Monday, December 26, 2016

FDA Approves Another Intragastric Balloon

Minimally invasive weight loss procedures that are less invasive than laparoscopically performed bariatric surgery procedures include endoscopic methods. In endoscopic approaches, procedures are performed using the mouth as an entry point. One example of a weight loss endoscopic procedure is the intragastric balloon. In 2015, the FDA approved two intragastric balloon systems. And this year, 2016, the FDA approved another intragastric balloon.

One of the balloon systems approved in 2015 is produced by San Clemente, California based ReShape Medical, Inc. And the other 2015 balloon is produced by Austin, Texas based Apollo Endosurgery, Inc. Both of these balloons are placed in the stomach through the mouth and retrieved through the mouth when necessary. The 2016 intragastric balloon gaining FDA approval in 2016 is produced by Carlsbad, CA based Obalon Therapeutics. And this balloon is a swallowable balloon that is inflated once the balloon reaches the stomach. The balloon is removed endoscopically after six months.

The Obalon balloon is used in conjunction with an intensive diet and lifestyle modification program. And the balloon can be successful. In one study, 387 subjects were randomly assigned either to a control group or a group using the balloon.  And "around 65% of the treatment group had clinically meaningful weight loss of at least 5% total body weight compared with half of those in the sham group."

In general, intragastric balloon usage has demonstrated weight loss effectiveness. In a recent study, the intragastric balloon produced a safe and respectable average weight loss of 42.7697 pounds "without intensive lifestyle" intervention in 85% of 672 patients. However, the study's investigators did indicate that there were complications in about 6% of the patients. And 53 of the patients asked that the balloon be removed. Still, the balloon shows promise.

As more minimally invasive weight loss methods, such as the intragastric balloon, are developed, weight loss service providers will have more weight loss options to offer their patients. And with the newly available obesity drugs, obesity medicine specialists may eventually introduce procedures that combine minimally invasive procedures with pharmacotherapy and other non-surgical interventions. 

Friday, December 16, 2016

Exercise Can Turn White Fat into Brown Fat

The common weight loss approaches in use today are lifestyle change, diet, exercise, antiobesity drugs, and weight loss surgery. It has been suggested that exercise may help a person lose weight by converting white fat into brown fat, the so called “good fat.” Indeed, some studies are showing just how exercise may make this white-fat-to-brown-fat conversion.

Brown fat is important because brown fat has been shown to burn energy rather than store it the way white fat does, making brown fat more desirable than white fat. Two studies have indicated that exercise produces a hormone, called irisin, which converts white fat into brown fat.

In a 2012 article, "Bruce Spiegelman, professor of cell biology and medicine at the Dana-Farber Cancer Institute, and his colleagues [reported] that, in mice at least, exercise can make [brown fat] appear, by turning ordinary white fat brown. When mice exercise, their muscle cells release a newly discovered hormone that the researchers named irisin. Irisin, in turn, converts white fat cells into brown ones. Those brown fat cells burn extra calories.” Further, Dr. Spiegelman believes that the human body may convert white fat into brown fat in a similar fashion."

In a more recent study, published in 2016, investigators at the University of Florida, turned human white fat into brown fat. Using human white fat tissue "from women who had undergone breast reduction surgery," the investigators soaked the white fat tissue in human irisin for four days. The white fat that was moderately or highly exposed to irisin displayed the characteristics of brown fat. The soaked fat also burned more energy than it did before the exposure to irisin.

With more research, we may one day be able to tailor exercise to be more effective in the white-to-brown-fat conversion process. This would be just one more tool in our fight to lose unhealthy fat and maintain a healthy body weight.
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