Wednesday, January 30, 2013

Brown Fat Transplants to Treat Obesity

Bariatric surgery is an important weight loss option, today. Bariatric surgery is usually defined as surgery that restricts the amount of food eaten (restrictive), or surgery that reduces the absorption of calories (malabsorptive), or surgery that is both restrictive and malabsorptive. However, if one uses a more broad definition indicating that bariatric surgery is any surgery that is done to cause weight loss, other forms of surgery could be included in the definition of bariatric surgery. Therefore, brown fat transplants could be viewed as a potential form of bariatric surgery.

Brown fat is burned in the body rather than stored the way white is. Therefore, brown fat is preferable to white fat, for the most part. Studies to understand how brown fat is created in an organism are ongoing. And at least one study demonstrates that we may be able to produce brown fat from white fat.

According to a recent article, Bruce Spiegelman, professor of cell biology at Harvard, led research that shows that at least in mice, exercise can cause white fat to be converted to brown fat. Based on Spiegelman’s research, as mice exercise, their muscle cells release a hormone that the researchers named irisin. After its release, Irisin converts white fat cells into brown ones. And those brown fat cells burn extra calories. Spiegelman believes that the ability to convert white fat into brown fat may also exist in the humans.

A research group at the University of California is also investigating brown fat. The group found that in mice, TZDs (thiazolidinediones, such as Actos and Avandia) interacted with the hormone, PRDM16, to induce the conversion of white fat into brown fat.

In the brown fat transplant, “Mice given brown fat transplants lose weight and avoid the kinds of metabolic changes that lead to type 2 diabetes, even on high-fat diets…” If this type of “bariatric surgery” proves viable in humans as a weight loss method, it could be an important tool in the arsenal of surgical weight loss tools. Further, weight loss surgical centers may be able to eventually improve their bariatric surgical services.

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Wednesday, January 16, 2013

Combination Drugs to Treat Obesity

With the recent approval of the two obesity drugs, Qsymia and Belviq, we have additional long term pharmacotherapy tools for weight loss treatment. Qsymia is the combination of the two drugs, Phentermine and Topiramate. Phentermine has been used as a weight loss treatment for some time, while Topiramate has been used to treat seizures. Combining Phentermine and Topiramate was found to be an effective obesity drug by Vivus, the maker of Qsymia. And a recent study is leading to the possibility of another combination weight loss drug.

Indiana University researchers, along with other investigators, combined estrogen molecules with molecules of the hormone, GLP-1 to produce a new substance that could lead to another combination weight loss drug. GLP-1 is produced in the digestive system. And estrogen is produced in a woman's ovaries. Both GLP-1 and estrogen have been found to be effective in treating obesity and type 2 diabetes.

However, the researchers found that combining estrogen and GLP-1 was even more effective in the treatment of obesity and type 2 diabetes, without many of the dangerous side effects associated with the individual substances. The combination, for example, shows a reduced risk of cancer and stroke, which is associated with estrogen treatment.

In what might be viewed as related research, Novo Nordisk, the maker of liraglutide, an analog of GLP-1, is investigating the drug as a weight loss treatment. Novo Nordisk is based in Denmark, and markets the FDA approved liraglutide as a treatment for type 2 diabetes under the name, Victoza. Novo Nordisk feels that the FDA’s approval of Qsymia and Belviq presents an opportunity for other weight loss drugs. Indeed, GLP-1 analogs could become important players in the area of weight loss treatments.

At any rate, with the FDA's approval of Qsymia and the Indiana University researchers actions, even more attention may be given to combining known substances for weight loss. With the continuing need for safe and effective weight loss drugs, we hope that researchers will endeavor to continue to look for pharmacotherapy options for weight loss providers and persons seeking weight loss.

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