Given the size of the obesity problem in the United States—and, increasingly, around the world—you'd expect the weight-loss drug market to be, well, huge. It's not. According to the market research firm Datamonitor, while the global market for drugs to combat diabetes will hit a projected $37 billion by 2018, the obesity drug market is likely to come to just $600 million. The reasons? A history of drugs haunted by sometimes dangerous side effects (including, most recently, the risk of heart problems associated with sibutramine, sold under the Meridia name in the United States, for some people with health issues) and the complex physiology of weight regulation.
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Yet, ever cognizant of the market opportunities that would greet a safe, effective drug, manufacturers are teeing up new attempts. Two companies have filed for Food and Drug Administration approval for their medications, and another is expected to file this year. Other drugs are further back in the pipeline. And researchers are urging the exploration of new avenues that may lead to entirely different pharmaceutical approaches to making weight loss easier (although probably never easy).
Shouldn't the obese lose weight the old-fashioned way, through diet and exercise? In an ideal world, probably, but that approach hasn't been particularly successful over the years (see Do Program Diets Work? Rarely—Here are 7 Tips to Shed Pounds). But if willpower alone isn't the answer, neither is treating obesity as a chronic illness to be managed solely through medical means. Behavior and biology both contribute, says Madelyn Fernstrom, director of the nutrition and weight management program at the University of Pittsburgh Medical Center and author of The Real You Diet. Medications, she says, can help make healthful lifestyle choices a bit easier.
But there's not much ammo in currently available prescription options. Phentermine is an appetite suppressant approved by the FDA only for short-term use (up to 12 weeks). It's a stimulant—it was the "good" half of the infamous fen-phen combination that led to dangerous heart and lung damage—and has a powerful but short-lived effect, says Fernstrom. Another drug that muffles appetite, diethylpropion, is also potent but even shorter-acting. Sibutramine is a long-acting appetite suppressant that was initially studied as an antidepressant, but recent data suggest it may cause cardiovascular problems in people with uncontrolled high blood pressure or who have had previous heart attacks or strokes. (The FDA requested a stronger label warning; the European Medicines Agency recommended the drug not be used at all.) Finally, a drug called orlistat (sold over the counter as Alli and by prescription, in a higher dosage, as Xenical) acts not on appetite but by inhibiting a fat-digesting enzyme and causing some of the fat in meals to pass through the digestive tract without being absorbed. If a person eats too much fat, he or she can experience gas, diarrhea, and other unpleasantries. And those are the survivors among weight-loss products; fen-phen spectacularly crashed and burned, while the much-hyped rimonabant was never approved in the United States and faltered in Europe after reports of depression and suicidal thoughts in users. A host of other drugs were abandoned during early studies and never even submitted for approval.
[See Why You Should Think Twice Before Using Alli or Other Weight-Loss Aids.]
With all the drugs, weight loss tends to top out at about 4 to 6 percent of body weight, on average, and then plateaus. Stop taking the drug, and the weight usually comes back. It's not surprising that it's so tough to make the body give up pounds, says John Fernstrom, a professor of psychiatry and pharmacology at the University of Pittsburgh and director of research for the school's Weight Management
Center. Fernstrom, who is Madelyn's husband, has researched weight-loss drugs. Like other physiological processes such as blood pressure, the balance of energy taken in from food and burned off through activity is fairly tightly regulated, he says. (Even if you gain 20 pounds over as many years, all it means is that your body isn't accounting for about 3,500 calories a year, or about 10 calories a day.) But things are lopsided; the body probably has a preference for fat accumulation, allowing weight to creep up far more easily than it creeps down, he says. Our bodies evolved in feast-or-famine conditions; when humans were hunter-gatherers, there was plenty of food available at some times of the year but not at others. So, he says, the pattern was to overeat during times of plenty, store fat, and then burning the fat when food wasn't readily available. Now, of course, conditions are different.
Keeping the percentage of body fat above some critical minimum level is one of the most important biological aspects of our existence, says Rudolph Leibel, a professor of medicine and pediatrics and codirector of the New York Obesity Research Center and the Diabetes and Endocrinology Research Center at Columbia University. Without enough body fat, survival is impaired. So is fertility: Women need enough energy on board to feed themselves and nourish a growing fetus and then, through breast milk, a child. No wonder the body has so many mechanisms in place to protect against too much change in the downward direction. "If you perturb the system in one way, it will compensate in another," says Leibel. "It's very hard to trick Mother Nature."
Will the new drugs currently being developed for the U.S. market work any better or have fewer side effects? Two of them—Contrave, made by Orexigen Therapeutics, and Qnexa, made by Vivus—are actually combinations of existing drugs prescribed for other purposes but married with an eye to boosting effectiveness, reducing side effects, or both. Contrave, expected to be submitted for FDA consideration this year, has bupropion (the ingredient in the antidepressant Wellbutrin and the antismoking therapy Zyban) combined with naltrexone, already prescribed for drug and alcohol addiction. Bupropion seems to stimulate the brain's so-called POMC cells, with the ultimate effect of "decreasing food intake and boosting energy expenditure," says Dennis Kim, senior vice president of medical affairs at Orexigen. Naltrexone, meantime, blocks beta-endorphin, a chemical that normally ratchets down the activity of POMC. The combination leads to "longer and greater weight loss," he says.
Qnexa, which was submitted to the FDA in late December, has produced the largest weight loss in trials. It combines low doses of topiramate, an antiseizure drug, with phentermine. In higher doses, both have side effects—cognitive dulling and fatigue for topiramate and high blood pressure in phentermine—but Peter Tam, president of Vivus, says the combination of the drugs at lower doses reduces those side effects and leads to greater weight loss. (The phentermine is similar to an amphetamine, acting as a stimulant and prompting the release of a neurotransmitter that is linked to appetite suppression. The mechanism behind topiramate isn't understood.)
Lorcaserin, made by Arena Pharmaceuticals, is a new drug that stimulates the serotonin 2C receptor, found mostly in the hypothalamus. This receptor is involved in appetite and food intake. (Fenfluramine, the "bad" half of fen-phen, stimulated the closely related 2B receptor that is found in the heart, with ill effects.) "It's targeting one specific [receptor] subtype that's in a part of the brain which should only affect food intake suppression," says Dominic Behan, cofounder and chief scientific officer of Arena. The drug also seems to have few side effects. Safety will be key for the FDA, given that an obesity drug is likely to find its way into the medicine cabinets of people who may only want to lose 10 to 15 pounds; for them, the risks of carrying the extra weight aren't large, so the risks of the drug better be extremely low, says Donna Ryan, president of the Obesity Society and associate executive director for clinical research at Pennington Biomedical Research Center in Baton Rouge, La. (Her financial relationships with drug and weight-loss companies ended in 2008.)
It's important to have more options, says Michael Cowley, developer of Contrave and a professorial fellow in the department of physiology at Monash University in Australia. He and others use the analogy of the antidepressant market to describe what more drugs would likely mean: a range of different options that work well in some people and not in others—so you try something, see if it works, and move to something else if it doesn't.
Sure Shot Ways to Burn Fat Fast I
‘How to get started’ is a major cause of concern. Whether it is sweating it out at the gym or going for long jogs, it is a tough call for most fitness novices. At such a juncture it is imperative to understand your body and its fitness requirement. And accordingly zero in on a work-out routine. We take a look at five fast fat burning moves...
Cardio exercises
Cardios are the best form of exercise for beginners. There is no refuting the fact that to blast calories you need to break a sweat. A lean body can never be yours without sweating out the excess flab. And cardio exercises help you achieve just that; they boost your stamina, make you energetic and flexible to take up an even rigorous fitness regime. Running on the treadmill, cross-trainer, cycling, swimming and skipping are the most popular forms of cardio. While a treadmill exercises the whole body, cross-trainers are for the hips and thighs. You can even go for the cycling option at a gym; there are two kinds of cycles, one for thighs and the other for thighs and stomach.
Diet
Once you have set up a routine, gradually cut down on fish, red meat, fries, butter, cheese and junk food of every kind. Take a good dose of water depending on your body requirement. Coconut water and fresh fruit juices too can be taken post meals.
Spinning
One might complain of lack of variety in a spinning class, as the exercise routine can get a tad monotonous. However, spinning is a wonderful way to burn calories and keeps your muscles toned. Agreed, cycling in the open is a far viable option as it lets you enjoy the local sights and take in fresh air, but rainy season and foggy winters can put a dampener on your fitness schedule. Request your trainer to come up with varied routines to keep up the interest. At a spinning studio, with the help of background music and varied lighting, a soothing and happy atmosphere is recreated. Not to mention, spinning works best when alternated with cardio exercises. It helps lose fat and build muscles. You can do 30-45 minutes of non-stop spinning once in eight days, if you are combining it with cardio.
Diet
Food intake should be half of your normal diet. You can consume small portions of all kinds of food you like, but say no to fries, butter and cheese.
Trapeze workout
The form of workout is named after the lesser-known trapeze muscle which all of us have, but isn’t very prominent. Trapeze muscles are connected at either ends to the collar bone and hence move parts of the skeleton. Little wonder, fitness addicts and body builders sport such a neat shoulder and neck line. To chisel out your trapeze muscles, the ‘Dumbbell shrugs’ and ‘Barbell shrugs’ are most effective. The former flexes your side form, while the latter is for the front form. It is to be noted that trapeze exercises are not for beginners, as it requires an already lean body. A few months of rigorous cardio and spinning can have you ready for trapeze. Outside of building swoon-worthy muscles, it helps keep sinus and cervical disorders at bay. A healthy trapeze routine requires each body part be exercised twice a week.
Diet
A wholesome diet, but avoid greasy and junk food at any cost. Drink plenty of water, fresh fruit juices and coconut water.
Aerobics and resistance training
Such an exercise routine is best practiced at a fitness club under the guidance of expert trainers who understand your fitness level better. Resistance and flexibility exercises help increase stamina, and if rigorously followed, bring you in shape. Resistance is a set of weight lifting exercises, while flexibility is for the lower body. With music in the backdrop, aerobic exercises are a fun way to burn extra fat and get fitter. It facilitates a great deal of interaction with your fellow practitioners and one could also pick up some interesting routines together. To achieve best results, do resistance workout at least thrice a week. Warm up with a set of cardio exercises such as jumping and skipping to build stamina. You burn more calories by alternating aerobics with resistance and flexibility exercises.
Diet
Avoid food with high carbohydrate content such as potato, banana etc. If you like eating rice, take a small portion in the afternoon. Simply keep away from all kinds of fried stuff.
Pilates
Pilates is also a kind of aerobic exercise which entails a whole set of routines on the floor - on a mat. Group classes are conducted at a fitness club, where the trainer shows new routines on a regular basis, depending on the ability of the students. After a basic two-day training, the body status of the student is decided and a goal is fixed for the week. Pilates exercises the whole body and burns calories. There are as many as one hundred routines for the abs only. While you are free to buy tapes and practice Pilates in your living room, the knowledge of a live trainer and his ability to access your body strength cannot be negated either. Ideally, about four kilograms a month is the healthiest way to shed weight.
Diet
A wholesome diet, but avoid greasy and junk food at any cost. Drink plenty of water, juices and coconut water. Not to mention, carbohydrate-rich food should be taken only occasionally.
Did you know, to lose a kilo you need to burn 7700 calories! Time you slipped into your track pants and broke some sweat. read moree.../timesofindia.indiatimes.com
Cardio exercises
Cardios are the best form of exercise for beginners. There is no refuting the fact that to blast calories you need to break a sweat. A lean body can never be yours without sweating out the excess flab. And cardio exercises help you achieve just that; they boost your stamina, make you energetic and flexible to take up an even rigorous fitness regime. Running on the treadmill, cross-trainer, cycling, swimming and skipping are the most popular forms of cardio. While a treadmill exercises the whole body, cross-trainers are for the hips and thighs. You can even go for the cycling option at a gym; there are two kinds of cycles, one for thighs and the other for thighs and stomach.
Diet
Once you have set up a routine, gradually cut down on fish, red meat, fries, butter, cheese and junk food of every kind. Take a good dose of water depending on your body requirement. Coconut water and fresh fruit juices too can be taken post meals.
Spinning
One might complain of lack of variety in a spinning class, as the exercise routine can get a tad monotonous. However, spinning is a wonderful way to burn calories and keeps your muscles toned. Agreed, cycling in the open is a far viable option as it lets you enjoy the local sights and take in fresh air, but rainy season and foggy winters can put a dampener on your fitness schedule. Request your trainer to come up with varied routines to keep up the interest. At a spinning studio, with the help of background music and varied lighting, a soothing and happy atmosphere is recreated. Not to mention, spinning works best when alternated with cardio exercises. It helps lose fat and build muscles. You can do 30-45 minutes of non-stop spinning once in eight days, if you are combining it with cardio.
Diet
Food intake should be half of your normal diet. You can consume small portions of all kinds of food you like, but say no to fries, butter and cheese.
Trapeze workout
The form of workout is named after the lesser-known trapeze muscle which all of us have, but isn’t very prominent. Trapeze muscles are connected at either ends to the collar bone and hence move parts of the skeleton. Little wonder, fitness addicts and body builders sport such a neat shoulder and neck line. To chisel out your trapeze muscles, the ‘Dumbbell shrugs’ and ‘Barbell shrugs’ are most effective. The former flexes your side form, while the latter is for the front form. It is to be noted that trapeze exercises are not for beginners, as it requires an already lean body. A few months of rigorous cardio and spinning can have you ready for trapeze. Outside of building swoon-worthy muscles, it helps keep sinus and cervical disorders at bay. A healthy trapeze routine requires each body part be exercised twice a week.
Diet
A wholesome diet, but avoid greasy and junk food at any cost. Drink plenty of water, fresh fruit juices and coconut water.
Aerobics and resistance training
Such an exercise routine is best practiced at a fitness club under the guidance of expert trainers who understand your fitness level better. Resistance and flexibility exercises help increase stamina, and if rigorously followed, bring you in shape. Resistance is a set of weight lifting exercises, while flexibility is for the lower body. With music in the backdrop, aerobic exercises are a fun way to burn extra fat and get fitter. It facilitates a great deal of interaction with your fellow practitioners and one could also pick up some interesting routines together. To achieve best results, do resistance workout at least thrice a week. Warm up with a set of cardio exercises such as jumping and skipping to build stamina. You burn more calories by alternating aerobics with resistance and flexibility exercises.
Diet
Avoid food with high carbohydrate content such as potato, banana etc. If you like eating rice, take a small portion in the afternoon. Simply keep away from all kinds of fried stuff.
Pilates
Pilates is also a kind of aerobic exercise which entails a whole set of routines on the floor - on a mat. Group classes are conducted at a fitness club, where the trainer shows new routines on a regular basis, depending on the ability of the students. After a basic two-day training, the body status of the student is decided and a goal is fixed for the week. Pilates exercises the whole body and burns calories. There are as many as one hundred routines for the abs only. While you are free to buy tapes and practice Pilates in your living room, the knowledge of a live trainer and his ability to access your body strength cannot be negated either. Ideally, about four kilograms a month is the healthiest way to shed weight.
Diet
A wholesome diet, but avoid greasy and junk food at any cost. Drink plenty of water, juices and coconut water. Not to mention, carbohydrate-rich food should be taken only occasionally.
Did you know, to lose a kilo you need to burn 7700 calories! Time you slipped into your track pants and broke some sweat. read moree.../timesofindia.indiatimes.com
What Kind of Yoga Will Help Me Lose Weight?
The type of yoga you need to do is called vinyasa or flow yoga. This style of yoga is based on the performance of a series of poses called sun salutations. Vinyasa includes many popular, athletic and sweat-drenched yoga styles. For weight loss purposes, try:
Ashtanga:
Ashtanga Yoga is a very vigorous style of practice with a few distinct advantages for those who want to lose weight. Ashtanga practitioners are among the most dedicated of yogis, and beginners are often encouraged to sign up for a series of classes, which will help with motivation. Another advantage is that once you learn the poses, Ashtanga Yoga is ideal for home practitioners.
Power Yoga:
Power Yoga is extremely popular, because it provides a very vigorous cardiovascular workout.
Hot Yoga:
Vinyasa yoga done in a hot room ups the ante by guaranteeing you’ll sweat buckets.
Keep in mind that if you are just starting to do yoga, are very overweight, or are quite out of shape, always choose a beginner-level class.
Yoga Workouts at Home
Keep yourself exercising by doing yoga at home on the days you can’t make a class. Follow along with a video or audio recording if you are new to yoga. When you are ready to plan your own workouts, use these yoga sequencing ideas to help you come up with yoga sessions of varying lengths that will fit your schedule.
Ashtanga:
Ashtanga Yoga is a very vigorous style of practice with a few distinct advantages for those who want to lose weight. Ashtanga practitioners are among the most dedicated of yogis, and beginners are often encouraged to sign up for a series of classes, which will help with motivation. Another advantage is that once you learn the poses, Ashtanga Yoga is ideal for home practitioners.
Power Yoga:
Power Yoga is extremely popular, because it provides a very vigorous cardiovascular workout.
Hot Yoga:
Vinyasa yoga done in a hot room ups the ante by guaranteeing you’ll sweat buckets.
Keep in mind that if you are just starting to do yoga, are very overweight, or are quite out of shape, always choose a beginner-level class.
Yoga Workouts at Home
Keep yourself exercising by doing yoga at home on the days you can’t make a class. Follow along with a video or audio recording if you are new to yoga. When you are ready to plan your own workouts, use these yoga sequencing ideas to help you come up with yoga sessions of varying lengths that will fit your schedule.
Will doing Yoga help me Lose Weight?
Practicing any type of yoga will build strength, but some types may not raise your heart-rate enough to make them the only form of exercise you need to include in your weight loss regime. It depends on the type of yoga you select and how frequently you practice it.
In order to lose weight, you must eat healthily and burn calories by doing exercise that raises your heart rate on a regular basis. Some types of yoga, such as Iyengar, in which yoga poses are held for several minutes with a resting period between each pose, will build muscles and improve your posture, but will not give you the cardiovascular workout you need to lose weight.
If you plan to make yoga your primary form of exercise, you must do a vigorous 90-minute yoga class at least three times a week. Many people also choose to combine yoga with running, walking or other aerobic exercise in order to reach their weight loss goals.
In order to lose weight, you must eat healthily and burn calories by doing exercise that raises your heart rate on a regular basis. Some types of yoga, such as Iyengar, in which yoga poses are held for several minutes with a resting period between each pose, will build muscles and improve your posture, but will not give you the cardiovascular workout you need to lose weight.
If you plan to make yoga your primary form of exercise, you must do a vigorous 90-minute yoga class at least three times a week. Many people also choose to combine yoga with running, walking or other aerobic exercise in order to reach their weight loss goals.
Top Ten Weight Loss Tips
"In November 2009, I weigh around 145 pounds. till from there my struggle starts. My struggle for Life, to look slim, to look beautiful, so fit in my favorite one piece dress. Till then from my hard work I am able to lose 45 pounds that too in three and a half months. Then , I thought that I will share my success tips with you all, as I am happy to have helped from my friends and family members. Feel free to add your own tips to this list, too!" -- Julia, Argentina
- Dietary control and exercise. It’s true what they say – all you need to do is watch what you eat, and expend more energy than you consume. It’s really that simple. You can quit reading this list now, you now know everything you need to know and didn’t need to fork over $500 for the privilege of me telling you the secret of losing weight. You don’t need to read a 4,000 page book, you don’t have to buy a tape series, you don’t need to stay up late at night to watch infomercials to understand this basic premise. It’s 100% true.
- Change your lifestyle. If you’re calling this a “diet,” then you’re going to gain all the weight back (and more) within a few months of losing it. Diets do not work. Diets are temporary. When you change your dietary lifestyle, however, you’re changing your habits – and you’re putting yourself on track for long-term / continued success and weight maintenance. Don’t ever tell anybody you’re on a diet – ever. I’m speaking from experience, here – a reformed low-carber. Worked out well for a while, but ultimately failed because my entire lifestyle didn’t change (permanently).
- Take before and after photos. I know it sucks to see yourself as a chunky monkey (sorry, that’s what I called myself – if only to get myself motivated to meet my weight loss goal). However, there’s no easier way to illustrate your progress. The “after” photos are far more fun to capture and share, admittedly. Find yourself on Flickr! It’s good to see yourself how others see you. Do you like how you look? In many ways, Flickr helped me lose weight.
- Hire a substitute teacher. Don’t reach for the brands you know and love immediately – or without thinking first. Eggs are “good” for you, but consider using egg substitutes instead (in fact, many restaurants will let you order lower calorie foods). There are countless “lower” alternatives for you to try. If something different doesn’t taste good, by all means – find a better substitute, or eat less of the original. In some cases, the substitute may be worse for you than the regular version of the product. The good news is, healthier choices are silently replacing their “normal” counterparts – and they taste just as nice.
- Identify your exercise. No exercise was created equal. You might like running, so run. You might like jogging, so jog. You might like stationary bikes, so bike stationarily. Find the one that works best for you – that isn’t too much of a chore for you to do regularly throughout the week. Don’t pick a routine that you don’t like – or you won’t want to do it, and you certainly won’t stick with it for long. I also wouldn’t recommend buying into that whole “no pain, no gain” mantra. I’ve lost weight without hurting myself, and you probably can, too.
- Set realistic goals. You can lose 50 pounds in a week if you work out 12 hours a day and eat nothing but celery – but not if you’re human. Slow and steady wins the race. Don’t bite off more than you can chew – literally. Make small goals on your way to the bigger goal(s). In the end, you’ll have achieved more (and more frequently, might I add).
- Become a Gazelle. You’ve probably seen Tony Little on TV, selling his Gazelle glider – a low impact exercise machine. I can tell you: it works. It’s easy on my legs, and really gives me a workout when I apply myself on it. Some people say it’s awkward to use, but I love mine – and would consider recommending no other home exercise equipment at this point. Then again, I’m a wimpy geek who only wants to burn calories.
- Avoid trans fats and high fructose corn syrup. I offer this suggestion for a few reasons. First, they’re not good for you anyway. Second, you’ll eliminate a lot of the “bad foods” outright – no questions asked. You’ll have to become more selective in what you eat by avoiding these two nasty ingredients – which are in more foods than you probably care to know.
- Take a magic pill. Nonsense! There is no such thing as a magic pill. Don’t fall victim to the hype of the latest fat-burning drug commercial. If you listen or read closely, you’ll see that every single one of these things is effective when combined with proper diet and exercise (which they even state in their advertisements). The side-effects for these drugs are usually worse than your additional weight, anyway.
- Ignore Ronald McDonald. You don’t have to eliminate fast food completely, but you should avoid it at all costs. Most of it is nasty, bad stuff anyway – if you’d even go as far as to call it food. If you’re looking for convenience, find a more convenient meal source. Besides, most of what they serve would be considered “food product,” not food. There’s a gigantic difference as far as your body is concerned. Your bloodstream does not have taste buds, need I remind you?
