A New Weight Loss Drug!

Have you heard that the FDA approved not one, but TWO new weight loss drugs this summer? Hooray! Our problems are solved, right? Are there still overweight doctors out there? Well...yes, there are, so that should give you a clue that these new drugs are not miracle workers.

Today I will focus on the first drug approved. Locaserin, brand name Belviq, came out in June 2012. This drug will decrease your hunger and increase your feelings of satiety (feeling full after a meal). Locaserin works within the serotonin system (like the antidepressants such as Prozac) but targets a specific receptor that is key in the appetite game, rather than mood. Fenfluramine, an older drug with a similar mode of action, was removed from the market in 1997 due to concerns of its detrimental affect on heart valves. The selling point of locaserin is that it targets a different, very specific receptor that is not linked to these deleterious valve changes.

In the studies necessary to get approved by the FDA, patients on this drug lost an average of 12 pounds in one year. Let me remind you that good steady weight loss is a pound or two per month (not the 30 pounds in 30 days we all would like), so this is reasonable weight loss. However, from my standpoint, I'd like to see a drug produce better results before risking the side effects. In this case,  side effects of lorcaserin include headache, dizziness & nausea. So at this point, I am not impressed enough to prescribe this drug.

BOTTOM LINE: Lorcaserin (Belviq) may provide obese patients help with decreasing their appetite & increasing satiety, but does not provide dramatic weight loss results.

How Fast Can You Lose 30 Pounds?

You only have to drive around town, flip open a magazine or your computer, and you will see an ad promising weight loss of "30 Pounds in 30 Days". And of course, all you have to do is buy this brand new miracle pill. You don't have to exercise or eat healthy foods. Ready to sign up? I hope not!

Our parents taught us that if it sounds too good to be true, it probably is. Yet, as Americans, we have become so used to instant gratification, we are convinced that somewhere out there exists a pill we can pop for easy, quick weight loss. Let me ask you this- do you think there would be any fat doctors (especially women, forgive my bias!) if such a prescription existed?

So, what is realistic? Well, obviously, it depends on your starting weight. If you are only 20 or 30 pounds overweight, though, a good rule of thumb is a half to one pound per week. It takes a 3600 calorie deficit to lose a pound. Period. If you can burn an extra 250 calories a day (walk 2 -3 miles, for example) AND delete another 250 calories from your usual diet (give up two sodas or one loaded latte per day), then you can expect to lose a pound per week.

Try to look at the big picture. There are 52 weeks in a year. If you make healthy changes such as eating MORE fruits and vegetable servings and moving MORE, you can easily take off those extra 20 to 50 pounds in a year...and KEEP THEM OFF because you did it through small, permanent changes!

BOTTOM LINE: Fast does NOT equal good, nor permanent, weight loss. Realistic, EXCELLENT weight loss is ONE POUND per week, so it will take 6 months to lose 30 pounds.

Amazing Weight Loss & the Acai Berry

Happy 2011! I hope your New Year's Resolutions include steps towards GOOD HEALTH this year! I am enjoying a snowy vacation in gorgeous Crested Butte, Colorado, this week. As I checked the weather report to decide on layers of clothing this morning, my attention was caught by a news headline by a Crested Butte health reporter.

The report was part of a series about effective weight loss strategies. I was immediately sucked in by the reporter's frank style and her admission that she was skeptical about different weight loss claims. She and the News 5 team decided to do their own trial, and guess what? She LOST 25 POUNDS in a MONTH, and looks slim and sexy with NO CHANGE in her diet! WOW!

Okay, wake up and smell the coffee! Of course, this is a SCAM and and AD to buy the berries. Unfortunately, it is SO CONVINCING that despite knowing the numbers and facts couldn't add up, I initially thought it was real, and that the reporter was simply exaggerating. The site looks amazingly valid, and she appears to be a legitimate health reporter. If you start to research the reporter, however, you quickly discover that no such reporter exists-ANYWHERE. This ACAI berry distributor simply created multiple websites under the names News5Health.com (and News6, and News7, etc.)

What is the truth?
1. You need a deficit of 3600 calories to lose a pound. Period. At burning (or not consuming) 500 calories per day, that is a pound of weight loss per week, which is terrific weight loss.
2. We do NOT have "gunk" lining our guts and creating "toxins". If we did, everyone who has a colonoscopy would be "cured" of obesity!
3. It's CALORIES IN vs. CALORIES OUT that creates weight loss or gain!

BOTTOM LINE: BEWARE OF WEIGHT LOSS SCAMS POSING AS NEWS REPORTS, especially the ACAI berry. Eat more fruits and vegetables and start moving more to lose weight in 2011!

Weight Loss Drug REMOVED from Market

Ah yes, it's becoming the all-too frequent headlines: Drug X removed from the market! This week, it's MERIDIA (sibutramine ), a weight loss medication by Abbott that has been available in the United States since 1997. A research study called SCOUT- Sibutramine Cardiovascular OUtcomes Trial- revealed a 16% increase in the risk for serious cardiovascular events such as nonfatal heart attack or stroke, the need for resuscitation (after the heart stopped), and even death, in patients who took sibutramine compared with those patients on a placebo.

Isn't obesity a risk factor for heart disease, though? Are you better off losing weight using a drug that might increase your cardiovascular risk versus simply staying overweight and being at risk from that? Researchers in this study say no. They believe the drug itself caused more increased risk than any benefit that might be derived from the weight loss itself. This was a large study, with over 10,000 men and women over the age of 55, who were significantly overweight and had a history of heart disease, diabetes, or other cardiovascular risk factor. As such, if you took Meridia and are overweight but have NO other risk factors, we do not know how much this drug might increase your risk.

What should you do if you took Meridia in the past? Let your doctor or FDA's Medwatch program know if you have developed any cardiovascular complications. If you are currently taking Meridia, you will need to discontinue it, and discuss an alternative weight loss program with your physician.

For the record, people in the study who received the real drug (not placebo) lost 2.5% more of their body weight over the five years of the trial. I would like to point out that following the MORE principles of increasing your fruit and vegetable intake plus adding in daily exercise will get you to the same or greater endpoint, with NO increase in cardiovascular risk!

BOTTOM LINE: The weight loss drug Meridia has been recalled- see the FDA report for further details, and contact your doctor if you are now or in the past took this medication.

New Weight Loss Drug in the New England Journal!

PLEASE do not ask me for this drug! I cringe every time that there is media attention to a new weight loss drug. This is not rocket science! If you read the study in the New England Journal of Medicine, ultimately this is what you will see:

1. All the participants received nutrition counseling and behavior modification in addition to the drug.
2. Yes, the folks on the test drug (Lorcaserin) lost more weight than placebo.
3. The people on the drug lost an average of roughly 12 pounds in ONE YEAR (note-one pound per month), and the placebo group lost an average of almost 5 pounds.
4. Everyone was relieved that there were no serious heart valve issues.
5. Side effects include: headache, dizziness and nausea.

Good weight loss from improving the quality of your diet (more fruits and veggies) and starting to exercise regularly is one half to one pound per week- so 2-4 pounds per month, or 50 pounds or more in a year. Side effects? Let's see- you feel better, have more energy, and bonus- don't mind looking in the mirror.

Please stop looking for a magic pill! All medications have side effects, and this new weight loss pill is no exception.
BOTTOM LINE: Old fashioned fruits, vegetables and exercise yield better weight loss with fewer side effects! Spend your money on MIchelle May, MD's book: Eat What You Love, Love What You Eat and break out of your "eat-repent-repeat" eating cycles!