The role of lorcaserin in obesity: identification of CNS targets using fMRI
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With the rapid and alarming rise in the obesity epidemic that continues to plague both developed and developing nations, increasing efforts are being directed toward solving this pressing issue that is associated with multiple metabolic complications. Research efforts continue to target this population for greater insight as to causes, preventative measures and treatment options that may provide health benefits to those suffering from the physical and psychological manifestations of this newly classified neurobiological disease, in addition to cut down on excruciating obesity-related costs affecting the current health care budget. Alongside an emphasis on physical activity and proper nutrition to both prevent and ameliorate the effects of obesity, pharmacological treatment has garnered an appreciable appeal as an additional interventional approach in an urgency to slow the progression of this widespread problem. The introduction of lorcaserin (Belviq®), a serotonin (5-hydroxytryptamine, 5-HT) agonist that selectively targets the 5-HT receptor subtype 2C (5-HT2C), has already exhibited great potential for combating the obesity epidemic since it was approved by the Food and Drug Administration (FDA) in 2012. With its ability to decrease appetite and enhance weight loss with few side effects, lorcaserin is a promising treatment option. However, the mechanisms behind the drug are still not fully known. Determining the exact role that lorcaserin plays in appetite control would provide valuable insight into appetite regulation and could illustrate the medication's potential for reversing the health-impairing effects of obesity on our current populations. This study examined, through the use of functional magnetic resonance imaging (fMRI), the effects of lorcaserin on the centers of the brain that control appetite and food intake, in addition to areas of cognition that are thought to be affected by obesity. Due to the nature of the double-blind trial, only baseline characteristics were obtained and analyzed. However, observed correlations from these data largely confirm previously established relationships seen in obese populations providing support for the validity of this study. These correlations were also important to obtain to set the stage for assessing any short-term or long-term neuroimaging changes and neurocognitive effects of lorcaserin on brain responses to high and low calorie food imagery.