Monday, November 21, 2016

Intermittent Fasting for Weight Loss and Type 2 Diabetes

Diet, exercise, and lifestyle modification are the typically preferred approaches to weight loss and weight management. However, employing these methods frequently fails to achieve long-term weight loss. So, experts are looking at a number on different weight loss approaches. Of course the weight loss and weight management investigations include diet. And one type of diet receiving attention is intermittent fasting (IF). In intermittent fasting, a person follows a very low calorie or zero calorie diet on some days of the week, and a non-restricted calorie diet on the other days of the week. And as might be expected, there are questions about the effectiveness of IF as a weight loss treatment, and about IF as a treatment for type 2 diabetes.

One popular version of IF is presented in the book, "The FastDiet." In this book, author, Michael Moseley, suggests that a man, desiring weight loss, should restrict his diet to 600 calories a day for two non-consecutive days. Moseley suggests that a woman, following his IF approach, should restrict her calories to 500 calories a day for two non-consecutive days. The man or woman should eat normally for the remaining five days of the week. This form of IF appears to be effective for some people. For example, reviews of Moseley's book on indicate that many followers of the diet do lose weight.

Another version of IF is alternate day fasting (ADF). In this form of IF, a person goes on a very low calorie diet on alternate days of the week, while following a normal diet on the other days. This form of IF can enable a person to lose weight. Indeed, one study indicates that ADF can help a person to not only lose weight, but the dieting approach can be effective in treating type 2 diabetes.
In one study examining ADF, where individuals restricted their calorie intake to 75% of their normal calorie intake, ADF was found to be as effective as continuous calorie restrictive dieting for "weight loss and type 2 diabetes risk reduction in overweight and obese populations."

Still, in a recent meta analysis, the investigators suggested that "IF ... represents a valid -- albeit apparently not superior ... option to continuous energy restriction for weight loss." But, at any rate, the above mentioned book and studies show that in some cases, IF might be beneficial in some cases.
More research is of course needed. But weight loss providers should monitor research on IF. And for specific patients, application of the IF approach might be feasible.

Thursday, November 17, 2016

How Does Lorcaserin Work?

There are five obesity drugs currently on the market that have gained FDA approval for long-term use. These drugs are orlistat, qsymia, contrave, saxenda and lorcaserin. Each one of these drugs can lead to a 5% weight loss. And a 5% weight loss can lead to improvements in blood pressure, cholesterol and HbA1c and other metabolic characteristics. While lorcaserin, one of the approved drugs, can lead to a 5% weight loss, it is not known, completely, how the drug causes weight loss.

It is known that lorcaserin activates the serotonin receptor which decreases a person's appetite, causing the person to consume fewer calories. And at least one study looked into what else lorcaserin does as a weight loss agent.

The study was done at Beth Israel Deaconess Medical Center (BIDMC). Over a period of four weeks, 48 subjects were looked at. In the study, which included men and women, half of the subjects were given lorcaserin and the other half were given a placebo. All study subjects were given physical examinations on four occasions during the four-week period. The examination included a physical and blood work. The examination also included brain scans using functional magnetic resonance imaging (fMRI).

In the study, the participants were shown images of desirable food, including onion rings and cake. The participants were also shown less desirable food which included vegetables, and other items that were not food, such as rocks and trees. The brain scans showed that "subjects who had the strongest brain responses to food prior to taking lorcaserin saw the most success with the weight-loss medication."

Indeed, 'Decreases in caloric intake, weight, and BMI were linked to strong responses to food cues in the areas of the brain related to emotion, pleasure and attention prior to taking the weight-loss drug, which suggests that lorcaserin could prove to be of particular benefit to those who eat emotionally."

At any rate, lorcaserin appears to cause weight loss via multiple pathways.

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