An anorectic or anorexic is a drug which reduces appetite, resulting in lower food consumption, leading to

weight loss Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat ( adipose tissue), or lean mass (namely bone mineral deposits, muscle, tendon, and other co ...

. By contrast, an appetite stimulant is referred to as orexigenic. The term is (from the

Greek Greek may refer to: Greece Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group. *Greek language, a branch of the Indo-European language family. **Proto-Greek language, the assumed last common ancestor ...

''ἀν-'' (an-) = "without" and ''ὄρεξις'' (órexis) = "appetite"), and such drugs are also known as anorexigenic, anorexiant, or appetite suppressant.

History

Used on a short-term basis clinically to treat

obesity Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's ...

, some appetite suppressants are also available over-the-counter. Most common natural appetite suppressants are based on ''

Hoodia ''Hoodia'' (; known locally as "ghaap" or "bobbejaanghaap") is a genus of flowering plants in the family Apocynaceae, under the subfamily Asclepiadoideae, native to Southern Africa. One species of ''Hoodia'' in particular, ''Hoodia gordonii'', ...

'', a genus of 13 species in the flowering plant family Apocynaceae, under the subfamily Asclepiadoideae. 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 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. Fucoxanthin absorbs light primarily in the blue-green ...

, found naturally in seaweed. Drugs of this class are frequently stimulants of the phenethylamine family, related to amphetamine. The German and

Finnish Finnish may refer to: * Something or someone from, or related to Finland * Culture of Finland * Finnish people or Finns, the primary ethnic group in Finland * Finnish language, the national language of the Finnish people * Finnish cuisine See also ...

:fi:Pervitiini militaries issued amphetamines to soldiers commonly to enhance warfare during the

Second World War World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposi ...

. 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 because of safety issues. Many amphetamines produce side effects, including

addiction Addiction is a neuropsychological disorder characterized by a persistent and intense urge to engage in certain behaviors, one of which is the usage of a drug, despite substantial harm and other negative consequences. Repetitive drug use o ...

tachycardia Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal ( ...

and hypertension, making prolonged unsupervised use dangerous.

Public health concerns

Epidemic An epidemic (from Greek ἐπί ''epi'' "upon or above" and δῆμος ''demos'' "people") is the rapid spread of disease to a large number of patients among a given population within an area in a short period of time. Epidemics of infectious ...

s of fatal pulmonary hypertension and

heart valve A heart valve is a one-way valve that allows blood to flow in one direction through the chambers of the heart. Four valves are usually present in a mammalian heart and together they determine the pathway of blood flow through the heart. A heart ...

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 Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ...

stroke led the

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...

(FDA) to request its withdrawal from the market in the United States in 2000, and similar concerns regarding

ephedrine Ephedrine is a central nervous system (CNS) stimulant that is often used to prevent low blood pressure during anesthesia. It has also been used for asthma, narcolepsy, and obesity but is not the preferred treatment. It is of unclear benefit in ...

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 health concerns with the ingredient as such.

Non-pharmacological alternatives

Weight loss effects of water have been subject to some scientific research as a potential non-pharmacological approach. Drinking water prior to each meal may help in appetite suppression. Consumption of 500 mL (approximately 17 fl oz) of water 30 minutes before meals has been correlated with modest weight loss (1–2 kg) in obese men and women over a period of 8 to 12 weeks.

List of anorectics

Numerous pharmaceutical compounds are marketed as appetite suppressants. The following drugs are listed as "centrally-acting antiobesity preparations" in the

Anatomical Therapeutic Chemical Classification System The Anatomical Therapeutic Chemical (ATC) Classification System is a drug classification system that classifies the active ingredients of drugs according to the organ or system on which they act and their therapeutic, pharmacological and chemic ...

: * Amfepramone (also known as diethylpropion) * Bupropion and

naltrexone Naltrexone, sold under the brand name Revia among others, is a medication primarily used to manage alcohol or opioid use disorder by reducing cravings and feelings of euphoria associated with substance use disorder. It has also been foun ...

(combination) * Cathine * Clobenzorex * Dexfenfluramine^† (the D-enantiomer of fenfluramine; withdrawn for the same reason as its racemate) *

Ephedrine Ephedrine is a central nervous system (CNS) stimulant that is often used to prevent low blood pressure during anesthesia. It has also been used for asthma, narcolepsy, and obesity but is not the preferred treatment. It is of unclear benefit in ...

(combinations) * Etilamfetamine * Fenfluramine^† (one of the two components he other being phentermineof Fen-phen. Since discontinued to its potential for causing valvulopathies and pulmonary hypertension) *

Lorcaserin Lorcaserin, marketed under the brand name Belviq was a weight-loss drug developed by Arena Pharmaceuticals. It reduces appetite by activating a type of serotonin receptor known as the 5-HT2C receptor in a region of the brain called the hypotha ...

(withdrawn in the United States by the FDA due to an increased risk of cancer) * Mazindol * Mefenorex *

Phentermine Phentermine ( phenyl- tertiary-butyl amine), with several brand names including Ionamin and Sentis, is a medication used together with diet and exercise to treat obesity. It is taken by mouth for up to a few weeks at a time, after which the ben ...

* Sibutramine^† (in some countries withdrawn from the market because of concerns regarding its cardiovascular effects) * Topiramate The following are listed as appetite depressants by

MeSH A mesh is a barrier made of connected strands of metal, fiber, or other flexible or ductile materials. A mesh is similar to a web or a net in that it has many attached or woven strands. Types * A plastic mesh may be extruded, oriented, exp ...

, an index of medical journal articles and books. * Benfluorex (removed from the market by the EMA due to increased risk of heart disease) *

Butenolide Butenolides are a class of lactones with a four-carbon heterocyclic ring structure.Joule JA, Mills K. (2000). Heterocyclic Chemistry 4th ed. Blackwell Science Publishing: Oxford, UK They are sometimes considered oxidized derivatives of furan. The ...

* Diethylpropion *

FG-7142 FG-7142 (ZK-31906) is a drug which acts as a partial inverse agonist at the benzodiazepine allosteric site of the GABAA receptor. It has anorectic, anxiogenic and pro-convulsant effects. It also increases release of acetylcholine and noradrenalin ...

* Phenmetrazine^† (withdrawn in some countries due to the danger of addiction) *

* Phenylpropanolamine * Pyroglutamyl-histidyl-glycine * Sibutramine Other compounds with known appetite suppressant activity include: * Amphetamine-Dextroamphetamine is known to hamper appetite. Amphetamine-Dextroamphetamine is used to treat Attention deficit hyperactivity disorder (ADHD) and is usually under the trade name "Adderall" or "Mydayis". * Amphetamine sulfate (also known as amfetamine) –

US FDA The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food s ...

-approved for the treatment of exogenous obesity under the brand name "Evekeo". *

Methylphenidate Methylphenidate, sold under the brand names Ritalin and Concerta among others, is the most widely prescribed central nervous system (CNS) stimulant medication used to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser exten ...

Cocaine Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Ameri ...

Caffeine Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class. It is mainly used recreationally as a cognitive enhancer, increasing alertness and attentional performance. Caffeine acts by blocking binding of adenosine to ...

Glucomannan Glucomannan is a water-soluble polysaccharide that is considered a dietary fiber. It is a hemicellulose component in the cell walls of some plant species. Glucomannan is a food additive used as an emulsifier and thickener. It is a major source o ...

* Leptin * Methamphetamine hydrochloride – USFDA-approved for the treatment of obesity (as a short-term) under the brand name "Desoxyn". *

Nicotine Nicotine is a natural product, naturally produced alkaloid in the nightshade family of plants (most predominantly in tobacco and ''Duboisia hopwoodii'') and is widely used recreational drug use, recreationally as a stimulant and anxiolytic. As ...

* Liraglutide as brand name Saxenda * Semaglutide (brand name Ozempic/Wegovy)

GLP-1 Glucagon-like peptide-1 (GLP-1) is a 30- or 31-amino-acid-long peptide hormone deriving from the tissue-specific posttranslational processing of the proglucagon peptide. It is produced and secreted by intestinal enteroendocrine L-cells and certa ...

agonist *

Opiates An opiate, in classical pharmacology, is a substance derived from opium. In more modern usage, the term ''opioid'' is used to designate all substances, both natural and synthetic, that bind to opioid receptors in the brain (including antagonist ...

/ opioids such as heroin,

morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a pain medication, and is also commonly used recreationally, or to make other illicit opioids. T ...

, codeine,

oxycodone Oxycodone, sold under various brand names such as Roxicodone and OxyContin (which is the extended release form), is a strong, semi-synthetic opioid used medically for treatment of moderate to severe pain. It is highly addictive and a commonly ...

fentanyl Fentanyl, also spelled fentanil, is a very potent synthetic opioid used as a pain medication. Together with other drugs, fentanyl is used for anesthesia. It is also used illicitly as a recreational drug, sometimes mixed with heroin, cocain ...

, etc.

References

External links

* * {{Authority control