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Investigational weight-loss drug looks promising
In a recent study of 2,502 obese patients, more than half of patients taking the drug taranabant, lost 5% of their body weight, and more than one-fourth of them lost 10%. Listen to the personal experience of a participant in the investigational trial of taranabant. (video left, courtesy of MedPage Today).

This drug is not yet approved or even submitted to the Food and Drug Administration for approval. MedPage Today, April 2008

Lentils better than white bread for weight loss
For weight loss and cholesterol control, a diet high in foods that release energy slowly and consistently into the blood stream, such as beans, whole-grain bread, and unsweetened cereals, is better than a diet high in foods that release sugar rapidly, such as white bread, white rice, and soft drinks. Foods with a lower glycemic index stimulate less insulin release from the pancreas, thus minimizing appetite. There is some evidence, Australian researchers found, that even when the caloric intake is the same, foods with a low glycemic index may stimulate greater weight loss in obese individuals. Lowering the glycemic load of the diet can be simply incorporated into a person's lifestyle. The Cochrane Library

An injection that makes fat melt away, at least in mice
In a recent study, mice who had gained weight due to stress, also received either an implanted slow-release pellet of a neuropeptide blocker or equivalent daily injections. This treatment resulted in a 40% reduction in abdominal fat within two weeks. This is the first well-described mechanism found that can effectively eliminate fat without using surgery. The Georgetown researchers noted, however, that a great deal of research remains to be done before the approach can be evaluated in humans. MedPage Today, July 2007

FTC fines weight-loss firms $25 million for false advertising
Marketers of the four products –Xenadrine EFX, CortiSlim, TrimSpa, and One-A-Day WeightSmart – have settled with the FTC for $25 million, and agreed to limit their future advertising claims. A number of unsubstantiated claims were made by the firms, including rapid weight loss and reduction in the risk of osteoporosis, Alzheimer's and even cancer. Some of the claims were made through infomercials or celebrity endorsements. Anna Nicole Smith, for example, endorsed TrimSpa. Despite the substantial fine, the pills pose no health risk to users and thus the pills will remain on store shelves. FTC January 2007

Newly approved by the FDA: Fat-blocking weight-loss pill, orlistat, which has been available by prescription, can now be sold in a reduced-strength version over the counter
The new OTC product will be marketed as "ally" by GlaxoSmithKline PLC. Xenical, the prescription version, has been produced by Roche Holding AG. Xenical was initially approved in 1999 as a prescription drug to treat obesity, and remains a prescription drug for obesity at twice the dose of the OTC version. February 2007

Orlistat helps produce weight loss by decreasing the intestinal absorption of fat. In controlled studies, for every five pounds people lost through diet and exercise, those using orlistat lost an additional two to three pounds. When taken with meals, orlistat blocks the absorption of about one-quarter of any fat consumed, and then results in the fat being passed out of the body in stools. About half of patients in clinical trials experienced gastrointestinal side effects such as loose stools or oily spotting. Eating a low-fat diet reduced the incidence of these adverse effects.

The 60 mg capsule can be taken up to three times a day with each fat-containing meal. Because of the possible loss of certain nutrients, the FDA recommends that people using orlistat should also take a multivitamin at bedtime.

The new OTC diet drug is approved for people 18 and older to be used along with a reduced-calorie, low-fat diet and exercise regimen. It is not for or for those who are not overweight, i.e. those who do not meet the National Institutes of Health definition of overweight, which is a body mass index of 27 or more.

Orlistat has significant side effects. Fat that isn't absorbed passes through the digestive system, causing abdominal pain, loose stools, oily flatulence, and even mild incontinence in some patients, depending on how well users comply with a low-fat diet. Also, people taking orlistat showed mild but consistent deficiencies of vitamins A, E, and beta-carotene. The drug's label is expected to include recommendations that users take a daily multivitamin. Orlistat can also lead to hepatitis, gallstones and kidney stones. It is not for people who have problems absorbing food, or for those who have had organ transplants. Also, anyone taking blood-thinning medicines or being treated for diabetes or thyroid disease should consult a physician before using orlistat.

In a six-month company study, moderately overweight patients who used 60 milligrams of the weight loss drug along with diet and exercise lost an average of 4 pounds more than patients who used diet and exercise alone.

As reported in the, the FDA's director of nonprescription products stressed that this OTC product is strictly intended only for use along with diet and exercise programs. "Using this drug alone is unlikely to be beneficial," he said at a telebriefing.

Although the FDA approved OTC orlistat based on the review of the sponsor's safety data and after consideration by an FDA advisory committee, Dr. Sidney M. Wolfe, director of Public Citizen's Health Research Group, called the approval "the height of recklessness." Wolfe said studies have associated the prescription version of the drug with precancerous lesions of the colon. He has also called for withdrawal of the prescription version of orlistat. (, Feb 8, 2007)

August 2006
Cellulite can be forever
A recent study of 51 women who were enrolled in medical weight loss programs found that cellulite can sometimes be reduced by weight loss, but not completely eliminated in some women. In general, the researchers found that obese women who lost significant weight reduced the severity of cellulite but for women who had less weight to lose at baseline, the cellulite significantly worsened with weight loss.

The American Society of Plastic Surgery estimates that 85% of postpubertal females have some cellulite on their thighs and buttocks. Plast. Reconstr Surg 2006; 118: 510-16

June 2006
Weight loss drug looks promising

Lorcaserin, an investigational drug for the treatment of obesity, produced weight losses between four and 7.9 pounds in 12-weeks. The drug was well tolerated by the study participants and also had a positive impact on most lipid values. Lorcaserin selectively stimulates specific serotonin receptors in the hypothalamus to provide central regulation of satiety and to influence metabolic rate. In comparison, Redux/Phen-Fen an earlier anti-obesity drug combination pulled from the market because of cardiovascular complications, was non-selective and targeted both central and peripheral receptors. That lack of selectivity, the researchers said, likely accounted for the adverse cardiac side effects seen in some patients who took Phen-Fen.

Lorcaserin needs considerable additional testing, but may in the future offer people who are obese another method for losing weight. Smith S et al. "APD356, an Orally-Active Selective 5-HT2C Agonist, Reduces Body Weight in Obese Adult Men and Women." Presented June 12, 2006 at the American Diabetes Association Scientific Sessions. MedPage Today

A new study found that roughly half of Atkins dieters stay on the diet long-term Weight Watchers did slightly better with 65%. The dieters were assigned to one of four popular programs: Weight Watchers (trims calories), Atkins (slashes carbs), the Zone (limits calories) and the Ornish diet (drastically cuts fat). Annals of Internal Medicine, 4 January 2005

Eat plenty of different fruits and vegetables...
Diets rich in fruits and vegetables may reduce the risk of cancer and other chronic diseases. Fruits and vegetables provide essential vitamins and minerals, fiber, and other substances that are important for good health. Most fruits and vegetables are naturally low in fat and calories and are filling. from the National Center for Disease Control 

Obesity is a major risk factor for heart disease  Do you know your BMI?
Recognizing that obesity is a major risk factor for heart disease, the American Heart Association has released a new scientific statement, published in "Circulation".    The statement provides healthcare professionals with treatment guidelines for weight management in adult patients with obesity who have or are at risk for cardiovascular disease. American Heart Association 10/25/2004,
The statement recommends diet, physical activity and behavior therapy for some people with a body mass index (BMI) of 25 to 29.9. Behavioral strategies include: self-monitoring, goal setting, stress management and social support.
Drug treatment can be considered for those with a BMI of 30 or higher who are unable to achieve adequate weight loss by diet, physical activity and/or behavior modification.
Surgery – such as gastric bypass – should be considered for those with a BMI of 35 or higher who are unable to lose weight with conventional therapy and have no contraindications for surgery.
Calculate your BMI

Read more from the American Heart Association

Written by N Thompson, RN, MSN, ARNP, Last updated March 2008

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