Saturday, June 27, 2009

Drugs for weight loss: Part 5

Follow-up therapy

The idea about treating obesity should be understood in the overall context of medical health. Treating obesity means one treats numerous potential risk factors and preventable disease at one time. Obesity is the genesis of a whole lot of other potential problems.

One of the major complaints most individuals have after using drugs to lose weight is that they re-gain the weight once they stop taking the medications. This suggests that further therapy with nutritional and behavioral therapy is essential to help maintain the initial weight loss. The drugs do provide a boost but they are not enough to cure the problem.

After 30 years of trying drug treatment therapy for weight loss, most experts believe that drug therapy alone is not adequate to control the obesity mania. It is unlikely that a perfect magical drug for losing weight will ever be developed and even if the drug is developed, it will not be the magic pill. Diet and exercise will always be the corner store therapy for weight control.

Drugs probably will end up being most beneficial to people who have a genetic propensity to being overweight. The majority of people who are obese today are as a direct consequence of their lifestyle and nothing to do with their genetics. These people better start walking and eating more vegetables.

The history of drugs for weight loss has taught us something- that these drugs have potent side effects and their long term complications are unpredictable. So far, drugs have not had a bigger success and have always come out on the shorter end in comparison to the food industry campaigns of “supersize”.

The last 30 years has seen a major erosion of our life style. We have abundance of food, which is cheap, readily available and the concept of supersize is now ingrained in us. We are always looking at how to make our lives easier with energy saving methods. A sedentary lifestyle is now a major preoccupation of more than 70% of North Americans. Even simple walking around the block has now become a burden for majority of individuals. New drugs may be another treatment for obesity but they will never be a replacement for a drastic change in our life style. Drugs will help lose a few pounds but beyond that, it is going to take a lot of hard work and exercise.

Drugs for weight loss: Part 4

Using other off label drugs

Other unorthodox weight loss experts claim that other not recommended drugs may also help in the weight loss program. These drugs are not approved for use in obesity. These drugs include thyroxin, diuretics and the anti diabetic agent, metformin.

The anti diabetic drug, metformin is an effective weight loss reducing agent and has been used by non diabetic individuals. However, in non diabetic individuals, the drug can cause profound drop in blood sugar and lead to coma. Thus daily blood glucose monitoring is mandatory.

The antidepressant bupropion (Wellbutrin) has also been associated with weight loss. When the drug is prescribed to patients with depression, weight loss has been a noticeable side effect.

Temporary weight loss can also occur with diuretics and thyroid hormone. However, these drugs have potent side effects but still are frequently abused by athletes and boxers.

Results

There is no doubt that no matter what weight loss drug is prescribed, most patients will initially lose 5-10% of their starting body weight. This is significantly more than any conventional behavior modifying treatments. The most important rule for success is that individuals have to have realistic goals. Setting sights at losing 10-15% of body weight in a year is reasonable but the majority of individuals are unrealistic and loose hope after a few months. For the physicians, it is essential to educate patient on a reasonable amount of weight loss. Physicians who promote 25-50% weight loss in a year are setting up all patients for failure.

Most weight loss experts now feel that it is essential to help patients lose 3-10% of body weight. Results indicate that medications plus aggressive life style changes can produce dramatic results. An important part of that strategy includes educating patients to stay on low-calorie, low-fat maintenance diets and continue to exercise. While losing 3-5% of the body weight may not sound too impressive and may not be the patient’s goal, these results combined with life style changes have shown a significant reduction in the risk of developing type 2 diabetes mellitus.

Drugs for weight loss: Part 3

Amphetamines like drug

Some weight loss physicians are returning back to using the amphetamine-like agents which were used in the 1980s. These drugs fell out of favor decades ago because of their potential for abuse and causing physical dependence. Some physicians have been using dextromethorphan in relatively small doses in longer acting forms, closely monitoring patients and having them take the medication consistently every day to reduce the possibility of dependence. The individuals taking these types of drugs require frequent monitoring by the doctor.

Fat-busters

There are many individuals who are obese because they just can’t stop eating. The food craving and the binges are strong and preoccupy the mind. In such cases, another type of drug class may help. These drugs help by preventing the food from getting absorbed in the body and may even bust the fatty food which does manage to get absorbed.

Orlistat (Xenical) is the only medication besides sibutramine that has been approved for long-term weight loss use. This drug acts by preventing the body from absorbing a moderate amount of dietary fat. Weight loss from these drugs usually amounts to about 5% to 10% in four to six months. Both drugs have side effects. Xenical often causes diarrhea, abdominal cramps and loose stools. Some individuals may not tolerate these side effects for too long. The drug can also inhibit the absorption of important vitamins and so additional vitamins are recommended.

To ensure that these drugs work, the individual must adhere strictly to a low fat diet. Eating fatty food and taking these drugs defeats the purpose of these drugs.

Drugs for weight loss: part 3

Appetite suppressants

Drugs which suppress appetite are the best choice for individual who have strong food cravings and have voracious appetites

The first appetite suppressant was Phentermine which has been available for about 50 years. It acts on the brain feeding enter. Over the years, a number of related drugs have been developed and include Ionamin, adieux and fasten. These drugs are only recommended for short term usage. The major problems with these drugs is that they can cause physical dependence after prolonged use. Other side effects may include an increase in blood pressure, palpitations, dizziness and insomnia. The major problem with these drugs is that they are often prescribed for longer periods without any medical follow up.

Even though the FDA recommends that these drugs not be used for more than 3 months, most weight loss physicians claim that with proper follow-up Phentermine is safe and effective for more prolonged use. To be on the safe side, most physicians get patients to sign a consent form acknowledging that they need to take the drug for longer than 3 months.

Recent anecdotal data suggest that combination of SSRI class of antidepressants like Prozac and Zoloft may be more effective in producing weight loss. However, none of these data have any scientific basis. Other less popular appetite suppressing agents include diethylpropion, phendimetrazine, sibutramine and mazindol.

Acomplia is the first of a new class of drugs that affect signals in the brain that influence appetite. This drug inhibits the appetite center in the brain. As an obesity treatment, Acomplia may be best suited for people who are not only overweight but also have metabolic syndrome. Metabolic syndrome is a collection of symptoms, including high blood pressure, high cholesterol, large waist circumference, obesity and insulin resistance that can lead to diabetes and heart disease without treatment.

Even though controlled clinical studies do show it to be an effective weight loss drug, the drug does have major side effects of concern. Severe depression nausea and vomiting are common. The drug has not been approved by the FDA for use in humans.

Drugs for weight loss: part 2

Brief History

The control of obesity with drugs has been a major struggle for more than 3 decades. All types of drugs have been used in the past to treat obesity.
In the past, thyroid hormone and diuretics were often used inappropriately. Dangerous drugs such as dinitrophenol and amphetamines were prescribed, with serious side effects. With better understanding of obesity in the 1980s, different types of weight loss drugs were manufactured. Drugs like fen-fenn helped individuals continue to maintain their weight loss. However, the drug was associated with serious cardiac side effects and its use has been banned universally.

Since then, two new drugs with different mechanisms of action have been approved for use by the FDA. Sibutramine (Meridia) is a serotonin-norepinephrine reuptake inhibitor acts on the appetite center in the brain, and orlistat (Xenical) is a pancreatic lipase inhibitor and inhibits the absorption of fat from the abdomen. However, these drugs do have side effects and their long term complications remain unknown. At present we have a huge gap in our armamentarium to treat obesity.

When does treatment start?

There are various guidelines and most recommend that drug therapy for weight loss should start when an individual has a body mass index (BMI) of > 27 or those who have obesity-related risk factors or co-morbidities, and in obese patients whose life style is severely affected. Under certain circumstances, weight loss drugs may also be effective for other patients. Some physicians also consider using obesity medications to patients with a BMI above 25 who have not responded to a rigorous program combining behavior modification, dietary changes and exercise.

Anti-obesity medications fall into two broad categories based on how they help patients fight fat. One group helps reduce food intake, while the other prevents fat absorption.

Drugs for weight loss part 1

Over the last 2 decades, obesity has become endemic in North America and is a major public health issue. It is estimated that more than half of American adults and 10-15% of children are obese. At least a quarter million Americans die each year from obesity related complications. The obesity epidemic is rising exponentially and it is predicted that obesity-related health problems will soon take over tobacco as the nation’s number one leading cause of preventable deaths. It has finally been realized that drastic changes are required to control the obesity epidemic. A newer breed of doctors, known as weight loss experts, has now been brought into the arena of obesity management. And of course when doctors get involved, drugs follow.

One thing that has been acknowledged is that drugs may not be the answer in controlling the obesity epidemic and a change in life style is mandatory. Therefore, along with these weight loss physicians, there has been an explosion of nutritionists, exercise gyms, herbal therapists, psychologists, spiritualists, yogis and a whole host of other experts- all who have been burdened with solving Americas number one health problem. The majority of these so called experts are in the business to make money and Quack therapy is very prevalent in the obesity business.

As Americans continue to increase their waist lines, there has been a resurgence by the pharmaceutical companies to search for the ideal weight loss drug. Many new medications are currently being investigated and a few may be available in the next decade for use. However, there are some problems with drug use in the control of obesity. For the past decade, physicians have been reluctant to use weight loss drugs. This has mostly been due to the side effects and the legal hassles which follow when prescribing these drugs. Today, physicians have only a few drugs to choose from in the battle against the bulge. The FDA has approved two weight loss medications for long-term use—typically a year or more. A few other newer agents have been approved for short term use but this may not be enough to produce the weight loss required.

Despite these concerns, the new breed of weight loss physicians are taking a second look at these drugs in combating the obesity epidemic. It is believed that more that 25% of Americans are now eligible for short term drug treatment for weight loss.

Monday, June 8, 2009

Weight loss surgery: part 3

There are hundreds of bariatric surgery centers located all over America. Since the surgery is expensive, many surgeons have joined the bandwagon to make money. While there are trained bariatric surgeons around, there are a lot of other surgeons who have very little training in bariatric surgery. The majority are in the field simply to make money. The cost of bariatric surgery is not cheap. On average it can cost anywhere from $14,000-$30,000. In addition, the results are not guaranteed.

Today, there are certain criteria for eligibility to undergo bariatric surgery. Some insurance companies will only pay if you meet these criteria. In general, complications are highest with surgeons who are not trained in bariatric surgery and those who do fewer than 25 cases a year. Do not be fooled by pre and post photos that surgeons show you. Go on cyberspace and get to know the procedure, the surgeon and talk to people who have had the surgery. Bariatric surgery can help make a big difference in your life when things go well, but when things go awry, life will suck big time.

So before you rush to get your surgery, check out your surgeon, ask for his/her credentials, talk to people and get referrals. If ever in doubt, go get a second opinion.

Weight loss surgery Part 2

Currently bariatric surgery is being hyped up as a panacea for treatment of obesity. Surgery is not new for obesity. It first started in the 60s and has slowly evolved. Bariatric Surgery lost impetus in the 80s and 90s because it was associated with severe complications. Unlike the past, current surgical procedures are more refined, anesthesia is safe and ICU care is outstanding. Still, the benefits of surgery are limited to a few percentage of individuals. What should not be forgotten is that bariatric surgery is also associated with serious complications, many of which can be life threatening.

Almost on a weekly basis, complications of bariatric surgery make the news. Some complications are inevitable, but many are caused by bad surgeons. This is not to say that surgery is not useful, it means that surgery has limitations also.

Many obese patients nevertheless are turning to safer surgical options for weight loss. Most individuals feel that this is the last chance. In some cases surgery has done wonders, but there just as many cases where the initial weight loss after surgery is rapidly gained in a few years.

Surgery for weight loss 101

By now, everyone knows that we have an epidemic of obesity in north America. Obese people are no longer in the minority; they are everywhere and very visible. Obesity is no longer a hidden disorder seen only in rural America. It is everywhere. One can walk down any street in America and there are fat people everywhere. Americans should take heart- obesity is now a global problem. This truly has been one of the most successful exports of North American society. Except for a few countries in Africa, almost every nation is beset with the problem of obesity.

Data from the communicable disease center indicates that about 50 percent of adults and more than 20 percent of children and teenagers are overweight. The real numbers indicate that at least 10% of these adults are morbidly obese. Morbid obesity is currently defined as having at least 100 pounds or more over the recommended body weight.

One should not trivialize obesity, it is not harmless. While it may appear to be physically distressing, obesity is associated with a number of serious medical problems. The majority of obese individuals go on to develop high blood pressure, osteoarthritis, type 2 diabetes, sleep apnea, depression, and urinary incontinence.
Obesity today is on par with smoking as public enemy number one. The condition is preventable in the early stages but once started, it is extremely difficult to control. Despite years of intense research, no one can really explain the onset of obesity. Not only are the complications of obesity hard to manage, but we have run out of options on how to prevent/treat it.

Countless therapies have evolved over the past 30 years. There are herbs, potions, lotions, potions, drugs, surgery and even alternative care therapies- they all have one thing in common- high failure rates when it comes to control of obesity.

Thursday, June 4, 2009

Fast Food Diet: Part 2

The book written by Dr Sinatra also contains a few simple healthy recipes. These foods are for the busy mum and can be prepared in less than 15 minutes. Dr Sinatra’s fast food recipes generally average about 1500 calories per day.

And of course being a doctor he does recommend walking, at least a mile a day.
His philosophy is simple, cut down a few calories each day and in a few weeks one can loose weight. Stop eating candies or chocolate- if you feel hungry eat a vegetable or a fruit and then go for walk. Substitute exercise for food. Moreover, if you do this every single day, one can lose 50 pounds in 12 months. Sounds great so far

Moreover, what to the experts say about Dr Sinatra and his fast food diet?

It does not work. How does one not order the yummy fast foods when one walks into a McDonalds? There are not many individuals who goes to a fast food store to eat green salads and a fruit bowl! The menus are very attractive at all fast food stores and everyone adds on at least an apple pie at the end. This is the problem with fast food diet. We all know how great fast food tastes. Therefore when we walk into such a restaurant, we normally cannot control our impulses and always order and eat more than what we had decided upon.

Dr Sinatra’s fast food diet plan makes a lot of sense but is not practical. There is no way one is going to keep off the burgers, ice cream, fries, and milk shakes the moment you are at McDonalds. There are very few testimonials by people who have lost weight using the fast food diet.

Plus, I am not sure when Dr Sinatra last went to a fast food store. Eating one small meal at McDonald’s today costs anywhere from $8-$10. There are no more cheap fast foods. Eating at a fast food restaurant on a regular basis is expensive. In addition, if you have a family to feed, eating out everyday is not practical. With today’s economy, it is considered a luxury.

So the search for the ideal weight loss diet continues.

What is the Fast Food diet?

There have been hundreds of diets developed for people wanting to lose weight. While the majority of these diets are restrictive and only allow you to eat breadcrumbs, vegetable and nothing exciting, we now have a diet that allows you to eat your favorite fast food and lose weight.

The fast food diet was written by a doctor who had the common sense to understand that no matter what people say about fast foods, they do taste great. Fast foods are available everywhere, are relatively cheap, fries are crispy and crunchy and the milkshakes beat any home made beverage. It is hard to find any individual who does not like fast foods. Therefore, Dr S Sinatra (no relation to Frank or Nancy) decided to develop his fast food diet that can help people lose weight.

The great thing about Dr Sinatra is that he does appreciate the difficulty with all other weight loss diets and understands what people want to eat. In his book, he does mention that he would prefer everyone eat wholesome healthy grains, vegetables and fruits, but this is unrealistic. So why not adopt a different philosophical approach to weight loss- I agree 100 percent.

So how does the Fast Food Diet work?

When you go to a fast food store, you can order a grilled chicken sandwich, baked potato, fruit salad and a junior burger. You are not allowed to order French fries, no soda beverages and no super sizing. DR Sinatra claims that the fast food diet is healthy because most stores have changed their ingredients and have low fat.

When you order a green salad, order vinaigrette instead of ranch. This will save you calories. Use minimal salad dressing or better still do not order any dressing. Instead of a coke or a Pepsi, get a lemon drink or green tea.

Monday, June 1, 2009

Body for life Diet- part 2

The Body for life diet is an enigma. It has less to do with weight loss and more to do with bodybuilding. The book and diet plan place more emphasis on bodybuilding. For most of us- we just want to get rid of a few pounds here and there and could not really care about pumping iron. We have all seen and heard enough about Mr. Schwarzenegger.

The body for life diet plan is all about eating healthy foods and drinking gallons of water. The author even encourages eating mega doses of nutritional supplements from a firm, which is partly owed by the author (this should be a warning to all consumers- recommending a diet plan and then encouraging consumers to buy supplements from his or her store always means one thing-selling junk). All consumers should wonder why there is a need to take supplements when one is eating lots of fruits, vegetables, and nutritious diet.

The body for life diet plan recommends eating non-processed foods. You can eat chicken, turkey, fish (every type) lobster, beef, egg, cheese, every type of carbohydrate and so on.

The bottom line is eating fewer calories and burning more with exercise. At the end of 12 weeks, you have weight loss.

There is not much to criticize about the diet plan. It is sure to appeal to the younger crowd, hyperactive, energetic individuals, and those who want to pursue a body with perfect abs. The one major flaw of body for life diet plan is the amount of exercises required. One cannot spend all day in the gym and no normal person has the time or the inclination to do 1000 push-ups or exercise with a dumbbell 500 times a week. Most overweight people do not even get up to change the TV program if they can’t find the remote-what makes Mr. Phillips think they will lift 300 pounds for 45 minutes 3 times a week?- not a chance.

So what to the experts say about the body for life diet plan? Do not believe everything that Mr. Phillip sells or says. The diet is more geared towards eating a lot and then burning off the calories with intense exercises. There is nothing magical about the diet plan, book, or Mr. Phillips.

For the average person who simply wants to get rid of a few pounds, Mr Phillips body for life isn’t gonna cut it. The diet is simply too good to be true. The diet does not insist on changing behavior on how to eat less. The problem with obesity is within the brain and we all want to know how to suppress the appetite center. Perhaps, Mr. Phillips can maintain a pumped up body with ripping muscles for the rest of life- for me there is only thing that I know is permanent- herpes, if you get it, is for life.

Body for life Diet

Everyone wants a nice looking body that will last forever. Unfortunately, for the majority of people, having a slim trim body past the age of 30 is a real struggle. However, never fear- another diet plan has been devised to help you maintain your youthful sexy body.

Body for life Diet was developed by Bill Phillips. This diet plan is quite rigorous, involves intense exercise and a healthy approach to diet. The aim of the diet plan is to help you like dieting and exercise. If you adopt the body for life diet plan for just 12 weeks, you are set for life. Sounds unreal but read on.

The body for life diet plan is not for everyone. It involves intense exercise with weight training, aerobics and a varied exercise 6 days a week. Some days you lift weights and other days you do aerobics.

The diet involves eating six small meals for 6 days. All the foods you eat are nutritious, healthy and include the typical vegetables, seafood, and rice. On the 7th day, you take off and can go on a eating and/or drinking binge.

The body for life diet book is all glamour and pumping iron. There are tons of photos of people who all look like Mr and Ms Universe contestants. Everyone has the perfect abs, well-chiseled bodies, glistening skin, pumped up muscles and nice tans.