Category Archives: Weight Loss

How Many Years Does Obesity Cut From Lifespan?

Are you tired of this stock photo yet?

Are you tired of this stock photo yet?

MedPageToday has the details. A quote:

In a computer modeling study, very obese men lost just over 8 years of life compared with normal-weight men, and very obese women lost as many as 6 years, Steven Grover, PhD, of McGill University, and colleagues reported online in the Lancet Diabetes and Endocrinology.

They also found that very obese men and women (defined as a body mass index [BMI] of 35 and higher) lost about 19 years of healthy life, defined as living free of chronic disease such as diabetes and cardiovascular disease.

Note that “very obese” in this context has a specific definition: body mass index 35 or higher. Calculate yours.

The number of life years lost to obesity and disease were highest for those who were very obese in young adulthood and presumably stayed obese for years. In other words, becoming very obese at age 60 is not as dangerous as at 25.

I first got interested in weight loss in the 1990s when I had an office-based primary care medical practice. It was obvious that many of the medical problems I was treating were related to years of obesity. Believe me, you’re much better off preventing those problems via diet and exercise.

In the 1990’s, both Dr. Dean Ornish’s vegetarian diet and Dr. Robert Atkins low-carb diet were very popular, and you couldn’t find any two diets that were more polar opposites. And do you remember Susan Powter and her “Stop the Insanity” diet? My desire to lead my patients onto the right path resulted in the first edition of my Advanced Mediterranean Diet.

Click for The Lancet study abstract.

Steve Parker, M.D.

Just What We Needed, Right? Americans Have a New Weight-Loss Drug: Saxenda

Well, it’s not entirely new. It’s liraglutide, which has been available to treat diabetes for a several years, sold in the U.S. as Victoza. Click for my brief review of the drug class for diabetics.

Click for the CBS News report on Saxenda. A snippet:

One clinical trial that involved patients without diabetes found that patients taking Saxenda had an average weight loss of 4.5 percent after one year. Of the people treated with the drug, 62 percent lost at least 5 percent of their body weight. Meanwhile, only 34 percent of those given an inactive placebo had the same result.

Another clinical trial that included patients with type 2 diabetes found that patients had an average weight loss of almost 4 percent after one year. Of those given Saxenda, 49 percent lost at least 5 percent of their body weight, compared to 16 percent of those who were given a placebo treatment.

Click for the FDA’s press release.

Oh, by the way. You have to inject it daily under the skin (subcutaneous). And if you were hoping for a shortcut to weight loss, this isn’t it. You’re still supposed to follow a reduced-calorie diet and exercise regularly.

I’d try The Advanced Mediterranean Diet first.

Steve Parker, M.D.

PS: Full prescribing information.

Laparoscopic Bariatric Surgery: Gastric Bypass Yields Greater Weight Loss But Higher Complications Compared to Banding

Click for details. Try the Advanced Mediterranean Diet first!

New Weight Loss Drug, Contrave, May Work But Also Cause Suicidal Thoughts

"These are flying off the shelves!"

“This’ll fix you right up!”

The FDA recently approved a new weight-loss drug for the U.S. market. It’s marketed as Contrave, a combination of naltrexone and bupropion.

Neither of the components is new. Naltrexone’s been used to treat alcohol and narcotic addiction. Bupropion, e.g., Wellbutrin, is for depression and smoking cessation.

Contrave joins two other recent drugs for weight loss. Belviq and Qsymia were approved in 2012. I still haven’t run across anyone using those.

To qualify for the new formulation, you need a body mass index over 30, or over 27 plus one or more weight-related medical condition such as type 2 diabetes or high blood pressure.

If you haven’t lost over 5% of your initial body weight in the first 12 weeks of use, the FDA recommends stopping the drug.

Potential adverse effects include suicidal thoughts and seizures. More commonly, users may experience headache, nausea, constipation, diarrhea, dizziness, insomnia, and dry mouth. Constipation and diarrhea?!

Even with the drug, you still have to be on a reduced-calorie diet and exercise program.

Why not try the Advanced Mediterranean Diet or Ketogenic Mediterranean Diet first?

Steve Parker, M.D.

Low-Carb Beats Low-Fat Diet for Weight Loss Without Increase in Heart Disease Risk

…according to an article at MedPageToday.

Many physicians have been reluctant to recommend low-carb diets out of fear that they increase cardiovascular risk. A recent study compared low-carb to low-fat dieting over 12 months and actually found better improvements in cardiovascular disease risk factors on the low-carb diet (max of 40 grams a day).

After 12 months, folks on a low-carbohydrate diet had lost 5.3 kg (11.7 lb), while those on a low-fat diet with similar caloric value had lost 1.8 kg (3.9 lb). Both groups showed lowering of LDL cholesterol, while the low-carbers had better improvements in HDL cholesterol and triglycerides.

DietDoctor Andreas Eenfeldt can add this study to his list of others that show better weight loss with low-carb diets compared to low-fat.

Steve Parker, M.D.

Eat Nuts For Longer Life

I recommend nuts to all of my patients. They help reduce risk of coronary artery disease (e.g., heart attacks) and overall risk of death. Don’t believe me? Check this out. Nuts are integral to the Advanced Mediterranean Diet, Ketogenic Mediterranean Diet, Low-Carb Mediterranean Diet, and the Paleobetic Diet.

Will I Eat Less If I Eat Slower?

In general, you would eat fewer calories compared to eating faster. It doesn’t affect your degree of hunger at the end of the meal or within the few hours thereafter. AJCN has the details.

Why the authors of the study didn’t report effects on body weight are a mystery to me. Probably trying to get another published article out of their work.

If calories matter in weight loss efforts, and I think they do, you may improve your weight loss success by eating slower.

PS: I only read the abstract.