, USA
Current Addiction Reports (2018) 5:202–211