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In recent years, the increase in obesity in the world has led to the development of new strategies in combating obesity. In the present study, it was aimed to investigate the effect of niacin and melatonin supplements to combat obesity in rats as a model organism. Treadmill exercise was performed on rats after niacin and melatonin supplementation for 10 days. In each group, weight loss was observed at the end of the 10 days exercise. In this study, it was observed that niacin supplementation leading to weight loss in rats that had treadmill exercise when compared to the control group. In addition, it was found that the weight loss observed in melatonin+niacin supplement was higher than niacin supplement only. It was found that the weight loss observed in the group given melatonin+niacin supplement was higher than the weight loss observed in niacin supplement only. As a result, niacin and melatonin supplementation can be recommended before exercise to combat obesity.

Obesity is a global health problem. In the past decades, the prevalence rate of obesity has risen sharply in epidemiology. Obesity has become an increasingly severe epidemic burden linked with diff...

Background: Obesity is one of the most serious problems worldwide. Using anti-obesity medications have gained growing interest among adults as a shortcut for bodyweight management practice. This study aimed to determine the prevalence, knowledge, usage determinants, intake pattern and experienced effects of anti-obesity medications, licensed and unlicensed, among university students in Jordan. Materials and Methods: A cross-sectional study was conducted using a structured web-based questionnaire. Univariate and multivariate logistic regression analyses were used. Results: 418 students with a mean age of 21.5 responded to the questionnaire. The prevalence of anti-obesity medication intake was 11%. The majority (67.2%) had scored poor knowledge regarding these medications. The intake patterns indicated that 78.3% of the consumers were self-administrated without prescription and 76.1% of the consumers used licensed type. Despite being perceived as useful in weight reduction, vomiting, and nausea, were very common adverse events (65.2%). Besides being obese, students with excellent knowledge demonstrated higher odds (OR=24.38 (95%CI: 8.12-73.19) and 10.48 (95%CI: 4.03-27.26), respectively) for medication consumption compared with other, p < 0.0005. Conclusion: Using anti-obesity medications among university students is of concern, particularly due to using unlicensed types and the lack of clinical prescription. With the reported poor knowledge, it becomes crucial to launching awareness campaigns and tailored programs for this age group and the general population.

Obesity, a disease involved with complex health problems, is indicated by increased BMI, triglyceride and cholesterol levels. Obese individuals are found to be highly susceptible to develop non-alcoholic fatty liver disease,cardiovascular diseases, and also type 2 diabetes mellitus. Synthetic drugs used for treating obesity have been found to be associated with side effects such as anxiety,sleeplessness,hypertension, and drug addiction. Research on natural productspossessing therapeutic biological activitieshasdiscoveredtheir potential to minimize or even completely eliminate such side effects. Medicinal properties ofCalocybe indica include antidiabetic, hypertensive, anticancer, anti-inflammatory, antibacterial, and hepatoprotective effects; however, its anti-obesity activity is obscure.In this study, the anti-obesity effects of Calocybe indicawere investigated using a diet-induced obese Zebrafish modeland compared with standard drug Atorvastatin.Results show that 200µg of C. indica was able to effectively bring down triglyceride levels (12.5± 0 mg/ml; normal control 12.7 ± 0.7 mg/ml), cholesterol (210± 15.9 mg; normal control =70.4± 0)and HMG COA Reductase levels (0.9± 0.03; normal = 1.2 ± 0.01). Excessive fat accumulation in the liver (steatohepatitis) reduced after treatment with C. indica to a greater extent than by treatment with standard drug Atorvastatin. 100 µg of C. indica was found to be optimum in decreasing the levels of the liver enzymes, AST (177.1±5.7 IU/L; normal control =177.7±43.02 IU/l), ALT (365.5±2.9 IU/L; normal control= 355.5±34.4 IU/l), and ALP (2.3±1.1μmoles of phenol liberated/mg of protein/min; normal control = 0.7±1.2 μmoles of phenol liberated/mg of protein/min).Whole-body Oil Red O staining of the zebrafishes showed that with increasing concentration of C. indica, the accumulation of triglycerides and lipids decreased.

Background: Aloe Vera, a medicinal herb, has been used for centuries in therapeutics and cosmetology. Objective: To compare Antiobesity effects of Aloe Vera whole leaf with new antidiabetic drug, Sitagliptin on streptozotcin induced diabetic rats. Study Design: Randomized Control Trial. Settings: Department of Pharmacology, Islamic International Medical College, Rawalpindi in collaboration with NIH, Islamabad, Pakistan. Duration: One year from September 2019 to August 2020. Methodology: Young Sprague Dawley rats, n=40, weighing 220-250 grams were taken and randomly divided into Groups A and B. Group B was fed on high fat diet for two weeks to develop insulin resistance. After induction of diabetes, with low dose streptozotocin, Group B was subdivided into: GroupB1 (Diabetic Control), Group B2 (Aloe Vera whole Leaf treated), Group B3 (Sitagliptin treated). Body weight was measured in all rats every week to assess progress of study, and finally on completion of study (on Day 60). SPSS version 25 was applied for statistical analysis. One-way ANOVA test was used for assessing any difference in the mean values. Post-hoc Turkey analysis was done to compare inter-group mean differences. P value of

Background : Obesity has become a global issue, leading to increased risk of metabolic syndrome, which encompasses diabetes, cardiovascular disease, stroke, hypertension, and certain cancers. However, obesity is difficult to control through diet and exercise alone, as they are difficult to implement. Objective: The objective of this review is to elucidate the active constituents that can be obtained from various natural sources that act as anti-obesity agents. Due to the global rise in the prevalence of obesity, an urgent need to prevent and control it has arisen. Methods: For this review, we compiled information about natural anti-obesity products through an electronic search of the articles available via PubMed, Scopus, and other internet sources for the period 1975-2019 and included our own research. We analyzed and organized data on various natural products in popular use in addition to relevant pharmacognostic and biological studies. The products’ mechanisms of action were also investigated. Conclusion: Consumption of diets that include high amounts of active anti-obesity natural compounds is a promising strategy for the suppression of lipid accumulation and adipogenesis in obese individuals.

ObjectiveTo review for Canadian physicians the latest pharmacological options for obesity management. Quality of EvidenceA literature search was conducted in PubMed with no time restriction. Canadian and international guidelines referenced. National and international statistics databases quoted for epidemiological data. Levels of evidence range from I to III. Main MessageAs a chronic progressive disease affecting over 7.2 million Canadians, obesity requires early identification and treatment by primary care practitioners. Three anti-obesity medications are approved for use in Canada under the tradenames Xenical®, Saxenda®, and Contrave® which help bridge the gap between non-pharmacological and surgical options for the treatment of obesity. Family physicians are front-line members of the obesity management team and should remain updated on the pharmacological options for weight management. ConclusionAnti-obesity medications lead to greater average weight loss when combined with behavior modifications and provide individuals with excess weight a sustainable option for obesity management. RESUMEObjectifExaminer, à l’intention des médecins canadiens, les dernières options pharmacologiques pour la gestion de l’obésité. Qualité des preuvesUne recherche documentaire a été effectuée dans PubMed sans restriction de temps. Les lignes directrices canadiennes et internationales sont référencées. Bases de données statistiques nationales et internationales citées pour les données épidémiologiques. Les niveaux de preuve vont de I à III. Message principal En tant que maladie chronique progressive touchant plus de 7,2 millions de Canadiens, l’obésité nécessite un dépistage et un traitement précoces par les praticiens de soins primaires. Trois médicaments contre l’obésité sont approuvés au Canada sous les noms commerciaux Xenical®, Saxenda® et Contrave®, qui aident à combler le fossé entre les options non pharmacologiques et chirurgicales pour le traitement de l’obésité. Les médecins de famille sont des membres de première ligne de l’équipe de gestion de l’obésité et doivent se tenir au courant des options pharmacologiques pour la gestion du poids. ConclusionLes médicaments contre l’obésité entraînent une perte de poids moyenne plus importante lorsqu’ils sont associés à des modifications du comportement et offrent aux personnes en surpoids une option durable pour la gestion de l’obésité.

Objectives: The aim of this study is to evaluate the anti-obesity, anti-hyperglycaemic, analgesic and antipyretic activities of Globularia alypum (GA).Materials and methods: GA methanol and water e...

Background and objectives A drug repurposing strategy is an approach for identifying new therapeutic uses for approved or investigational drugs. Thanks to the moderate cost of repurposing a drug compared to bringing new chemical entity to the market, drug repurposing is rapidly gaining ground. The aim of this work is to study the anti-obesity effect of disulfiram (DSF), an irreversible aldehyde dehydrogenase inhibitor approved by the Food and Drug Administration (FDA) to treat chronic alcoholism since 1951. Methods Thirty male Albino rats were randomly assigned to six groups. G1, the control group, was given a standard diet. G2, the positive control group, was given a high-fat diet (HFD). G3 was given an HFD, and DSF 50 mg/kg/day was administered orally from day one for six weeks. G4 was given an HFD, and DSF 200 mg/kg/day was administered orally from day one for six weeks. G5 was given an HFD for six weeks; then treatment started with 50 mg/kg/day DSF orally. G6 was given an HFD for six weeks; then treatment started with 200 mg/kg/day DSF orally for three weeks. The body weight, food consumption and blood glucose levels were monitored over the given time interval. Results Both doses of DSF significantly limited the body weight gain caused by an HFD for the treated animals. HF-fed rats received 50 and 200 mg/kg/day of DSF had their body weight increased by 51.93 ± 7.89% and 20.88 ± 15.05% respectively, whereas the body weight of control animals increased by 93.1 ± 20.04%. DSF also significantly decreased the body weight of obese animals. At 50 and 200 mg/kg/day of DSF, HF-fed rats lost 16.74 ± 8.61% and 23.9 ± 3.93% respectively, as their untreated counterparts had their body weight increased by 11.85 ± 3.79% after three weeks of treatment, thus restoring a body weight matching those who received a standard diet. Conclusion FDA-approved disulfiram has a strong anti-obesity effect on HFD-fed rats.

Objective: To evaluate anti-obesity effect of aqueous P. nigrum extract in a murine model of high-fat diet (HFD) induced obesity. Methods: Male Wistar rats were fed with a high-fat diet (HFD) (20g/day/rat) for a period of 50 d to induce obesity. Aqueous P. nigrum extract (20 mg/kg) administered orally to high-fat diet (HFD) fed rats from 8th day to 50th day (total 42 d). The parameters like gain in body weight, serum lipids, insulin and leptin were measured. Results: The rats treated with extract showed a significant reduction in body weight gain, serum insulin, leptin, lipids as compared to rats fed with only a high-fat diet (HFD). In addition, the extract-treated group showed a considerable rise in high-density lipoprotein (HDL-C) level (29.61±7.68 mg/dl) as compared to the control group (23.23±9.69 mg/dl). Conclusion: The results indicate that aqueous P. nigrum extract possess the potential to reduce obesity markers in a high-fat diet (HFD) fed rats.

Summary Objective In shared medical appointments (SMAs), multiple patients with a similar clinical diagnosis are seen by a multidisciplinary team for interactive group sessions. Very few studies have specifically studied SMAs and weight loss in patients with obesity. This study compared weight loss outcomes and anti‐obesity medication (AOM) access between patients with obesity managed through (SMAs) versus individual appointments. Methods Retrospective study of adults seen for obesity between September 2014 and February 2017 at Cleveland Clinic Institute of Endocrinology and Metabolism. Percent weight loss from baseline was compared between two propensity score‐matched populations: patients who attended ≥1 SMA and patients managed with individual medical appointments. Results From all eligible patients identified (n=310 SMA, n=1,993 non‐SMA), 301 matched pairs were evaluated for weight loss. The SMA group (n=301) lost a mean of 4.2%, 5.2% and 3.8% of baseline weight over 6, 12 and 24 months; the non‐SMA group (n=301) lost significantly less weight (1.5%, 1.8% and 1.6%, respectively) (paired t‐test, P

Background: The medical and social impact of being overweight, as well as the difficulty in making long-term changes in diet, physical activity, and pitfalls associated with allopathic management, lure obese individuals to over-the-counter weight-loss herbal products (WHPs). However, the safety of herbals is questionable, as reports from all over the world suggest adulteration with synthetic weight loss agents. Objective: The present study was carried out to develop a rapid and sensitive method to screen potential weight loss adulterants in WHPs. Methodology: We procured 33 licensed brands of WHPs that are available in Puducherry (India) and through web stores. Drug-free spiked herbal matrices were used for internal proficiency testing. Spiked herbal matrices and samples were extracted and centrifuged. The supernatant was collected and subjected to liquid chromatography–tandem mass spectrometry analyses. Isocratic elution was carried out by the mobile phase of methanol: 0.1% v/v formic acid (70%:30% v/v) through a C18 column. Analytes were monitored in electrospray ionization positive and negative modes, and an multiple reaction monitoring (MRM) scan was used. Results: Run time was 12 min. Intra- and inter-day precision was < 15% and recoveries were in the range of 99% to 115%. Limit of quantification (LOQ) of the analytes were in the range of 0.1 to 0.3 ng/ml. Conclusion: We developed a sensitive and rapid validated method for the detection of potential adulterants in WHPs. None of the WHPs analyzed were found to contain adulterants. The proposed method will be useful for routine monitoring. WHPs analyzed in this study were not adulterated indicating that WHPs from licensed sources are reliable.

Background: Healthcare disparities associated with race/ethnicity and low English proficiency are well established in the US. We sought to determine if there are race/ethnic differences in anti-obesity medication prescription rates among youth with severe obesity (body mass index (BMI) ≥1.2 times the 95th percentile and/or BMI ≥35 kg/m2) treated in a pediatric weight management clinic (PWMC). We secondarily sought to determine if, among youth from families in whom English was not the primary language, there are differences in prescription rates between those using an interpreter during visits and those not. Methods: We reviewed electronic health records of youth 2–18 years old with severe obesity seen at a PWMC from 2012–2020. Race/ethnicity was self-reported and categorized as Non-Hispanic White (NHW), Hispanic/Latino, Non-Hispanic Black (NHB), Asian, American Indian/Alaska Native and Mixed. Anti-obesity medicines included stimulants (i.e. phentermine, lisdexamfetamine), topiramate, naltrexone (± bupropion), and glucagon-like peptide-1 agonists. We used Poisson regression models with robust standard errors to compare incidence rates of medicine prescription (incidence rate ratio (IRR), accounting for visit frequency) within the first 1 and 3 years of being followed in a PWMC. We controlled for age, baseline degree of obesity (percent of the 95th BMI percentile (%BMIp95)), number of obesity-related comorbidities (i.e. insulin resistance, hypertension, fatty liver), area-level socioeconomic status (median household income based on ZIP code), and interpreter use. We repeated similar analyses among families in whom English was not the primary language, comparing those using an interpreter with those not. Results: From 2012–2020, 1258 youth (mean age 11.8 years; %BMIp95 143%) were seen in our PWMC (57% NHW, 19% Hispanic/Latino, 16% NHB) of which 26% were prescribed anti-obesity medication. 86% primarily spoke English and 5.2% used an interpreter. There were no statistically significant differences in the IRR of prescriptions by race/ethnicity at 1 and 3 years; however, although not statistically significant point estimates suggest Hispanic/Latino youth being prescribed medication less often at 1 (IRR 0.71; p=0.08) and 3 (IRR 0.75; p=0.13) years compared to NHW. Among non-primary English speakers, rates of prescriptions were higher at 1 (IRR 5.7; p Conclusions: We found no significant race/ethnic differences in anti-obesity medication prescriptions; however, Hispanic/Latino youth received fewer prescriptions, albeit not statistically significant. Among non-primary English speakers, use of an interpreter was associated with increased prescriptions. Our results suggest that addressing healthcare disparities and language barriers may improve care delivery for youth with obesity.

Obesity has an important influence on health conditions, causing a multitude of complications and comorbidities, and drug therapy is considered to be one of the treatment strategies. Nowadays, there is increasing interest in the study of intestinal microbiota regulation of obesity; also, an increasing number of agricultural and sideline products have been found to have anti-obesity potential. In the present review, we summarize an overview of current known and potential anti-obesity oligosaccharides and their molecular structures. We describe their anti-obesity potential activity and the molecular structure associated with this activity, the regulation of intestinal microbiota composition and its mechanism of action, including regulation of the short-chain fatty acid (SCFA) pathway and altering bile acid (BA) pathway. This review will provide new ideas for us to develop new anti-obesity functional foods.

Over the last 5 years, the Korean Ministry of Food and Drug Safety has approved four anti-obesity drugs for long-term weight management. In this review, the mechanisms of action and clinical applications of lorcaserin, naltrexone/bupropion, liraglutide, and phentermine/topiramate have been clarified. Lorcaserin stimulates proopiomelanocortin/cocaine- and amphetamine-regulated transcript neurons in the arcuate nucleus. Naltrexone/bupropion reduces body weight by controlling the hedonic reward system of food intake. The hypophagic effect of liraglutide depends on the direct activation of the proopiomelanocortin/cocaine- and amphetamine-regulated transcript neurons and indirect suppression of neuropeptide Y/agouti-related peptide neurons through gammaaminobutyric acid-dependent signaling, with an additional thermogenic effect. Phentermine/topiramate induces weight loss by elevating the norepinephrine levels in the hypothalamus, reducing energy deposition in the adipose tissue and skeletal muscle, and elevating the corticotropin-releasing hormone in the hypothalamus. In patients with high cardiovascular risks or type 2 diabetes mellitus, lorcaserin and liraglutide are appropriate. In patients with mood disorders, naltrexone/bupropion could be considered as the first choice of therapy. Notably, lorcaserin and liraglutide are neutral in the aspect of sleep disorder. In case of obese individuals with obstructive sleep apnea, liraglutide or phentermine/topiramate would be selected as the treatment option. These four drugs should be used after considering the patients' co-morbidities of obesity.

In the present study, we investigated a saponin-enriched fraction from Gynostemma pentaphyllum extract (GPE) and isolated gypenoside L (GL), gypenoside LI (GLI), and ginsenoside Rg3 (Rg3). To explore the anti-obesity activities of these compounds, we investigated the effects of GL, GLI, and Rg3 on glucose uptake and activation of AMPK in L6 skeletal muscle cells. GPE, GL, GLI, and Rg3 markedly increased glucose uptake activity and GLUT4 gene expression in L6 myotubes. The enhanced glucose uptake was mediated by the activation of the AMPK-ACC signaling pathway. In addition, we observed that GPE, GL, GLI, and Rg3 increased the expression of SIRT1 and PPARγ coacvtivator-1α (PGC-1α). Our results suggest the potential use of Gynostemma pentaphyllum in developing a therapeutic agent to reduce body weight and prevent diet-related diseases via glucose uptake and AMPK activation.

BackgroundResearches and publication discussing performance of medicinal plants as anti-obesity have proliferated in recent years. In the view of ethnopharmacology, empiric evidence of Indonesian medicinal plants in management of obesity is widely accepted. In attempt to find anti-obesity agent, it is evidenced that the disorder can be resolved through inhibition of pancreatic lipase since the mechanism allowed to retard absorption of fat into cells. This current work aimed to screen Indonesian medicinal plants by using ethnopharmacology and meta-analysis approaches, emphasizing their ability to deal with obesity via pancreatic lipase inhibition. MethodsThe study followed two stages, i.e. systematic review and meta-analysis. Data from 6 scientific (Scopus, Science Direct, Proquest, Ebsco, Cengage Library and Emerald) were collected, screened according to inclusion and exclusion criteria. The eligibility of the trials was determined according to criteria as follows: (1) design for lipase inhibition experiments; (2) population in all researches using in vitro protocols for antiobesity in last 10 years; (3) intervention for comparison between lipase inhibition IC50 properties of selected medicinal plants and orlistat; and (4) data adequacy enabling to estimate the standardized mean difference (SMD) and the corresponding 95% confidence interval (CI). Further, all published papers we reviewed were written in English. Furthermore, steps of meta-analysis were performed on the selected data. Extraction of data in these articles collected number of samples, average values and standard deviation of IC50. The values focused on IC50 of samples in inhibiting lipase activities performed by plant extracts and orlistat as control. ResultA total 10 selected data meet the inclusion criteria. Morever these plant can be found and common as traditional medicine plant in Indonesia ConclusionAs the results, there were top 10 anti-obesity medicinal plants as follows: i.e. kelor (Moringa oleifera) leaves, kemangi (Ocimum basilicum) leaves, asam jawa (Tamarindus indica) leaves, asam gelugur (Garcinia atroviridis) fruit, lengkuas (Alpinia galanga) rhizome, and kencur (Kaempferia galanga) rhizome, kumis kucing (Orthosipon aristatus) leaves, jambu biji leaves (Psidium guajava leavaes), serai wangi (Cymbopogon nardus) and kayu secang (Caesalpinia sappan).

Introduction: Current health trends indicate that the rate of incidence of obesity has risen considerably. According to the World Health Organization (WHO) report 2017, the issue of obesity has grown to an epidemic proportion, with over 4 million people dying every year. Orlistat, a potent pancreatic lipase (PL) inhibitor for long-term treatment of obesity has been recently reported to cause hepatic and renal toxicities. Hence, there is a need to develop newer, safer and efficacious therapeutics that targets obesity and its associated disorders.Areas covered: The present article attempts to review patents on compositions of natural origin that include either combination of two or more lead NPs/whole extract(s)/ mixture of one or more NPs/extracts from various plants and micro-organisms. Patents that were granted during the period 2010 to 2021 have been considered.Expert opinion: The article highlights the recent trends in the rise of the global obesity population. Patents are classified based on the mechanism of action of extracts/NPs. It has been observed that in the years 2013, 2017 and 2019 maximum number of patents from China, South Korea, United States and Japan have been filed for the anti-obesity compositions.

Summary Objective This retrospective study aimed to evaluate the impact of anti‐obesity medication (AOM) initiation, usage and duration on weight loss in a 72‐week precision obesity programme. The type of AOM, diet and exercise plan was chosen based upon an individual's biological and psychosocial needs. The 72‐week study duration allowed for a fair investigation of the downstream impact of delayed versus early AOM initiation. Methods Participants, aged ≥18 years with body mass index ≥30 kg m−2, enrolled from 1 March 2015 to 1 April 2017, were included. Subgroups were assigned by AOM usage (users versus non‐users, early [before 8 weeks] versus delayed [after 8 weeks] AOM initiation and short [5% weight loss (P = 0.006). A higher proportion of users lost ≥15% of weight (45.1% vs. 19.0%; P < 0.001). Mean percentage reduction in weight was greater for early versus delayed starters (−17.60 ± 5.3% vs. −13.95 ± 5.5%; P = 0.024), and longer AOM usage trended towards increased weight loss. Conclusion Early initiation of AOM may enhance weight loss.

Introduction: Obesity is a global pandemic and new pharmacotherapies which combine weight loss efficacy, long-term safety, and reversal of metabolic co-morbidities are sorely needed. Gut hormones p...

Present meta-analysis investigates the effects of phytosterols and phytostanol (PS) supplementation on anthropometric indices, using data from randomized controlled trials. We performed a systematic search in the databases: PubMed, Scopus, Cochran, and Web of Science. Weighted mean difference (WMD) with 95% confidence intervals (CIs) were presented. Overall, 79 randomized controlled trials investigated the effects of PS on anthropometric indices. Meta-analysis results did not reveal any significant effect of PS supplementation on weight (66 trials-WMD: -0.083 kg; CI [-0.233, 0.066]; I2 = 42.5%), percentage fat mass (6 trials-WMD: -0.090%; CI [-0.789, 0.610]; I2 = 0.0%), and waist circumference (WC; 5 trials-WMD: -0.039 cm; CI [-0.452, 0.374]; I2 = 0.0%). However, body mass index (BMI) significantly decreased after PS supplementation (39 trials-WMD: -0.063 kg/m2, p = 0.024, I2 = 25.1%). Subgroup analyses showed that PS supplementation in subjects with baseline BMI ≥25 and hyperlipidemic significantly decreased body weight and BMI. The overall results showed that although PS supplementation did not affect anthropometric indices (except BMI), baseline status regarding BMI and hyperlipidemia and also dose and duration could be contributing factors for favorable effects.

The incidence of obesity has been increasing dramatically worldwide over the past decades, thus requiring novel and effective therapeutic approaches. OBEX is an oral nutritional supplement composed of antioxidants with antiobesity activity. The effects of OBEX have been tested in vivo and in vitro. In vivo, OBEX reduces weight gain by decreasing adiposity gain and increasing energy expenditure in high fat diet-fed mice through the activation of thermogenesis in brown adipose tissue (BAT) independent of eating behaviors. In vitro analysis with 3T3-F442A cells revealed anti-proliferative and anti-differentiation effects of OBEX. In addition, OBEX induced a clear reduction of the lipid load in mature adipocytes obtained from 3T3-F442A cells. Overall, our findings suggest that OBEX has a protective effect against an obesogenic environment This work has been partially supported by Catalysis S.L., CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn) (Grant CB06/0003 to F.F.C.), an initiative of the Instituto de Salud Carlos III of Spain which is supported by the regional development funding program (FEDER), Xunta de Galicia (Grant GRC2014/034 to F.F.C.), Instituto de SaludCaros III (Grant PI17/01287 to F.F.C.). AGIand M.C.C. are researchers under CIBERobn contracts. A.B.C. is a researcher funded by Fundación Ramón Domínguez SI

Background: Galacto-oligosaccharides (GOS) is a commonly used as a prebiotic with a variety of metabolic benefits. Whether GOS plays a protective role in obesity is still unknown. Here we demonstrated that GOS possesses an anti-obesity activity by promoting adipose tissue browning and thermogenesis. Results: Our results showed that GOS effectively slow weight gain of diet-induced obese (DIO) rats without affecting energy intake. GOS significantly suppressed the hypertrophy and hyperplasia of white adipose tissue (WAT), as well as markedly lessened the ratio of fat pad to fat body. Consistently, GOS significantly improved serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels, which indicated an appropriate weight loss activity of GOS. Interestingly, GOS also significantly increased the expression levels of browning proteins (UCP1, PPARγ, PGC1α and PRMD16) both in the WAT and brown adipose tissue (BAT). We further found that GOS markedly increased the expression levels of LXRα, PPARα, LDLR and CYP7A1 proteins in the liver of obese rats. Conclusions: Taken together, we concluded that GOS inhibits obesity by accelerating the browning of white fat cells and the thermogenesis of brown fat cells, moreover GOS improves host lipid homeostasis by promoting cholesterol catabolism.

Over the past few decades, several anti-obesity medications have demonstrated an association with adverse cardiovascular outcomes, leading to their market withdrawal. This has caused researchers to investigate the cardiovascular safety of such medications in cardiovascular outcome trials. However, the data from these trials are limited, and their outcomes are not promising. Therefore, the aim of this review is to provide an overview of the current and past Food and Drug Administration-approved medications for weight loss, including novel diabetes medications (glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter-2 inhibitors) and non-diabetes medications, and to highlight the current designs of cardiovascular outcome trials and their importance in the evaluation of the overall safety concerns associated with these anti-obesity medications. The limitations of the trials and opportunities for improvement were also evaluated. Finally, we also briefly describe cardiovascular safety and risks in this review.