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Because of the limited ef cacy and the side-effects of the current medication, the pharmacotherapy of obesity is problematic On the other hand, many patients ask for medication as they have often had poor results with energy-restricted diets Also they are often frustrated by the quick return to their original body weight after the period of dieting is nished Because of this, but also because of the reports on television and internet (there are over 800 websites on orlistat), patients often have great expectations of medication The current medication has proved to give no more than an additional weight loss of 4 kg This will not result in the often desired cosmetic effect, so patients wanting to lose weight purely for cosmetic reasons will have little success through medication However, this additional 4 kg can be signi cant for the reduction of health risks associated with obesity.



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If a reduction of the total alimentary fat intake is indicated (eg if the daily intake is high) treatment with orlistat can be considered, but to prevent steatorrhoea, good compliance to the fat restriction is essential Sibutramine is effective, but the side-effect of hypertension is a potential problem At this moment it is not yet clear if there will be a role for leptin in the treatment of obesity The perfect drug for obesity does not yet exist Ideally it should combine a good therapeutic effect (preferably more weight loss than the average additional 4 kg) with minimal side-effects Treatment of obesity primarily means a reduction of the (obesity associated) risks of cardiovascular disease or type II diabetes From this perspective, hypertension as a side-effect of drug treatment is a potential problem Like type II diabetes, obesity is a chronic metabolic disease.

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When you consider the relationship between the price and the quantity demanded at each price, you need to understand that increases or decreases in price simply move you along the demand curve, so that you just read off the price and quantity at a new point on the same curve. In the previous section, we mention that economists divide all the variables that can affect demand into two groups, price and everything else. Geometrically, this division is reflected in the fact that price changes move you along the demand curve, whereas the other variables combine to determine the curve s exact location and shape.

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Without additional therapy, weight loss is often followed by a subsequent weight gain This implies that the ideal drug for obesity has to be suitable for chronic (possible lifelong) treatment..

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In the hands Pseudoathetosis: the patient is unable to keep his ngers still in the outstretched position. Because of the lack of feedback on hand and nger position, curious postures develop in the outstretched ngers and hands when the eyes are closed. Clumsiness of nger movement, e.g. when turning over the pages of a book singly, and when manipulating small objects in the hands, made much worse by eye closure. Shirt and pyjama top buttons, which cannot be seen, present more dif culty than other buttons. Dif culty in recognizing objects placed in the hands when the patient s eyes are closed, and dif culty in selecting familiar articles from pockets and handbags without the use of the eyes. Loss of touch and joint position sense in the ngers. In the legs Marked and unequivocal Rombergism. The patient immediately becomes hopelessly unsteady in the standing position when the eyes are closed. As the patient walks, he is obviously looking at the ground and at his feet. Loss of touch and joint position sense in the feet and toes.

Here D is the mean diameter of the loop and a is the tube radius. Most practical single turn loops will have D >> a, so the reactance is well approximated by: X = 60 kD n

Perfectionism /rigidity Continued vulnerability Negative evaluation of self Dietary restraint Shape and weight-based self-esteem Disgust of food and body stimuli Bodily shame 3 4

Beside the old problem of non-compliance with BARG s requirements (to implement daily transfer by EDI as the standard mechanism for the exchange of billing records between GSM networks and to cope with the standard time scale for the exchange of billing records), there are numerous TAP le problems such as:

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