Diabetes Injection beats Xenical for weight loss

Here's an interesting new finding for people struggling with their weight, as reported on BBC News (link), and published in the latest issue of the medical journal The Lancet: in a randomized, controlled study, the injectable diabetes treatment Victoza (liraglutide) helped overweight people lose significantly more weight than prescription Xenical, which is one of the leading weight-loss medications. Victoza (liraglutide) is awaiting FDA approval here in the U.S.A.

This is actually an exciting, unexpected finding, and holds promise for treatment of diabetes, metabolic syndrome and obesity.

In this 20-week European study, 564 individuals with obesity were randomly assigned to one of four Victoza (liraglutide) doses, to placebo, or orlistat. All individuals were given a 500 kcal diet and increased their physical activity throughout the trial.

Participants on Victoza lost significantly more weight than did those on placebo or orlistat. Weight loss increased with the dosage of Victoza, and was 7·2 kg (15.8 lbs) in the high dose group, compared with only 2·8 kg with placebo and 4·1 kg with orlistat. The medication also reduced blood pressure, and reduced the prevalence of prediabetes in the 20 week trial.

If Victoza (liraglutide) does meet FDA criteria, it will be interesting to see whether people will accept the idea of a daily injection for weight loss treatment. With any new drug, it's also very important to fully understand the potential side effect profile, as well.

U.S. Obesity is getting worse...

According to a recent report, obesity rates in the U.S. have further increased over the last year, with adult obesity rates rising in 23 states.

For the fifth year in a row, Mississippi had the highest rate of adult obesity at 32.5%. Three other states - West Virginia, Alabama and Tennessee - also had adult obesity rates in excess of 30%.
In just one state - Colorado - was the adult obesity rate below 20%.

In 1991, not one state had an adult obesity rate above 20%.

Mississippi also had the highest rate of obese and overweight children (ages 10 to 17) at 44.4%. Minnesota and Utah had the lowest rate at 23.1%.
Childhood obesity rates in the US have more than tripled since 1980.

This is an epidemic, people!

Obesity and Pancreatic Cancer

Pancreatic cancer is the fourth leading cause of cancer-related death for both men and women in the U.S. An interesting new study, published this week in the Journal of the American Medical Association has found that, not only is obesity linked to the risk of developing this fatal disease, but that obesity in early adulthood in particular makes you significantly more likely to develop the disease, compared to gaining weight later in life.

The researchers from M.D. Anderson Cancer Center found that obese youths between the age of 14 and 19 years old had a 60 percent higher chance of developing pancreatic cancer than their less overweight peers.

Obese individuals between the age of 20 and 40 were two to three times more likely to develop pancreatic cancer. Interestingly, the risk levelled off for those who gained the weight in their 40s and 50s.

The study also found that obese or overweight individuals were more likely to develop pancreatic cancer earlier on their lives.

Since the medical and surgical treatments for cancer of the pancreas are so very limited, this data adds yet another argument to the need to combat the obesity epidemic here in the United States. Go to the gym and do your bit for cancer prevention!

When Abdominal Fat can be deadly - "Metabolic Syndrome"

It's well known that America has an obesity epidemic, which affects both adults and children alike. But what's not as well known, even in the medical community, is the rapid rise in an obesity-related problem called "Metabolic Syndrome".

Metabolic Syndrome is diagnosed if you have 3 or more of:
- increased waist size (>40 inches for men, 34.6 inches for women
- elevated blood sugars or known Type II diabetes
- elevated blood pressure (> 130/85) or known hypertension
- decreased good cholesterol (HDL)
- increased triglycerides

Why is Metabolic Syndrome important? Because it causes a huge increase in the risks for heart attack and stroke. According to a 2002 article in the Journal of the American Medical Association ("JAMA"), middle aged men with Metabolic Syndrome are three to four times more likely to die of coronary artery disease, and have double the all-cause mortality rate. It affects women similarly, too.

About 47 million people in the United States are believed to have the syndrome, or about one-fourth of the population. It's common here due to our sedentary lifestyle and overall level of obesity.

It's probably more even common than that at my office, because the patients I see for liposuction and tummy tucks are often self-selected; they are seeing me specifically because they have an increased waist size, which is the most obvious part of the syndrome. I now routinely check these patients for the other parts of the syndrome.... Almost every month, we find men and women who never knew they had untreated diabetes, or cholesterol abnormalities, or the whole package -- Metabolic Syndrome. And let me tell you, are they ever thankful we discovered the problem early, rather than after a heart attack! "Doc, I came in for a tummy tuck, and you saved my life!"

It turns out that the fat inside the abdomen, the so-called "visceral fat" (as opposed to the fat that is immediately underneath the skin - "subcutaneous fat") is the chief culprit, together with insulin resistance. Visceral fat is not the harmless layer of insulation we used to think it was - it is metabolically active, giving off hormonal messenger compounds that affect our body. The thicker the visceral fat is, the more health problems are seen. Unfortunately, this internal fat can not be removed by way of liposuction or tummy tuck, so there's no quick fix.

There is an answer, though, and hope for those with the syndrome. Insulin sensitizing medications such as metformin can be used to help with the insulin resistance. Blood pressure and cholesterol medication can help, too, controlling those parts of the syndrome.

Probably the most important treatment, though, is the one that takes the most determination and effort - diet and excercise, particularly aerobic fitness. Several studies show that aerobically fit people with Metabolic Syndrome improve their odds substantially, reducing their risks by a factor of three. Furthermore, overweight people who are aerobically fit have a lower risk of cardiovascular mortality than those who are lean but unfit.

It's time to turn off the TV's and computers, America, and go get some exercise! (And that includes me, too!) Your heart will thank you for it.