Hormone discovered - now no exercise needed?

Big News flash - the discovery of a hormone which gives the benefits of exercising without exercising.

 "Just take a pill and it will be like we exercised?" asked one newscaster of Dr Steven Garner who was not associated with the study.  The doctor answered affirmatively, explaining that it switches the "bad fat" to "good fat".  "If you want to do without exercise, you would only would take this pill for 10 weeks!" continued the doctor.

"Wouldn't there be other benefits of exercise though that this hormone would not provide?" The newscaster asked.  Dr Garner admitted it did not build up muscle mass.  And when the newscaster asked how much this pill would cost, Dr Garner suggested it might be very expensive because only one pharmaceutical has the patent.

I am a strong believer in "if it's too good to be true, it probably isn't" so I investigated.  An article by Bloomberg, admitted the hormone had only been tested in mice.  That definitely, might be a problem as far as it working the same way in humans. For example, giving mice Leptin makes them slim and it was once touted as the magic obesity curing hormone yet it was very disappointing in human trials.  For some reason, Leptin doesn't have the same effect on humans as it did on the mice.  Whatever the case, the announcement that it would even be effective, let alone safe in humans was very premature.

The reality is first of all, it's unproven whether it's safe or effective in humans and Dr Garner on Fox News using buzz phrases like "all natural" and "no KNOWN side effects" is code for "we haven't really tested it and won't know about its safety or effectiveness until we market it and people live or drop dead."  

Secondly, the greatest benefit from cardio exercise is exercising the heart and no pill will do that.

Bottom line, unless you trust the pharmaceuticals with your life, pass on this one and don't throw out your treadmills or bicycles.
More than likely, this headline was more about obtaining funding for the scientists rather than a real breakthrough and nothing does that so well as an eye catching, anti-obesity headline given to the news services.

Pillz pillz pillz - do they really offer hope for easy weight loss

A headline in the AZCentral website boasts that "Experimental diet pill has promise, little risk".

Apparently a large study in the New England Journal of Medicine stated that this medication,

Lorcaserin caused more people to lose at least 5 percent of their body weight over one year, more than twice the rate achieved by those on dummy pills.

So what is this wonder drug? Yet another flavor of an SSRI i.e. like Prozac etc. And in fact, according to the newsletter, Heartwire, Lorcasin isn't that much different from fenfluramine - one of the medications in Phen-Fen:

Lorcaserin is a selective serotonin 2C receptor agonist, and previous studies have shown that drugs targeting serotonin are beneficial in weight loss. The nonselective serotonin agonist fenfluramine, which, along with phentermine, made up the antiobesity medication fen-phen, for example, was approved by the Food and Drug Administration (FDA) in the early 1970s as an adjunct for the treatment of obesity. It was pulled from the market after reports it caused valve disease and pulmonary hypertension.

And what was this amazing weight loss the drug caused? Well, the average weight loss among the people in the study, was 12 lbs over a year which they apparently kept off mostly during the second year of the study. This compared to a weight loss of 4.8 lbs in those taking sugar pills (Placebos).

Adverse events according to the researchers on the study ( abstract is available,) were 'only' headache, nausea and dizziness.

Fact remains, to lose 12 lbs in a year, is easy even without their drug. For example something as small as a walk a day will do it. (That's about 1 lbs a month)In fact, a 2003 study (reported on in the JAMA) by Stanley Heshka found that people on Weight Watchers who attended most meetings, lost an average of 11 lbs in a year - without any drugs. (JAMA. 2003 Apr 9;289(14):1792-8.)

This isn't the only "wonder drug" coming out - there is another I recently read about called Qnexa which is really a combination of two already available medications, Phentermine (yes, the stimulant and part of Phen-Fen, the combination which caused Pulmonary hypertension in some people) and Topamax, the anti seizure drug. Vivus called the combination Phen/TPM in the FDA documents but obviously since that's uncomfortably close to the unsafe Phen-Fen, I'm sure it won't be marketed under that name.

According to the releases on this medication, the weight loss was better than the serotonin agonist above:

Qnexa showed the best weight loss results in clinical trials, with patients losing between 13 percent and 15 percent of their body weight. But the drug also had the highest rate of patient dropouts due to side effects, which include memory and concentration problems. Qnexa is a combination of two older drugs: the amphetamine phentermine and topiramate, an anticonvulsant drug sold by Johnson & Johnson as Topamax. According to the company, phentermine helps suppress appetite, while topiramate makes patients feel more satiated.

In other words, the Phentermine makes your heart beat faster (which can't be good for the heart) and the Topamax causes you to forget how hungry you are?

Kidding aside, there seems to be conflicting reports how much weight the cohort lost as well as what those side effects are. (Vivus, the manufacturer has not yet published their two 56 week long studies on the drug combo yet)

UPI reported a weight loss of 3-11 percent which is considerably less than reported in the Dallas news media:

Included in the review [for the FDA] are two randomized, double-blind, placebo-controlled 56-week trials conducted by Vivus and presented at medical meetings, but not yet published in peer-reviewed journals. Under the low dose, body weight losses were 3 percent or more, while the higher dose (including 100 mg of Topamax - enough to cause the adverse side effects) resulted in a body weight loss of about 11 percent.

I have a friend who was put on Topamax for seizures - she didn't lose any weight and she complained bitterly about the side effects of the drug. What she described which seems to have been missed in the news but was described in an FDA memo document was as follows:

When used at doses of 100 mg to 400 mg per day for migraine prophylaxis and the treatment of seizures, topiramate is associated, in a dose-related manner, with an increased incidence of cognitive-associated adverse events including confusion, psychomotor slowing, difficulty with concentration/attention, and difficulty with memory, speech or language problems, particularly word-finding difficulties.

Another adverse side effect reported on in the FDA memo was Metabolic acidosis in a percentage of the cohort on Qnexa - this could cause kidney stones as well as osteopenia:

A mild, sustained metabolic acidosis increases the probability of developing nephrolithiasis [kidney stones] and adversely affects bone structure and function. In the one-year clinical trials, there were twenty-two reported cases of nephrolithiasis [kidney stones] in the PHEN/TPM group compared with five in the placebo group.

(Having gotten a kidney stone once in my life, I would add- you so don't want to suffer that one - yes, it is true what people say, that the pain is exquisite and intense!)

Finally the FDA memo stated that although cardiac arrythmias and other cardiovascular events were of low incidence, there was no information available about the repercussions of using it for the long term treatment of obesity.

And according to the FDA Briefing document from the manufacturer, most of the year, those on in studies were told to change their lifestyles to one of regular exercise and calorie restriction, which will, of course, cause a weight loss without the drug.

One blog stated that the FDA had concerns about the drug combo:

FDA reports show that Qnexa has potentially bad side effects on the heart. Increased heart rate, depression, adverse effects on pregnant women and memory and language problems were noted during testing. Attention span also seems to decrease with usage.

Unfortunately, I could not find the affore mentioned FDA reports and the blogger did not give the cite however, since Phen-Fen caused serious heart problems, I would not be surprised if Phen-TPM did also. They will only find that out in the aftermarket studies after thousands of people have been the guinea pigs for the new drugs.

There is a dark side of stimulants also, (and the serotonin agonists also work as stimulants which is why they are often used to treat depression) according to "PROZAC BACKLASH" by Joseph Glenmullen, MD, is that on the long term, they can significantly raise the risk for Parkinson's disease, something which people are seldom warned about despite a body of research suggesting this. Serotonin agonists tend to cause a flood of the brain chemical serotonin, which causes the brain to react by producing more dopamine - this imbalance of an overage of dopamine is what is thought to raise the risk for Parkinsonism.

Additionally some "whole life" animal studies have suggested that longer term use of the serotonin agonists can also damage the serotonin receptors in the brain.

The only wonder about these two drugs in my book is that I would bet people will buy them, still looking for the elusive "easy way out" of counting calories and exercising to achieve and maintain weight loss.

Truth being that people do not have to lose weight to get healthy - they only have to make mostly healthy food choices and try to exercise (cardio) 4-5 times a week - this is called HAES and is well proven by clinical studies including the 2 year study at USC - researchers on this clinical study were Linda Bacon and Judith Stern and since Stern is a member of the Weight Watchers International Medical advisory committee, she would have undoubtedly, preferred a different finding than the finding of the HAES study i.e. that healthy lifestyle without a focus on weight loss trumped dieting as far as reducing health risks.

Take a look: Link for the HAES study

For more info, also see Dr Bacon's website.

Even thin people get diabetes

An article carried on MSNBC (reprinted from the magazine "MensHealth") began with this promising headline.

Unfortunately, the headline of the article was probably the best and truest part. At least 33 percent of type II diabetics have never been fat in their lives.

But the article itself is typical from what can be expected from "MensHealth" magazine - MensHealth is a real pop science mag and not an accurate source at all. We KNOW that MSNBC would LIKELY NOT print a REALLY informative article about anything regarding obesity or diabetes and in that way, this article did not disappoint.

Most people will NOT slog through the verbiage which is very extensive ... I slogged through about 3/4 of it and then, decided the rest was more of the same.

The picture most people will take away with them from reading a couple of paragraphs, however, is the gaunt emaciated father (whom the author carefully avoids directly SAYING has diabetes by the way, so he may not even have the disease) who is in a nursing home and obviously suffering from Alzheimers. Well, news flash...Alzheimers is not only NOT related to diabetes (it's a gene also) but it's one of those diseases which fat people seldom get for some reason.... My FIL, a thin man who had diabetes and lost his legs to the illness, was intelligent and sharp up to the day he died just short of his 70th birthday. And my hubby's cousin is the same age as the author's gaunt father, has diabetes, takes medication and has a BMI which is in the high 50's or even the 60's - she travels all over the place, goes on cruises and doesn't even particularly adher to avoiding the sweets she's always liked. And she certainly is NOT senile in any way - she still lives on her own, having out lived her slim, health minded husband by several years, by the way.

Most people will just read the first couple of paragraphs and take with them the frightening picture of the senile father with Alzheimer's which the author has now connected with diabetes. But the media has that covered - most will scan the sub-headlines and get the message they want to convey anyway. One of these, is suggesting "low carb diet" for diabetes. But in reality that the reason even the ADA has NOT embraced low carb diets for diabetes is because there is NO PROOF that these diets are of ANY benefit to reducing sugar levels. It seems logical but people forget that EVERYTHING ends up glucose for energy. And I've seen my hubby, GG, a diabetic diagnosed 15 years ago, eat an all carb dinner and have a high reading in the morning and then the next night eat totally not only carb but fats and simple carbs and sugar and then have a low reading the following morning.

Diabetes sugar levels do apparently not rely on what you eat. They MAY rely on HOW MUCH you eat but the jury is still out on that one also. However there is certainly more observational evidence that eating less can bring down sugar levels but some of the slimmest diabetics have very high sugar levels so who really knows?

I have a friend who BELIEVEEEESSSS in the low carb way... she is an apostle for low carb eating. But her husband on much more metformin than GG even though HER husband is newly diagnosed, and who eats faithfully low carb, has sugar levels which range in the 300's (morning reading). She is not deterred however. Low carb dieting has not been kind of her figure either - she's got a high BMI even with never touching sugar and seems unable to lose the weight which has bugged her for decades. (We know she IS upset about her weight because she had weight loss surgery which was a health disaster for her, many years ago)

The article has a short blurb about exercise and this is about its only saving grace however, in the length of it, I bet most folks will have missed the paragraph about exercise so here it is for your convenience:

*** Just how powerful an antidote is exercise? A study published recently in the American Journal of Physiology — Endocrinology and Metabolism revealed that insulin resistance in rats decreased more from exercise than from taking metformin, the leading diabetes drug.***

That's it... pretty slim for what probably is the ONLY thing they know of to help control sugar levels besides medication. And by the way, they have a lot more than RAT studies suggesting the benefits of exercise for everyone and specifically for diabetics (i.e. intentional cardio).

More inaccuracies of the article? Diabetes is NOT the fastest growing disease. In fact, levels have DECREASED slightly in the last decade or so. How they are proclaiming that the incidence of diabetes has increased, may be because they are now counting everyone with a slightly elevated sugar level as in the realm of diabetic. Also they count women with gestational diabetes however, it has been observed that only about 50 percent of those with gestational diabetes actually come down with the illness. Often fat people even those with normal sugar levels are counted among the "pre diabetics".

The statement about diabetes greatly rising in incidence among children is erroneous also. People are BORN with insulin resistance - what is rising in incidence is our ability to DIAGNOSE insulin resistance in kids - something we were not able to do a couple of decades ago. But are we using this to get ALL KIDS to exercise or re-instituting P.E. on a daily basis in the schools? NOPE! It's just used as a scare tactic to sell diets and diet foods and impose diets on our children in their most vulnerable years.

What IS scary is not the "shockers" this article promises but rather than there is so much misinformation floating around about diabetes, it's frightening. Few doctors REQUIRE exercise of diabetics even though that's the only thing which has been shown to help.

Luckily we have medications which are excellent like metformin and do not have to rely on the "pancreas" burners like our parents were stuck with.

Many diabetics die of heart disease (which the media is quick to blame on the disease thus forgetting that heart disease in general IS the leading cause of death of ALL Americans not only diabetics!). And the greatest help in preventing or healing heart disease... The big "E" word, exercise.

Only 25 percent of Americans exercise cardio (which is what strengthens your heart) 3 times a week. Only 5 percent of Americans do daily cardio which is really what you need.

That (and not this inane article) is sobering and scary. Have YOU done your cardio today?