Weight Loss Drugs Reveal Minimal Effects - Study

No magic pills: Anti-obesity drugs provide only modest weight loss, study shows

Most severely overweight patients taking anti-obesity drugs will realize only modest weight loss, especially if they fail to augment the medications with regular exercise and a healthy diet, say Canadian researchers after reviewing numerous studies on the agents' effectiveness.

Despite being touted in the marketplace as miracle pills that can melt away pounds, doctors say that in reality the medications are no panacea to society's growing obesity epidemic and should only be taken by certain people.

"I think the most important thing that people need to understand is these are definitely not magic pills," said Dr. Raj Padwal, an assistant professor of internal medicine at the University of Alberta and principal author of the review.

Padwal and his colleagues looked at the results of 30 clinical trials of three drugs recommended for obese patients for long-term use - orlistat, sibutramine and rimonabant - and found that they helped people shed on average less than 11 pounds.

"We found that the amount of weight loss on average with these medications ranges between three and five kilograms," Padwal, who specializes in treating hypertension and obesity, said from Edmonton.

Orlistat (Xenical) reduced patients' weight by 6.4 pounds, sibutramine (Meridia) by about nine pounds and rimonabant (Acomplia) by just over 10 pounds in the studies, which each lasted at least a year. Participants had a mean weight of 220 pounds, with a body mass index (BMI) of 35. A BMI of 25 is considered normal.

In their analysis published in Friday's issue of the British Medical Journal, the researchers showed that those given one of the drugs were significantly more likely to achieve the minimum weight loss target of five to 10 per cent than those given a dummy pill.

But although the drugs overall can be beneficial in reducing risk factors for cardiovascular disease and diabetes, they have differing side-effects that in some cases can be detrimental, Padwal pointed out.

For some people, sibutramine can significantly boost blood pressure; rimonabant - which is commonly prescribed in the U.K. and some European countries but not approved in Canada or the United States - can elevate the risk of mood disorders such as depression.

In fact, a review of studies published Friday in The Lancet shows that obese patients taking rimonabant have a 40 per cent increased risk of developing severe depression and anxiety compared to those taking a placebo. Participants were up to three times more likely to stop taking the drug because of those mood disorders.

Padwal said getting patients to stick with any of the three weight-loss drugs long-term is a challenge.

"There's a large disconnect between what patients want in terms of weight loss and what practitioners desire," he said. "So patients will often want to lose . . . about 30 to 40 per cent of their initial weight. They want to get down to the weight they were in high school, two to three decades earlier."

"And they're disappointed when they're told that's going to be difficult to achieve."

Cost is also a major factor: orlistat and sibutramine (the only ones approved in Canada) will set back patients $80 to $130 per month, he said, noting that the drugs along with rimonabant represent more than $1 billion in worldwide sales for their makers each year.

Patients may also stop taking the drugs because of adverse effects such as gastrointestinal upset, anxiety or headaches.

But one of the biggest reasons, said Padwal, is the health-care system's failure to provide proper followup for Canadians battling obesity.

"We don't make it easy for individuals to see their practitioner if they want to have a visit regarding lifestyle changes or dietary counselling. And I think if people have to wait one to two hours to get in to see their doctor, it's unrealistic to think patients are going to come to us and wait that long for a medical assessment and counselling."

Dr. Jean-Pierre Despres, director of cardiology research at the Quebec Heart Institute, agrees that the system is far from ideal in helping overweight and obese Canadians trim excess fat and keep it off for good.

"In clinical practice we do a dismal job at this because we're not providing hospitals and physicians with adequate support with dietitians and exercise physiotherapists and kinesiologists," he said Thursday from Quebec City.

But Despres, who has studied the effects of rimonabant, said the medical community needs to redefine obesity. It should be based not on BMI but on waistline measurement and the proportion of abdominal fat - a much better indicator of weight-related risk for cardiovascular disease and diabetes, he said.

Furthermore, so-called weight-loss drugs should be used judiciously, he said, and only to cut a person's risk for heart attack and other conditions.

"There are some obese patients out there who are just fine, that are at very low risk of diabetes and heart disease, and they shouldn't take a weight-loss drug, period. It's not worth it," said Despres, who was not involved in Padwal's research group.

"It's like managing hypertension or high cholesterol. Why do you give a drug? You give a drug because you have no other option. If you don't, people are going to die, people are going to develop diabetes."

Padwal said the pills will assist in achieving the five to 10 per cent threshold. "Some people will have more weight loss . . . but that's very rare."

"So people have to understand the reason to prescribe these medications is to improve the obesity-related co-morbidities (illnesses) that they have. And if they stop the medication, they're going to see the weight back."

In an editorial accompanying the review, Dr. Gareth Williams, dean of medicine and dentistry at the University of Bristol, said he has reservations about the U.S. approval of a half-strength form of orlistat for over-the-counter purchase without a prescription.

"Even though orlistat seems to be innocuous, selling it over the counter could cause insidious collateral damage," writes Williams. "Globally, obesity is spiralling out of control and will only be reined in by public health campaigns that somehow persuade people to eat less and exercise more."

"Selling anti-obesity drugs over the counter will perpetuate the myth that obesity can be fixed simply by popping a pill and could further undermine the efforts to promote healthy living, which is the only long-term escape from obesity."

Source: CBC.ca

Obeez City and the XBOX

New DVD game battles childhood obesity

JIM ELLIS Associated Press

ORLANDO, Fla. - Obesity may be a global epidemic, but it's Obeez City that is spreading out of control in a new DVD game to be released nationwide Tuesday.

The game teaches youngsters how to avoid the ravages of being overweight, and may the healthy force be with you.

Gamers join a team of super heroes called Body Mechanics and war against the Evil Coalition of Harm and Disease, battling villains with names like Col Estorol and Betes II. The fighting takes place inside the body of Jack Decayd and if Obeez City is not contained, "Jack will die soon," says Neuro, the Yoda-like wise one who narrates the game's story line.

"I remember how it started. A few snacks here, a soft drink there," Neuro speaking in an ominous tone says during the opening. "And before we knew it, the Evil Coalition of Harm and Disease was threatening us all."

Neuro then makes his plea: "You must join the team of heroic Body Mechanics. They need your help in order to gain the knowledge necessary to save Jack's life. Only you can change how this story ends."

The Body Mechanics DVD game is the latest in a string of products in the video gaming industry to buck long-held notions and stress exercise and healthy living. The game is packaged with an animated movie and sold as a two-disc set. Body Mechanics will be in limited release Tuesday in retail outlets such as Target, Borders, Walgreens and CVS/pharmacy.

Viewed as sedentary pastimes, video games, and its cousins, the television and the personal computer, are typically the object of parental finger waving.

And children are becoming gamers younger than ever - 2 years old, according to a survey conducted by NPD Group, a market research firm. With sales in the U.S. totaling $12.5 billion in 2006, the gaming industry's foothold is firmly planted in American culture - and so is childhood obesity.

About 16 percent of children ages 6 to 19 are overweight in the United States, according to the Centers for Disease Control and Prevention. There is an 80 percent chance that overweight children will become obese adults and will be at risk for high blood pressure, high cholesterol and type 2 diabetes.

But with the highly popular active video game, Dance Dance Revolution, and gaming console's such as Nintendo's Wii and now Body Mechanics, the negative hype that video games enable teens to lay around and gain weight may meet some resistance.

Imagine Harry Potter, Star Wars and Lord of the Rings all mixed up inside the body and that's Body Mechanics, said Tony Findlay, the game's creator, who is based in Australia.

Findlay, 40, said the idea for the game and movie came while on tour to promote his book, "DIETS SUCK."

"Parents approached me and asked how they can teach their kids to eat better and exercise more," said Findlay, who said his own father was obese and died of a heart attack at 56.

Butch Rosser, one of Body Mechanic's contributors, was once a morbidly obese medical student whose weight topped 450 pounds. He admits that he used video games - dating back to Pong in the 1970s - to escape the stresses of all-night study sessions.

Now a surgeon in New York City, father of five and yes, still a gamer, he weighs in 160 pounds lighter these days due to gastric bypass surgery six years ago. Rosser lends his acting ability in the movie as Dr. Bludd, the good doctor who stresses the importance of saving not only Jack Decayd's life but "all of humanity."

His prescription for the young and overweight today is the very thing he says enabled his weight gain early in life - video games.

"We have a new genre of video games today," Rosser said. "You can lose pounds while having fun and that's a beautiful combination."

Jake Schweizer, an 8-year-old gamer who lives in Orlando, plays his XBox about an hour every day. He is within the 5- to 11- year-old age range Body Mechanics aims to reach.

Players choose one of three main missions and then follow along on an animated adventure, answering 10 questions along the way. Answer too many questions incorrectly and Jack Decayd dies.

"I like the questions. They're fun to answer," said Jake, who only missed one the first time he played Body Mechanics during a recent video game convention in Orlando.

Video games like Body Mechanics have a difficult task, said Dr. Karen Cullen, associate professor of pediatrics/nutrition at the Children's Nutrition Research Center in Houston.

"You can give someone an hour's worth of facts and you'll bore them to death," she said. "The games have to be entertaining to compete in the marketplace."

Cullen was one of the researchers at Baylor College of Medicine who developed a computer game that improved eating habits in children. Fourth graders from 26 elementary schools participated in the study.

Children played a medieval-themed game called Squire's Quest. Players advanced from squire to knight. But along with achieving knighthood, gamers were encouraged to eat more fruits and vegetables.

The new video games and consoles that require more than thumbs pounding a handheld controller is a positive development, Cullen said.

Rosser, who performs weight-loss surgeries, said he hopes reaching children at a young age with the message of eating healthy will prevent problems with weight later in life.

"I don't want people to have to undergo a surgical procedure to save their life," Rosser said. "I want to put my knife out of business."

Source: brandenton.com (brandenton herald)

Obesity Radio Treatment

Radio Frequencies Used To Zap Fat

It's the bane of most people's existence. And it happens to just about all of us.

There's a certain irony in the fact that cellulite contains the word 'lite' - a term the food industry uses to sell you goodies with reduced calories.

But while getting rid of fat in food doesn't appear to be a problem, getting it off your body often seems to be impossible without major surgery.

Until now.

A Toronto company is the first to employ a new laser technology called Accent. It melts the cellulite away without any pain and without any invasive procedures. Hard as it is to believe, an attendant simply passes the specially focused beam over the troubled area and the fat disappears.

It's not inexpensive (see list below) but after trying everything else, Sophie Pavlou decided it was worth the money. "We tried exercise, kickboxing, this, that," she remembers. "Cellulite would not go. Diet, caffeine. Nothing works."

Then she put on a new 'Accent". "It's night and day," she proclaims after her treatments.

How does it work? The beam heats the skin with radio frequencies. "This technology penetrates deep and smoothes out the skin and ... eliminates [the cellulite]," explains Mandy Maresky of Cosmedicare.

Doctors will still tell you that it's important to eat right and exercise to get the fat off you and keep it that way. But Sophie is appreciative of the shortcut.

"It's literally melting the fat," she marvels. "The fat just melts away." She claims to have lost 13 lbs. with the method. And she's more than willing to come back for additional treatments if it becomes necessary.

"Just sitting here doing nothing and getting a massage and you're losing weight," she concludes. "I know it's crazy, but it works. And I'm proof. I mean it's unbelievable!"

So how much will your body area cost you? Check out the list below.

Thighs (back and front): $800
Abdomen: $400
Buttocks: $450
Arms: $400
Love Handles: $400
Face: $400
Double Chin and Neck: $350
Face and Double Chin: $650

Source: Citynews.ca