Fast weight loss

Meridia

What is Meridia?

Meridia is the trademark for “Sibutramine” in the USA. This drug is known as Reductil in Europe. This drug is also referred to as sibutramide hydrochloride monohydrate, and it is an orally administered compound used in fat and weight loss treatments.

How does it work?

Sibutramine is a stimulant, chemically related to amphetamines and phentermine, which acts on the central nerve system. It is a neurotransmitter that acts as an appettite suppressant by inhibiting the reuptake of serotonin (by 73%), norepinephrine (by 54%), and dopamine (by 16%). However, it works in the area of the brain that signals the sense of fullness (satiety). The drug is reported to increase serotonin and noradrenaline levels in the brain and, its seronergic action, is responsible for its influence on appetite, by regulating the sense of fullness. Some researchers also reported that Sibutramine also acts as antidepressant, by means of its action on neurotransmitters.

Beneficial effects

According to the manufacturers, Meridia is for people who need to lose 30 pounds or more depending on height, and should be used in conjunction with a reduced-calorie diet. Hence, Meridia is neither for low overweight cases nor people who are allergic to any of the ingredients of Meridia.

Because Meridia acts on the appetite control center in the brain, when used along with a reduced-calorie diet and exercise it helps patients lose weight and maintain weight loss for up to two years.

Testing

According to manufacturers, Meridia has been studied all over the world in more than 100 clinical trials on more than 12,000 patients.

In those studies, Subtramine (Meridia) has proved effective in producing and maintaining significant weight loss in the majority of obese patients compared to diet and exercise alone. After those trials some 14 million patients have used this drug in more than 75 countries with excellent results in their fight against obesity since 1997, when Meridia was approved.

Dosage

Most studies agree on that 10mg once daily, usually in the morning, is best. Nevertheless, if this results insufficient the dose may be increased to 15mg per day, after 4 weeks.

This drug is taken by mouth, under doctors’ prescription, usually once daily. It is advisable to take it for some six weeks to realistically assess the effect on weight loss. For that reason, increasing the dose is not advisable before that period and because this drug can be habit-forming. Moreover, daily intake should not be suddenly stopped without the physician’s approval. If the patient misses a dose, the pill should be taken as soon as he or she remembers. However it is close to the time for the following dose, the missed one should be skept and the doses schedule resumed as soon as possible. It is not advisable to double-up with the intention to catch up.

Side effects

Meridian shows fewer side effects than most appetite suppressants and fat burning drugs. However it should be taken with caution because it can increase in blood pressure and heart rate, especially if the patient takes large doses (more than 15mg). Researchers also reported some tolerable side effects such as insomnia, dry mouth, constipation and headache, according to Cornell Medical Center’s Dr. Louis Aronne (Anonymous, 98).

Conclusion

Meridia acts as an appetite suppressant. If used in combination with an overall diet plan and regular exercise, it is an excellent aid to reduce weight. In spite of some possible side effects it is highly recommended in cases of morbid obesity, because those effects are more tolerable than the ones produced by other weight loss drugs. If taken under medical supervision, these effects are kept under control and within tolerable parameters, which allows the patient follow the treatment and achieve the goal of a healthy weight condition and avoiding weight regain. .

References
1. Heal DJ, Aspley S, Prow MR et al. Sibutramine, a novel anti-obesity drug. A review of the pharmacological evidence to dfferentiate it from d-ampetamine and d-fenfluramine. Int J Obes. 1998;22(supp 1):S18-S28.
2. James WPT, Astrup A, Finer N, et al. Effect of sibutramine on weight mainteancne after weight loss; a randomized trial. Lancet.2000;356;2119-2125.

Acomplia

Acomplia (rimonabant) is the first in a new class of drugs that target certain receptors on the surface of brain cells that are part of the endocannabinoid system, which helps regulate food intake and energy expenditure. Its specific action is to block the cannabinoid type 1 receptor, which is the same receptor that is active when people are hungry. In fact, people who overeat are believed to have an overactive cannabinoid system, which is active also in cocaine use and smoking. Cannabinoid type 1 receptors are found not only in the brain, but also on the surface of fat cells.

Is it necessary?

Although many people may think that marketing this kind of drug would mean some great money expenditure for regular citizens, obesity is now considered a health condition that may lead to some predisposes to many serious illnesses; so there might be a chance of getting it paid by insurance.

Many statistics reveals some alarming numbers that give an idea about the reach of obesity. By the moment, in some parts of Europe over 70% of men aged 55-64 years are clinically obese or overweight -Body Mass Index higher than 25; while one in five of all Americans are obese and one in three overweight. So even if slimming pills have had a questioned history, due to its relative effectiveness and adverse side effects, when these kinds of statistics are analyzed, experts seem themselves urged to find a reliable help for those who are struggling to lose weight, in order to put their health on safe.

At the moment, many drug companies are developing their own compounds that work on the same brain receptors, but Sanofi-Aventis is the first in doing clinical trials.

Trials

- Stratus-US study: It evaluated the drug’s effect on smoking cessation. 787 smokers with an average of nearly 23 cigarettes per day were randomized to receive either placebo, or rimonabant in doses of either 5 mg or 20 mg per day during 10 weeks. For the first 2 weeks, they were permitted to continue smoking, though they were instructed to attempt to quit smoking on Day 15. The number of patients who had not smoked during the last 4 weeks of the 10-week period was tabulated. The final results were that 36% from patients who received 20 mg of rimonabant had quit smoking, while from patients who took either placebo or 5 mg rimonabant, only 20% successfully quit.

However, experts have also taken advantage of this trial in order to analyze the drug effects over fat loss. So they have seen that of those patients who quit smoking, the ones taking either placebo or 5 mg rimonabant gained 84%, which is more weight than those taking 20 mg rimonabant. In their case, they have seen a significant increase in the rate of successfully quitting smoking, and also greatly reduced post-smoking-cessation weight gain.

- RIO-Lipids study: 1036 overweight or obese patients who had blood lipid disorders were also randomized to one of three groups described on the other trial -placebo vs. 5 mg/day or 20 mg/day rimonabant- for one year. Besides, 50% of them suffered also from metabolic syndrome X –a constellation of metabolic disorders that all result from the primary disorder of insulin resistance.

By the end of the trial period patients receiving 20 mg rimonabant lost an average of about 20 pounds of weight, compared to 5 pounds for patients on placebo. Moreover, in comparison to placebo, patients receiving 20 mg rimonabant had significant improvements in waist circumference, HDL levels, triglyceride levels, CRP levels, and insulin sensitivity. Regarding the ones who suffered metabolic syndrome X, half of those taking 20 mg rimonabant no had longer this disease at the end of the study.

Final words

There is still a lot to research about rimonabant, so further studies will be required before the drug is released. But in case it turns out to be as effective and as safe as these –and some other- studies suggest, its uptake once released has the potential to be explosive.
If we take into account the quantity of victims that obesity has gained, not only in Europe or the USA, but also around the world, literally millions of patients may be receiving it within a short period of time.

All these facts give the organizations on whose its approval depends on –like the FDA- many reasons to be cautious and deeply analyze all possible side effects, in order to guarantee that Acomplia will be a reliable and safe drug in every sense of the word, before putting it on circulation.

Xenical

Obesity in childhood and adolescence

According to the Archives of Pediatrics and Adolescent Medicine dated April 2006 the long time spent watching TV would increase overweight in children and adolescents.

In the light of such statement several studies have been conducted, because obesity implies a number of associated risks - such as cardiovascular diseases and diabetes 2 - that became more and more dangerous in with the passing of time.

However, some researchers claimed, in that same article, that the association of risk factors and obesity is only valid for children who were born to obese parents, because in the studies conducted with children whose parents were not overweight, the time exposed to TV did not show as a cause for obesity. On the contrary, the sedentary time spent in watching TV was a determinant factor among those children with, at least, one obese parent.

Although the conclusions of these studies show that generalizing the effects of watching TV on obesity would not be correct, they also state that the weight of parents is an important factor to be borne in mind along with the amount of hours spent in that sedentary activity. They also posed the need for further research.

In an article published by the Department of Family Medicine and Community Health in the Tufts University School of Medicine, USA, researchers make a distinction between short-term and long-term risks.

They mentioned some short-term physical risks for severely overweight children, such as orthopedic, neurological, pulmonary, gastro-enterological, and endocrine conditions. Apart from that, researchers emphasize the “social burden of pediatric obesity, especially during middle childhood and adolescence, may have lasting effects on self-esteem, body image and economic mobility. ”

Regarding the intermediate and long-term consequences, such as the development of cardiovascular risk factors and persistence of obesity into adulthood, researchers said that “these effects of early obesity presage later adult disease and premature mortality.”

What can be done?

There is an only path to follow: a low calorie diet and a regular exercise program. However, defining the solution in those simple terms is, to a certain extent, quite naif as stated by Dr Chanoine a researcher who conducted some studies related to obesity and Xenical: “It is very hard to change teenage behavior. They can be very independent. They would rather play video games and eat pizza.”

In view to that situation, some teenagers may need an extra aid to be able to follow a long-term lose-fat plan and that is the main reason why many physicians prescribe Xenical today - the drug blocks the up to 30% of the fat consumed by blocking the enzymes before they can be absorbed into the body. Dietary fats are large molecules that are broken down by enzymes before they can be absorbed and eventually stores in the body ’s fat depots.

The studies conducted show that overweight teenagers who exercise and go on a low calorie diet will better control their weight if they also take Xenical. However, Jean-Pierre Chanoine, MD, a diabetes specialist at the British Colombia Children’s Hospital and lead author of the study, emphasizes that Xenical is not “a magic pill.” He explained that the drug does not make patients lose fat by itself, but as a part of a comprehensive lose weight plan .

Conclusions

Dr. Holly Wyatt, the program director of the Centers for Obesity and Research and Education in Colorado, said that weight loss drugs may be an imperfect way to lose weight, but they are here to stay in spite of some side effects such as increased blood pressure and heart rate. That is the reason why Xenical should be prescribed by a physician, who must check the patient periodically along treatment.

Wyatt said it is necessary to help teenagers and children to change their mentalities and motivate them to become more physically active in their daily lives. “Anything is better than being sedentary,” she said, “This can prevent them from continuing to gain weight.”

Acomplia
What is Acomplia or “Riomonabant”?
For those who have weight or fat loss concerns and for the ones on the look of a radical solution to their smoking habits there are good news: It has been found that “rimonabant” stops both food and cigarette cravings, besides some other unhealthy urges.
Rimonabant is a CB1 cannabinoid receptor antagonist, whose main effect is the reduction in appetite. Thus, it is effective in weight control and some metabolic disorders. It is also associated to cardiovascular risk factors.
How does it work?
Rimonabant (whose commercial name is Acomplia) blocks the CB1 receptor, one of two receptors found in a newly described physiological system called the Endocannabinoid System (EC System). Researchers report that this system plays a fundamental role in the regulation of food intake and energy expenditure.
In order to make sure whether a drug that halted this action might curb appetite, the first animal study was conducted at the National Institute of Alcohol Abuse and Alcoholism in Bethesda, Md, in 2001. Genetically altered mice that lacked cannabinoid receptors were used as subjects in the study. They ate less than their litter mates, even after 18 hours of fasting. When the normal mice were given rimonabant, which blocked their CB1 receptors, they reduced dramatically their food intake.
The studies on humans began in 2002. In one study, Acomplia, helped overweigh people lose an average of 20 pounds and in another doubled the chances that smokers would quit. The blocking of signals that control cravings results in weight loss, improvement of cardiovascular/ metabolic risk factors in overweight/obese patients and reduces tobacco dependence. As an important plus, researchers report that it also helps keep their weight in people who are trying to give up smoking. The drug is also believed to help people cut their alcohol consumption, and as a possible treatment against drug addiction and schizophrenia.
According to a press release by The Guardian, the studies with tobacco use and Rimonabant are still in progress and involve more than 6,000 subjects. Those studies explore two smoking-related therapies

1) to use rimonabant directly to aid in smoking cessation
2) to help prevent weight gain in former smokers

At the moment, results suggest that rimonabant is effective in both cases. The FDA has explicitly stated to Sanofi-Aventis (the company who owe Acomplia rights) that without additional studies rimonabant cannot be approved in the United States for smoking cessation therapy, and they are still in progress.

Side Effects
Acomplia showed to be well tolerated in testing. The most relatively common side effects were dizziness and mild GI side effects; these were said to be transient.
Acomplia compared to other weight-loss drugs
Because of their undesired and widely spread side effects, many people who have struggled to lose weight over years are still reluctant to take the weight-loss drugs on the market. Xenial for example can give severe diarrhea, which may make it impossible for some patients to continue using the drug. Meridia (Reductil in Europe) was meant to treat depression. It also presents severe side-effects as well, such as sleeping problems, constipation, dry mouth syndrome, and high blood pressure. Phentermine stimulates the central nervous system, so it makes the body run on “full throttle” all the time, which may cause a great strain on many body systems. IN consequence, Phentermine should not be used for longer periods. It should only used in obesity cases along with exercise, diet and behavior therapy, not for common overweight.

Conclusions

Acomplia looks really promising as a great help to the ones who want to lose weight, reduce fat and sugar blood levels, and reduce the subsequent cardiovascular risk. Besides, because its even non-existing side effects, it is well tolerated for most patients. However, always consult your physician, especially if you are suffering from previous diseases or problems associated with obesity.

References
Despres JP, Golay A, Sjostrom L Effects of rimonabant on metabolic risk factors in overweight patients with dyslipidemia. N Engl J Med. 2005 Nov 17;353(20):2121-34. Entrez PubMed 16291982

Ephedra

Supplements with ephedrine: Are they safe? Do they work?
Ephedra has been a well-known plant in China for hundreds of years and is Pharmacological properties are an active powerful stimulant whose composition is similar to the one of an amphetamine. This plant could reduce the fatigue sensation, to increase the alert status or to increase the metabolism and that is why it is one of favorite ingredients of the supplements for “losing weight” or “burning fat”. For that reason, using it is very popular among overweight athletes, such as baseball players. It is also one of the most popular supplements among people who train themselves in gymnasiums to reduce weight, lose fat or “to get in shape”. It is promoted as a component in some products - such as pills - to increase energy and optimize training results as well.
In spite of being a fascinating supplement for many, the adverse effects of Ephedra must be taken into account, since they are related to the stimulation of the central nerve system and hypertension, heart beatings, dizziness, insomnia, headache, and intestine problems.
Positive effects
The idea to consume a fat burning product is a temptation for athletes who must lose weight, but are reluctant to go on a diet. For that reason, there are a number of supplements that promise to make them lose fat. Nevertheless, it is necessary to read the products’ labels because ephedra can be part of them, but be mentioned under different names, such as: Ephedrine, Ma huang, Epitonin, Chinese ephedra, Ma huang extract, Ephedra, Ephedra extract, Ephedrine alkaloids, sinica Ephedra, Ephedra herb to powder, tea Squaw or tea Mormon.
What is “ephedrine”?
Ephedrine is classified as a drug that acts by stimulating the central nerve system. In fact, it acts in a similar way than an amphetamine, because both have similar chemical structures. Hence, ephedrine can reduce fatigue and increase the attention span. It can also increase the metabolism in tissues. This property caused the addition of ephedrine to some fat-burning products. Ephedrine is present in supplements such as alkaloids, which are part of the family of alkaline components. Substances containing nitrogen are usually derived from plants and are biologically active.
Is ephedra safe?
Since ephedrine is a derivative of the plant of ephedra, this is classified as a nutritional supplement. In the United States, the act of Dietetic Supplements, Health and Education of 1994 (DSHEA), regulates the market of dietetic supplements. Although the Food and Drugs Administration (FDA) is trying to remove dangerous products from the market, the regulations of the DSHEA determine that FDA hast the legal obligation to prove that some product is uncertain, instead of having the producer or distributor proving that the product is safe.
A common dose is of 20 mg per ration, and the typical frequency of use is of 2 to 3 times to the day. Some of the effects above mentioned were related to much smaller doses, indicating than some individuals can be more susceptible to the adverse effects of ephedrine. Nevertheless, due to the absence of strict regulations, the products could contain but ephedrine doses ranging from 1 to 100 mg with no mention on the label at all.

Could ephedrine improve the athletes’ performance or facilitate fat loss?

Ephedrine intake could produce small changes in corporal weight. Nevertheless, because the loss of weight is so small, several products have been designed by combining ephedra, caffeine and aspirin, which increases the stimulating effects of ephedrine. Although the combination is a powerful agent for fat loss, this also increases the possibility of adverse effects due to the stimulation of the central nerve system and the cardiovascular system. Those people interested in using them as a fat-burning product must consult their physician first.

Dr. Priscilla M. Clarkson is who has conducted most of the studies related to the Ephedra. She is a professor of Sciences for the School of Health and Sciences of Health at the University of Massachusetts, Amherst. She is also a Fellow member of the American School of Sports Medicine and has presided this institution. She has published more than 100 scientific articles and at the moment she is the co-publisher of the magazine “International Journal of Sport Nutrition and Exercise Metabolism.”

At present, she is a member of the scientific group that develops laboratories for the space stations in the NASA and also a co-worker of the group of sports medicine revision of the Gatorade Sports Science Institute.