Thursday, January 29, 2015

Investigating Brown Fat, Cells, and Hormones to Develop Obesity Drugs

Within the past few years, a number of new weight loss drugs have come on the market. These drugs are Qsymia, Belviq, Contrave, and Saxenda. However, none of these drugs achieve results that many in the weight loss industry would like to see. So researchers continue to look for new obesity drug possibilities. The new possibilities include drugs that may convert white fat into brown fat, drugs that may reduce cells in the brain that cause hunger, and drugs that may activate or deactivate hormones that affect how much we want to eat.
 
According to a study described in the Harvard Crimson, researchers, led by associate professor Chad Cowan,  have discovered two compounds that can change white fat to brown fat in mice. If the researchers are able to create drugs that can convert white fat into brown fat in humans, this will be a great discovery for the weight loss industry. "The significance of the discovery, according to Cowan, lies in its potential to transform the body’s energy-storing white fat into energy-burning brown fat."

And researchers from UC San Francisco found that mice that were fed a high fat diet experienced a growth in the number of immune cells called microglia in the hypothalamus of the brain. The researchers suggested that "Immune cells perform a previously unsuspected role in the brain that may contribute to obesity..." The researchers took a hard look at microglia cells. And the researchers found that when they used an experimental drug or performed genetic manipulation to remove the microglia, hypothalamus inflammation was reduced and the mice ate less food.

In another investigation, scientists in Germany created a drug that combines parts of the hormones GLP-1, GIP, and glucagon to make a single molecule. GLP-1, GIP, and glucagon are hormones that play major roles in how much we eat. The combined drug activates GLP-1, GIP and glucagon, but no other hormones. In mice, this drug causes as much weight loss as bariatric surgery. If some version of the drug eventually works in humans, the scientists suggest that the drug could rival "the dramatic benefits seen with [bariatric] surgery, dropping excess body weight by a third."

Although the above studies were done in mice, human studies may show results similar to the mice results. If this happens, we could have noninvasive weight loss approaches that compete with weight loss surgery. 

Tuesday, January 20, 2015

Additional Minimally Invasive Weight Loss Approaches Might Soon Be Available

Bariatric surgery is an effective weight loss approach. But according to the American Society of Metabolic and Bariatric Surgery, less than 2% of those who qualify for bariatric surgery actually get the surgery. There are a number of likely reasons why eligible persons don't get the surgery. Cost might be a factor. And for some, there is a fear of the irreversibility or possible complications of the more drastic forms of the surgery. However, there are minimally invasive weight loss procedures, under study, that are less invasive than the three most common forms of bariatric surgery. And these less invasive approaches may eventually prove to be safe and effective. So, these procedures may be viable in the future.

The three most common forms of bariatric surgery are gastric bypass surgery, lap band surgery and sleeve gastrectomy. In gastric bypass surgery, the stomach is made smaller, and parts of the small intestine are bypassed. In lap band surgery, a band is placed around the upper part of the stomach, limiting the amount of food one eats, and causing a delay in food passing through the body. In sleeve gastrectomy, about 85 percent of the stomach is removed, thus restricting the amount of food one wants to eat. These surgeries are generally performed laparoscopically which is a minimally invasive procedure.

Minimally invasive weight loss procedures that are less invasive than laparoscopically performed bariatric surgery include endoscopic approaches. In endoscopic approaches, the procedures are performed using the mouth as an entry point. Two examples of endoscopic procedures, receiving attention, are the endobarrier and the gastric balloon.

The endobarrier is endoscopically placed in the small intestine via the mouth. The device acts as a barrier between the food a person eats and digestion of the food. The endobarrier mimics gastric bypass surgery. The gastric balloon is also placed endoscopically in the stomach through the mouth. After placement, the balloon is filled with a liquid or air, making a person's stomach feel full with less food.

The gastric balloon is expected to  receive FDA review within the next few years. The balloon has led to weight loss success. In one study, the gastric balloon resulted in a safe and respectable average weight loss of 42.7697 pounds "without intensive lifestyle" intervention in 85% of 672 patients. Now there were complications in about 6% of the patients, and 53 patients requested that the balloon be removed. Still, because the balloon appeared to be safe and effective in most of the cases, the balloon may eventually be another tool used in the fight against obesity.

As more minimally invasive weight loss procedures are refined and developed, weight loss providers will have more options to offer their patients. And someday, surgeons and obesity medicine specialists may create weight loss methods that combine pharmacotherapy and minimally invasive weight loss methods that are as safe and effective as gastric bypass surgery.
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