Abdominal Obesity and the Endocannabinoid System: From Basic Aspects to Clinical Management of Related Cardiometabolic Risk PDF

Preface

Why a book on abdominal obesity and the endocannabinoid system? This work summarizes about 20 years of exciting developments and conceptual advances in our understanding of the form of overweight/obesity carrying the highest risk for chronic disease: visceral obesity. Indeed, we now better understand that many complications of obesity are more related to the distribution of body fat than to excess total fat per se. On the other hand, studies conducted over the last decade have documented the importance of the endocannabinoid system in the control of regional fat deposition and in the regulation of carbohydrate and lipid metabolism. Thus, it is only recently that we have begun to recognize the interplay between a dysfunctional endocannabinoid system and visceral obesity and its complications. These notions have tremendously important clinical implications on how to target the endocannabinoid system in order to reduce abdominal obesity. Unfortunately, the pharmaceutical industry and regulatory agencies have used the old "overall obesity" paradigm to evaluate "anti-obesity" drugs under development, including the antagonists of endocannabinoid action. This traditional view of obesity, assessed in the old fashioned way on the basis of indices of relative weight such as the body mass index, have led to a very difficult and uncertain path for drug developers and for physicians and their patients who are still expecting a "miracle drug".

This book is currently the most comprehensive effort at describing the endocannabinoid system as a whole and its role in the regulation of body fat distribution and of abdominal obesity-related metabolic complications that increase the risk of type 2 diabetes and cardiovascular disease. Whether pharmaceutical companies and regulatory bodies will agree on better experimental designs and more carefully selected patient populations for the evaluation of drugs targeting the endocannabinoid system is, at this stage, unclear.We hope that this comprehensive effort will help shed light on these issues.