(1) thyroid hormone. Thyroid hormone drugs, including thyroxine (T4), triiodothyronine (T3) and thyroid tablets, are mainly used to treat hypothyroidism. Theoretically speaking, thyroid hormone can improve the metabolic rate of human body and increase calorie consumption, so it is an ideal drug to lose weight. But only when used in large doses can thyroid hormone have a clear weight loss effect. Except hypothyroid obesity, there is no obvious weight loss effect on other types of obesity by using general dose. Ordinary physiological dose, for obese patients with normal basal metabolic rate, generally will not make them lose weight. The plasma T3 level of obese patients decreased after losing weight. Therefore, some people advocate adding T3 to the extremely low calorie diet to prevent the metabolic rate of patients from decreasing during weight loss, so as to improve the weight loss effect. This method does increase the patient's weight loss in a short time, but 75% of the weight loss caused by thyroid hormone comes from lean body mass (the weight of muscles and bones is lean body mass), not fat loss.
Thyroid hormone accelerates protein decomposition and increases bone calcium loss, which may cause myopathy and osteomalacia. It will also damage the cardiovascular system, and the elderly will easily aggravate coronary heart disease and induce angina pectoris.
In addition, exogenous thyroxine can also inhibit the secretion of endogenous thyroxine. The FDA has formally proposed that the drug label of thyroxine must be marked as "not used for weight loss treatment". In recent years, people think that the reduction of T3 level in obese patients treated with extremely low calorie diet may be a protective measure to prevent their protein loss. Therefore, it is not recommended to lose weight with thyroid hormone.
(2) anabolic steroids. Nolongphenylpropionate can lose weight by consuming fat and increase the synthesis of protein. Dehydroepiandrosterone can increase metabolic rate, reduce fat synthesis and deposition, increase the synthesis of protein, affect the release of thyroxine, and thus lose weight.
(3) growth hormone. Growth hormone plays an important role in the development of human adipose tissue, especially for young people before the age of 20. Studies have shown that long-term exposure of adipocytes to growth hormone will reduce glucose transport and utilization ability and fat synthesis stimulated by basal state and insulin. Growth hormone can also directly increase lipolysis and strengthen the role of adrenaline in promoting lipolysis. The effect of growth hormone on lipolysis may be related to its increase in hormone-sensitive lipase. Growth hormone deficiency in children and adults can lead to obesity, so growth hormone has a good effect on this kind of obesity. Some people use growth hormone to treat simple obesity, especially childhood obesity, but its effective weight loss dose is still inconclusive.
Growth hormone injection can increase the body's heat production, reduce body fat, increase lean body mass, and reduce the protein loss of low-calorie dieters. However, due to the role of growth hormone in acromegaly, its application in obesity treatment is still controversial.
The Australian research team has developed a growth hormone analogue, which on the one hand specifically enhances the activity of lipolytic enzymes and promotes lipolysis, and on the other hand directly inhibits fat accumulation, thus achieving the purpose of losing weight. This analog has no other effects of growth hormone, and its potential toxic and side effects have not been found in animal experiments, so it may become a promising weight loss drug.
(4) Insulin-like growth factor-1(IGF- 1). Lack of this factor will lead to obesity and mild hyperlipidemia. For example, in patients with Laron syndrome, due to the defect of growth hormone receptor, circulating growth hormone increases abnormally, while the level of IGF- 1 is very low. IGF- 1 synthesized by recombinant DNA method, with daily dose of 50 ~ 150μ g/kg, can be injected subcutaneously for a long time, which can significantly reduce subcutaneous fat content, serum cholesterol level and increase lean body mass.
IGF- 1 can directly increase the catabolism of fat, reduce the blood insulin level of insulin resistance patients and increase insulin sensitivity, which may be due to its reduction of body fat content.