 |
 |
This
map shows the percentage of obese residents in each
state as of 2003
(click
to enlarge)
|
|
January
18, 2005 – Obesity
surgeries are an increasingly popular weight loss technique
—
and their successes can be quite dramatic. But going under
the knife is a drastic step that plenty of obese people are
hesitant to make, and surgery may be inappropriate for other
people who haven't crossed the line from overweight to obese.
Experts stress that a healthy diet and exercise are key, but
it's not easy to lose weight the old-fashioned way. Scientists
are working to expand the range of fat-fighting tools in the
doctor's bag —
and plenty in the pharmaceutical industry are searching for
drugs that melt away excess pounds.
---------------
Our
bodies' weight control mechanisms are highly complex, and
researchers are just beginning to untangle all the different
systems that interact to regulate weight. Scientists scrutinize
each newly identified mechanism to see how the fresh information
could help design a drug to combat obesity. Even on the distant
horizon there are no magic pills that will effortlessly slim
obese patients down to fashion plate size. But even a relatively
modest weight loss of 5 or 10 percent of body weight is enough
to make a patient healthier, as seen in rates of high blood
pressure, high cholesterol and diabetes, for instance.
 |
|
|
|
|
"Medication
is going to be the way to go," says Dr. Louis Aronne, president
of the North American Association for the Study of Obesity.
"I look at this as a valid form of treatment and not a 'shortcut'
or a cosmetic treatment." Dr. Aronne says that many of his
patients have serious medical problems that could have been
prevented, or at least lessened, if their weight hadn't continued
to climb unchecked. And once people gain weight, their bodies'
resistance mechanisms make it very hard to lose it. We need
help! That brings us to the promise of drugs.
Only
two obesity drugs have been approved so far by the Food and
Drug Administration for long-term use. One is sibutramine,
marketed as Meridia. Doctors can prescribe it for patients
with a body
mass index (BMI) of 30, or 27 if the patient has other
risk factors besides obesity. Meridia doesn't suppress appetite,
it makes patients feel more full once they start eating. The
drug works by preventing the neurotransmitters serotonin and
norepinephrine from being reabsorbed and recycled in the brain
when they are first released in response to eating. These
neurotransmitters are at least partially responsible for the
feeling of satiety we experience when we eat. Meridia allows
them to linger and make the sensation of fullness last longer.
So patients reduce their caloric intake — they feel satiated
sooner and end up eating less. Meridia can help patients lose
up to about 10% of their body weight. Side effects include
increased blood pressure and heart rate, which put Meridia
off limits for the large number of obese people who already
have hypertension.
The
second drug currently on the market is orlistat, sold under
the brand name Xenical. Rather than acting in the brain, Xenical
works in the digestive system to prevent absorption of fat.
Its focus is the fat-digesting enzymes known as lipases. They
normally break down triglycerides from food into fatty acids
and monogylcerides that the body can absorb. Xenical attaches
to the lipase enzymes and prevents them from doing their job.
Since fats are filled with calories, blocking the body from
absorbing them is an effective way to cut calories from the
overall diet. Xenical's maker, Roche Laboratories, says that
the drug can prevent absorption of about 30% of the fat a
patient eats. Xenical can help patients lose between 5 and
10% of their body weight. There can be some unpleasant side
effects, though, as the undigested fat is excreted from the
bowel. As Roche puts it, Xenical users can experience "oily
spotting, gas with discharge, urgent need to go to the bathroom,"
and other effects in this vein. 
--------------------------
3 pages: | 1 | 2 | 3
|
|
