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6.18.6.1 History

In spite of the large literature on obesity (a PubMed search of the term in 2005 yielded over 78000 references), the history of the pharmacologic treatment of obesity is relatively brief, and the types of agents used have been relatively few. In fact, in the US, as safety concerns grow, the list of compounds approved by the FDA for the treatment of obesity has actually been shrinking.

Perhaps the earliest pharmacologic treatment of obesity that had a scientific basis was the use of thyroid extract, which dates from the late 1800s.4 Also of historical interest was the use of dinitrophenol, which came to be used after the observation in the early 1900s that textile workers lost weight after on-the-job exposure.5 Needless to say, this uncoupler of oxidative phosphorylation was discontinued due to serious side effects.

Table 3 Summary of the FDA and CPMP clinical trials recommendations

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