Saturday, January 24, 2009

Two Drugs Plus Leptin as a Weight Loss Tool

Leptin is a natural hormone that suppresses appetite. However, leptin loses its effectiveness in obese persons. But there are two drugs that the FDA has already approved for non-weight-loss purposes that may improve leptin’s effectiveness in obese persons. The two drugs are 4 phenyl butyric acid or PBA, "which treats cystic fibrosis, and tauroursodeoxycholic acid or TUDCA, which treats a liver disease."

In a study done by researchers from Christian's hospital in Boston and Harvard Medical School, mice were fed leptin, PBA, and TUDCA. And significant weight loss resulted. Although there was significant weight loss, we must remember that combining two drugs for weight loss has been done before with dire results.

You might recall the weight loss drug fen-phen, a combination of fenfluramine and phentermine. Both of these drugs were approved by the FDA as short term appetite suppressants. But they were never approved as a combination drug. And using the drug combination can cause harmful side effects, as indicated by the FDA. In fact in 1997, the FDA asked that fenfluramine be taken off the market. So, combining two drugs for weight loss, or for any purpose, should be studied with care, even if the individual drugs are FDA approved.

Perhaps the PBA-TUDCA combination will be different. But, again, it is important to be leery of any medication created by combining two drugs. Also, it is important to be leery of drugs approved for one purpose and used for another.

However, as we've said before in this blog, a successful obesity drug could fill the gap between lifestyle modification and weight loss surgery. Filling this gap with a safe and effective drug is most important to many of those interested in weight loss. And if the PBA-TUDCA combination drug pans out, the drug will be especially important to the weight loss industry.

Wednesday, January 14, 2009

Weight Loss and a Whole-Grain Diet

The combination of diet and exercise is widely used for weight loss. It is generally accepted that exercise alone is not as effective as exercise plus a low calorie diet. Some may wonder if one low-calorie diet is better than another low-calorie diet. A study done by researchers at the University of Rhode Island indicated that exercise plus a high fiber whole-grain diet might indeed provide the maximum benefit. This diet supplies valuable nutrients as well as fewer calories than many diets.

For the study, three groups were established consisting of 180 subjects. One group used exercise, only, to lose weight. Another group used exercise plus a reduced calorie diet that included whole-grain cereals, and the third group used exercise plus a low calorie diet that did not include any whole-grain cereals. The groups consisted of sedentary men and women, and the study was carried out over a six month period.

The results of the study were as follows: The two groups that used exercise in conjunction with a low-calorie diet lost more weight than the group that used exercise alone to lose weight. But the group whose diet included whole-grain cereal may have received a healthier diet, because that group used a diet containing more nutrients than the other two groups. The whole-grain-cereal diet group received more fiber, magnesium and vitamin B6 in their diet than the other two groups.

It was determined, however, that all three groups needed more calcium and vitamin E. Although cereal is commonly eaten with milk, the whole-grain-cereal group ate the cereal as a snack and without milk. Milk would have been a source of calcium.

Using exercise plus a diet rich in whole grains is a good combination on which to build for a nutritious, weight-loss diet. Adding foods such as milk, green vegetables, and almonds would provide the needed calcium. And adding foods such as avocado and mango would provide Vitamin E.

At any rate, it appears that to lose weight, it is important to combine exercise with a low calorie diet. And if that diet is one that provides good nutrition, the diet plus exercise could be a winning combination. Bariatric and weight loss centers should take note of this research.

Wednesday, January 7, 2009

Companies That May Produce an Effective Weight-Loss Medication

In its history, the FDA has approved only a few drugs for weight-loss related use. These drugs include phentermine, approved in 1959, fenfluramine, approved in 1973, dexfenfluramine (Redux), approved in 1996, sibutramine (Meridia) approved in 1997, and orlistat (Xenical), approved in 1999. Fenfluramine and dexfenfluramine were pulled from the market in 1997 because the drugs produced serious, undesirable side effects. And although phentermine, orlistat and sibutramine remain on the market, they too usually produce undesirable side effects. Further, these drugs commonly provide less than a ten percent weight-loss. However, we do believe that some companies are involved in research that could lead to safe and effective weight-loss medication.

Because more and more people are overweight or obese, there is great demand for weight-loss medication that will produce few or no side effects, while providing at least a ten percent weight loss. JPMorgan Securities indicates that the weight-loss market was a $50 billion market in 2006. The market is probably larger today. Although high, the demand for a safe and effective weight-loss drug may have to be met by products from lesser known or smaller companies operating in the pharmaceutical industry.

Large pharmaceutical companies such as Merck & Co, Pfizer Inc., Bristol-Myers Squibb Co, AstraZeneca, and Sanofi-Aventis have failed, so far, to produce an effective, safe weight-loss drug, despite expensive efforts to produce such a drug. In fact, Sanofi-Aventis, Pfizer, and Merck recently ended weight-loss drug tests because drugs in clinical trials, from these companies, produced severe side effects. AstraZeneca and Bristol-Myers Squibb do still have tests underway.

Lesser known or smaller companies working to bring a weight-loss drug to market include: California based Orexigen Therapeutics Inc., Denmark based Novo Nordisk A/S, California based Arena Pharmaceuticals Inc., California based Vivus Inc., Ohio based Athersys Inc., Osaka (Japan) based Takeda Pharmaceutical Co., Lille (France) and Massachusetts (US) based Genfit, Cambridge (UK) based Alizyme plc, Maryland (US) based Ore Pharmaceuticals, and California based NeuroSearch.

All companies mentioned above, currently engaged in weight-loss research, are worth watching. Perhaps, one of these companies will develop a safe and effective weight-loss drug. If and when this happens, it will be beneficial to those wanting to lose weight, and strategically significant to weight loss or bariatric centers wanting to offer the most effective weight-loss options.

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