The FDA has just approved the first new weight loss drug in 13 years called Belviq (lorcaserin). This is essentially a “new and improved” version of Fen-Phen pulled by the FDA in 1997 due to heart valve problems. On the same day this week of the new drug’s approval, a recommendation against using diet drugs was published online in the Annals of Internal Medicine. Referring to currently marketed diet drugs, the U.S. Preventive Services Task Force concluded that because of safety problems and a lack of data showing that people can keep weight off after discontinuing diet medications , the task force could not recommend that anyone use diet drugs.
Although an FDA advisory committee that reviewed lorcaserin for medical weight loss voted to approve it, it did so reluctantly, particularly because of widely shared concerns about evidence of heart valve damage in people using the drug in clinical trials. When these last heart valve-damaging diet drugs were banned in 1997, the knowledge of this life-threatening adverse effect was known only after approval. But in this case, the FDA has known before today’s approval of lorcaserin that it could damage heart valves. The agency’s own advisory committee concluded that “[t]here’s probably not sufficient data at this time to rule out a clinically meaningful increase in the risk for valvular heart disease.”
This is hardly an overwhelming endorsement for a new drug for medical weight loss by the FDA. A major medical journal and a government task force advocates against “diet pills” because of serious side effects and no one really keeps the weight off long term when using them. In complicated conditions like overweight and obesity the old mentality of “a pill for an ill” is too simple minded. Doctors and the general public know that the only long term solution is changes lifestyle in food choices that do not cause serious health issues like heart valve problems.
We help many people in our clinic with weight related medical problems like high cholesterol and triglycerides, blood sugar, blood pressure and body pains related to excess weight. Please see our success story video and the tab for FirstLine Therapy lifestyle program and see how safe medical weight loss can help you.
Help Me Lose Weight
In parts I and II I covered two hidden causes of weight loss frustration, lack of adequate sleep and disruptions of bacteria in the intestinal tract. The next hidden cause of weight loss frustration is toxic chemicals stored in our fatty tissues. These are called Obesogens. Some of the most common obesogens are pesticides and other chemicals called POP’s or persistent organic pollutants such as PCBs (dry cleaning fluid), DDE (a break down product o DDT), hexachlorocyclohexane (pesticide), Pthalates and Bisphenol A (both in some plastic bottles and packaged foods). These chemicals disrupt normal weight loss signals in the body. In your quest to “Help me lose weight” we have to consider these toxins.
In an article entitled: “Chemical toxins: a hypothesis to explain the global obesity epidemic” in the Journal of Alternative and Complementary Medicine in 2002 the authors state, “Because the obesity epidemic occurred relatively quickly, it has been suggested that environmental causes instead of genetic factors may be largely responsible. What has, up to now, been overlooked is that the earth’s environment has changed significantly during the last few decades because of the exponential production and usage of synthetic organic and inorganic chemicals. Many of these chemicals are better known for causing weight loss at high levels of exposure but much lower concentrations of these same chemicals have powerful weight-promoting actions. This property has already been widely exploited commercially to produce growth hormones that fatten livestock and pharmaceuticals that induce weight gain in grossly underweight patients. This paper presents a hypothesis that the current level of human exposure to these chemicals may have damaged many of the body’s natural weight-control mechanisms. Furthermore, it is posited here that these effects, together with a wide range of additional, possibly synergistic, factors may play a significant role in the worldwide obesity epidemic.”
A strong correlation was seen between increased levels of specific POPs and insulin resistance and Body Mass Index reported in the journal Obesity in 2010. Research from Diabetes Care 2007 suggest that persistent organic pollutants (POPs) may be associated with type 2 diabetes risk by increasing insulin resistance in obese individuals.
See our video about our 10 day metabolic detoxification program and ask us to “Help me lose weight“.
In Help Me Lose Weight Part One, I discussed how lack of sleep can create a hormonal imbalance to slow down weight loss. In today’s blog here is a question I ask everyone who is struggling to lose weight, “How often have you taken antibiotics in your life?” I ask this question because antibiotics disrupt the intestinal environment of bacterial we all have which is about 3 pounds. Yes, we all carry several pounds of life sustaining bacteria which starts growing at birth. In addition to antibiotics, a fast food diet high in fat and sugar can also disrupt the gut bacteria by starting a low grade inflammatory process that disrupts the chemical signals of glucose and insulin regulation by gut hormones. These individuals are screaming. “Help me lose weight.”
The evidence is growing. Cecil Lewis of the University of Oklahoma a member of a team of scientists studying the DNA of ancient gut bacteria says, “My first hypothesis would be that chlorinated water and antibiotics fundamentally changed human microbiomes (i.e. gut bacteria).” Other research on gut bacteria has found that obese individuals tend to have a makeup of pathogens in their intestines different from that of people who are of normal weight. In one experiment, researchers found that an obese mouse’s gut microbes extracted more of the calories from a given piece of food than did those of non-obese mice. This caused the obese mice to gain more body fat than the non-obese mice did. But even stranger, in a type of mouse with a different mutation that leads to obesity, transferring gut microbes from the obese mice into other mice led the non-obese mice to eat more.
So the answer is a change in the diet to whole fresh foods, minimally processed, high in fiber, low in fat and sugar. It may also be necessary to rebuild the good bacteria through probiotics containing live cultures of lactobacillus and bifidobacterium. In part III of â€˜Help Me lose Weight‘ I will cover another hidden cause of weight loss frustration. See our success story video.
Help Me Lose Weight
Frequently it is necessary to look beyond diet and exercise for the hidden obstacles that make weight loss a frustrating experience. I see some patients who limit their calories too much and exercise too much to “force” the weight off. Sometimes I hear, “If I eat over 1000 calories per day I gain weight.” There is more to weight loss than just calories in and calories off. What is in between is your own biochemistry including hormones you probably have never heard ofâ€¦but more on that in a minute. I recently saw a woman in her early 40′s who was frustrated with lack of weight loss even though she had been following the dietary plan in our FirstLine Therapy program and being active. At her last visit I asked her about her sleep. She said she goes to bed around 10 or 11 but gets up at 3 am when her husband goes to work and does not go back to sleep. She gets up just to see him off not because he needs anything done for him. So her main concern is “Help me lose weight.”
Researchers in the long term nurses study in 2006 found that the women sleeping 5 or fewer hours per night were 32% more likely to experience major weight gain, defined as an increase of 33 lb or more, and 15% more likely to become obese during the 16-year study period than the women who slept at least 7 hours per night. In addition, women who slept for 6 hours were 12% more likely to have major weight gain and 6% more likely to become obese compared with women who slept at least 7 hours per night.
The key result was that sleep deprivation decreases the levels of leptin (a hormone produced in our white fat cells) which signals to the brain that the body has had enough to eat, producing a feeling of satiety with a corresponding increase in the levels of ghrelin (a hormone produced in the stomach and pancreas) which increases the sensations of appetite and hunger.
So for my patient, it will be necessary to make a lifestyle change to better “regulate her hormones” and have an easier time of losing weight. In my next Help Me Lose Weight blog I will cover another hidden cause of weight loss frustration.
2 tbsp Earth Balance Spread*
2 cups frozen cut okra
2 cups oyster mushrooms, sliced length wise into rough strips
1 cup broccoli
7 oz extra firm tofu, drained and sliced into about 1 1/2-inch by 1/2-inch blocks
2 cloves garlic, chopped
2 tbsp yellow miso paste
Freshly ground pepper
1/2 cup almonds roughly chopped
In a large pan, warm 1 tbsp of plant-derived margarine spread and stir in the frozen okra. Stir on medium-high heat for a few minutes until okra starts to brown.
Pour okra into a bowl and set aside. Add the remaining tbsp of plant-derived margarine spread to the pan and stir mushrooms, broccoli, and tofu until they begin to brown. Stir in the garlic. Cook about 30 seconds, or until fragrant. Add the okra back to the pan, stir in the miso paste and combine well. Toss in the almonds, then give it one more good stir and remove from heat. Serve over brown rice, quinoa or pasta. Or enjoy on its own