2 successful drugs suggest new methods for fatloss....

Today's Post: Thursday, 10-29-2009

Recently there were two news stories about drugs that tested as increasing the fat & weight lost by people who were both eating a reduced calorie diet and exercising.

1. Last Friday, 10-23, 2009, HealthDay News had a story with this headline.:

“The diabetes drug liraglutide helps obese people without diabetes lose weight, researchers have found.”

The study included 564 diabetes-free obese patients aged 18 to 65 & the ones that got injected doses of 3 milligrams, the highest dose tested did the best. The second group got a placebo once a day; & the third group got 120 milligrams of the drug orlistat three times a day.

In all three groups the people increased their levels of physical activity and ate a calorie-restricted diet, about 500 calories less each day than they were expected to use.

Weight loss among patients taking liraglutide doses of 3 milligrams was 7.2 kilograms (15.8 pounds), compared with 4.1 kilograms (9 pounds) taking orlistat and 2.8 kilograms (6 pounds)with placebo.

Also, weight loss of more than 5 percent occurred in 76 percent of patients taking 3 milligrams of liraglutide, 44 percent of patients taking orlistat, and 30 percent of patients in the placebo group.

The patients taking liraglutide had lower blood pressure after the weight loss. Not surprisingly, since liraglutide is a diabetes drug designed to lower blood sugar readings, those taking the liraglutide who initially had borderline high blood sugar measures, got improved measures and lower blood sugar. (The story did not have the actual decreases in fasting glucose & HBA1C.)

Nausea and vomiting was more common among patients taking liraglutide than among those in the placebo group, the study authors noted.

The study was released online Oct. 22 in advance of publication in an upcoming print issue of The Lancet.

As I recall, one of the other stories on this study said that the nausea and vomiting side effect tended to go away over time in those who had it though it didn’t say how long that took or how many of those people dropped out of the study. Neither story said what percentage of the people getting the high dose liraglutide that was most effective had this side effect.

In those who had this side effect, it certainly would tend to reduce their appetite.

But in one of the stories was the information that liraglutide’s main mode of action is by delaying stomach emptying thus blunting any glycemic response & too rapid rise in blood sugar as a result.

This would result in lower insulin levels. And lower insulin levels lead directly to less fat storage.

But there’s good news in this. You can achieve each of these 3 effects without the drug injections.

Modest amounts of vinegar slow stomach emptying.

And using extra virgin olive oil, &/or nuts or avocadoes as your fat or oil source (instead of high omega 6 oils such as corn or soy or safflower and eating very little fat from animals purposely over- fattened with grain and that excessively fatty source of excess saturated fat by eating beans or fish or very lowfat dairy or eggs or very fat trimmed meat and poultry instead) has been found to have multiple health benefits. One of those is that your insulin levels will go down and you’ll tend to lose fat from your waist.

Third, nonstarchy vegetables have very few calories per pound. But more than that, they have fiber that fills you up AND slows your glycemic response to other foods.

So, eating a salad at lunch and at dinner each day with a modest amount of a vinegar you like and extra virgin olive oil as the dressing and NOT eating refined grains or artificial sweeteners or sugar at those meals, may well have a very similar effect to the injected drug.

Also, I’ve been reading fatloss books by doctors who have been successful at helping patients lose weight and excess fat.

One insists that, at lunch and dinner, this kind of salad be the first course & a large serving of a variety of nonstarchy vegetables be the second course to help slow glycemic response and fill up his patients before they have any main dish or other foods.

A second doctor, also directs his patients to eat a lot of vegetables at each meal AND to take a special fiber supplement before each meal that he has found slows glycemic response.

The third doctor has found a protein and fiber supplement that can be made into a shake and has his patients start by having that at breakfast and lunch and then just a breakfast. Between the strong appetite turning off effects of the strong amount of high quality protein and the appetite turning off effects of the fiber supplement, he reports that his patients tell him they are delighted to find they can stay on his program without any excess hunger to overcome.

Lastly, having some of your exercise each day be quite vigorous even if only for 30 seconds or so has been found to lower blood sugar levels and insulin levels.

These things have been independently shown to increase fat loss. They replicate the effects of this drug. And, you needn’t spend the money on the drug, put up with shots, or worry about the side effects to use them. Further, each of them has other health benefits.


2. The second story appeared a day later on Saturday, 10-24, 2009.

Reuters had this headline.:

Orexigen obesity drug shows added benefits: studies

Nearly half of patients who completed 1 yr pus 4 weeks of treatment with the drug, Contrave, from Orexigen Therapeutics Inc's experimental obesity treatment, lost at least 10 percent of their weight. And, they also had improved cholesterol and blood sugar levels.

61.8 percent and 75.8 percent of the people in the two groups that took the drug and completed the study lost at least 5 percent of their weight.

And 23 percent lost 15 percent of their weight in one of the groups studied.

All of these results were dramatically better than those in the placebo group, roughly three times as many lost this much weight who were taking the drug compared to the placebo group.

People with indicators of being at high risk of heart disease improved these measures even more than the average for the group.

That also included all the patients who began the studies, including those who discontinued the medicine at any time.

The study also found that people lost inches on their waist and inflammation improved as well as cholesterol measures and blood sugar levels.

Here’s the good part both as a reason for some people to try the drug and a key to how to get these effects without the drug.

Contrave combines the antidepressant Wellbutrin, known generically as bupropion, with a sustained- release version of naltrexone, an opioid blocker used to treat alcoholism and other addictions.

Wellbutrin is also known as Zyban and used by itself to help people quit smoking.

(I would guess that using this combination drug, Contrave, would improve the results for people quitting smoking as well. And, I presume that will be tested next.)


In addition, 48.2 percent of Contrave patients lost at least 10 percent body weight studies.

One of the results was striking & potentially of great value. In those people in the group taking the Contrave who had too high levels of the blood sugar indicator, HBA1C, that measures the 60 to 90 day average blood sugar level, there was a reduction of 1.1.

That’s extremely significant since you can go from a clearly diabetic level of 7.0 to a non-diabetic level of 5.9 with a 1.1 reduction. Similarly, you can go from a dangerous level of 8.0 for which doctors tend to prescribe multiple drugs that themselves have side effects, to a 6.9 level where they will often feel OK with you only using lifestyle measures or doing that plus low doses of the relatively safer and cheaper drug metformin.

So the combination drug, Contrave, sounds like a very useful drug for many people.

Is there a way to get these effects without that drug?

Yes there is.

A researcher in Kansas has developed a protocol that turns off depression better than drugs – about three times better according the studies. (About 75% get better on his protocol vs. about 25% with the drugs.) Even better, one of his methods is regular exercise. So using his protocol also means an extra way of ensuring that people exercise which is known to help people lose fat weight and keep it off.

My guess is that people using his methods can get the antidepressant effect of the Wellbutrin part of Contrave without needing the drug.

I did a post on the 6 methods he uses and added two methods that also work that he doesn’t yet include. See 8 ways to end depression -- proven to work better than drugs....Friday, 8-21-2009.

One of these, talk or cognitive therapy using the work of Martin Seligman, has been shown to be effective both at reducing depression and improving your chances of success at virtually everything you do.

People who get it are able to become much more self-disciplined, effective, and proactive.

We did a post on the finding that people who succeed at fat loss look first to the consequences of eating fattening foods before deciding if they will have any and how much while those who fail only look at how much they might enjoy the foods.

Clearly the sustained- release version of naltrexone, an opioid blocker used to treat alcoholism and other addictions in Contrave works in part by making this far easier to do by turning down the addictive reaction to sweet and starchy foods.

But talk or cognitive therapy using the work of Martin Seligman may even work better at doing precisely the same thing.

So, my conclusion is that you may be better off getting the effects of the drug liraglutide using other methods to achieve its effects.

You very likely can get the stronger effects of the drug Contrave using other methods. In addition, those methods are like learning to ride a bicycle or swimming, you can maintain them without outside help once you know them well enough.

However, these studies also suggest that we now have two drugs, particularly, the Contrave, that can really help people lose fat weight who have failed to do it well on their own.

So regardless of how you use this information, you now have some new tools that work to lose fat and keep it off that we weren’t sure worked that well until now.