Definizione di obesità e sovrappeso 

Obesity is a major public health problem in the world, and the World Health Organization (WHO) has defined it as one of the four main risk factors for serious chronic diseases, along with tobacco consumption, physical inactivity and excessive alcohol consumption. Overweight and obesity represent a growing health problem and the search for new strategies for reducing body weight continues.
Given the multifactorial pathogenesis of obesity, it follows that its treatment involves an integrated approach between various modes of intervention. The first and fundamental criterion to solve the problem of obesity must be the change of lifestyle through an adequate diet and the practice of a regular program of physical activity adapted to one's abilities and state of health.
A drug therapy against obesity can be prescribed only in addition to lifestyle changes (diet and physical activity) and in the presence of a certain BMI value (see the document "Definition of obesity and overweight").
At present, the drugs approved in Italy for the treatment of obesity and overweight in adults are three: orlistat, liraglutide, bupropion/naltrexone.
Often for weight loss we also resort to food supplements or masterful galenic preparations. Unlike the drugs mentioned above, the active ingredients prescribed in magistral galenics for slimming purposes do not have specific therapeutic indications approved for the treatment of overweight and obesity, while food supplements are food products that have no therapeutic indication for the treatment of any pathology. In both cases, the use of these products for the treatment of overweight and obesity is not supported by evidence of clinical efficacy and their safety profile is not defined. For the magistral galenic prescriptions for slimming purposes, the Ministry of Health has set up a use and safety monitoring activity carried out by the Istituto Superiore di Sanità.

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Definition of obesity and overweight
The Body Mass Index (BMI) is the most widely used indicator for overweight/obesity conditions. The WHO definitions state that there is:

• overweight, if the body mass index is between 25 and 29.99 kg/m2
• obesity, if the body mass index is equal to or greater than 30 kg/m2

Given the multifactorial pathogenesis of obesity, it follows that its treatment involves an integrated approach between various modes of intervention. The first and fundamental criterion to solve the problem of obesity must be the change in lifestyle through an adequate diet and the practice of a regular program of physical activity adapted to one's abilities and state of health. Drug therapy against obesity can be prescribed only in addition to lifestyle changes (diet and physical activity) and only in case of:

• BMI greater than 30 kg/m2
• BMI greater than 27 kg/m2, if in the presence of other risk factors or other diseases

At present, the drugs approved in Italy for the treatment of obesity and overweight in adults are three:

• orlistat
• liraglutide
• bupropione/naltrexone

These drugs are not used as a first choice, however they can support, if necessary, the other approaches allowing the obese person to control his disease through adequate weight loss also in order to maintain the results achieved in the long term.