Obesity Villains – Insufficient Hormone; Excessive Faith

Unicorn Cake of Awesomeness

Here is the gist of interesting research from Rutgers University, as reported by Robert Gebelhoff:

A new study published this week in the journal Cell Reports suggests that overeating happens when people don’t have enough of a hormone called glucagon-like peptide-1, or GLP-1. The chemical is secreted from cells in both the small intestine and the brain to let our brain know when we’ve had enough to eat… When GLP-1 was reduced in the mice, they over-ate and consumed more high-fat food.

Gebelhoff mentions up front a detail that many journalists forget or omit, namely that “it still needs to be established that the same effect happens in humans.” Meanwhile, word comes from the University of Copenhagen of a small study of just 37 subjects, yet they were human women and not mice, and the authors suggest that an answer to a troublesome aspect of obesity therapy might be found here. Extreme weight loss, especially if it is rapid, can cause the bones to lose mass and break more easily, and apparently this happens “frequently.”

The good news is that GLP-1 might be capable of aiding weight loss without increasing the risk of brittle bones. It might even of help to build new bone. Not actual GLP-1, but its analogue or mimetic, a pharmaceutical product that is also a GLP-1 receptor agonist capable of fooling the body into thinking it is the real thing. Its generic name is liraglutide, marketed as Saxenda. It also helps to keep blood sugar levels as close to optimal as possible, and is even credited with benefiting the sugar metabolism in ways that outperform diet-induced weight loss. This is the assertion of the University of Copenhagen Associate Professor Signe Soerensen Torekov, the study’s lead author, who said

It appears that treatment with liraglutide makes it possible to lose weight and maintain the beneficial effect on the bones, while at the same time reducing the risk of cardiovascular disease and type 2 diabetes.

A functional weight-loss drug is the unicorn everyone has been chasing. What could go wrong? Sadly, it turns out that liragludite can adversely affect the patient’s gallbladder, pancreas, or kidneys – parts that it’s really not advisable to mess with. That is only the beginning. Drugs.com lists an astonishing array of debilitating side effects.

Also, the patient has to deal with a needle every day forever, which is a major drawback in the quality-of-life sweepstakes, and comes at a “nontrivial cost,” according to other authorities. Drs. Elias S. Siraj and Kevin Jon Williams wrote in the New England Journal of Medicine that liraglutide is not a cure, because “Most obese participants stayed obese, reversal of the metabolic syndrome was not quantified, and liraglutide may be required indefinitely.” Then there’s the little matter of breast cancer, which may not be a factor but definitely needs to be monitored.

Adjunct, not replacement

Liraglutide is permitted to be sold as an adjunct to calorie reduction and increased exercise, not as a replacement for them, and the same goes for any pharmaceutical that makes weight-loss claims, whether injectable, orally administered, or otherwise. Not long ago, the American Marketing Association (AMA) commented on a study that appeared in the Journal of Public Policy & Marketing and named yet another obesity villain – the public’s false beliefs about the efficacy of pharmaceuticals. It concluded that,

Weight management remedies that promise to reduce the risks of being overweight may undermine consumer motivation to engage in health-supportive behaviors.

In other words, knowing that a weight-loss drug is available encourages overweight people to eat even more. Rather than welcoming a temporary boost that will kick-start their weight loss efforts, many apparently interpret the existence of such a medication as permission to abandon all restraint. In fact, the study authors warned, “the more fattening the cookie, the more the participants would overeat, as long as they expected to be able to take the weight loss pill.”

One might think the AMA would wish to sweep such a study under the rug. After all, the interests of the marketers are aligned with those of the pharmaceutical corporations. It seems like the last thing they would want to do is publicize a study that says people are foolish to put faith in weight-loss drugs. Then again, consider the old Hollywood saying– there is no such thing as bad publicity.

For the pill mills, this is a wonderful piece of propaganda – a gift to them, really. They have been handed a universal disclaimer. If patients don’t lose weight, it is not because the products don’t work, good heavens, no. It’s because the customer’s expectations were unrealistically high!

Your responses and feedback are welcome!

Source: “Overeating may be caused by a hormone deficiency, scientists say,” WashingtonPost.com, 07/24/15
Source: “Treating obesity with GLP-1 hormone helps prevent loss of bone mass associated with weight loss,” News-medical.net, 06,11/15
Source: “Saxenda Side Effects,” Drugs.com, undated
Source: “Another Agent for Obesity — Will This Time Be Different?,” NEJM.org, 07/02/15
Source: “There’s a pill for that: How are weight loss drugs fueling the obesity epidemic?,” ScienceDaily.com, 11/11/14
Image by randy stewart

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