Liraglutide (SAXENDA) May Lead To Weight Loss By Slowing Stomach Emptying

MedicalResearch.com Interview with:

Prof Michael Camilleri, MD Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Mayo Clinic, Rochester, MN

Prof. Camilleri

Prof Michael Camilleri, MD
Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER)
Mayo Clinic, Rochester, MN

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Liraglutide is approved for treatment of obesity; the precise mechanisms for the beneficial weight loss are unclear. We are interested to learn whether it is possible to identify people who are more likely to benefit from this treatment.

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Intermittent Dieting May Result In Greater Weight Loss

MedicalResearch.com Interview with:

Professor Nuala Byrne PhD Head of School | Health Sciences Faculty of Health University of Tasmania

Prof. Byrne

Professor Nuala Byrne PhD
Head of School | Health Sciences
Faculty of Health
University of Tasmania 

MedicalResearch.com: What is the background for this study?

Response: Calorie restriction (or cutting back on the energy we are eating) triggers powerful compensatory responses by our body’s metabolism – we might think of it as a “Famine Reaction”. Our body weight is regulated by a series of nervous system and hormone networks that act together to make sure we have enough energy to sustain life. When we eat more energy than our body needs to meet our daily metabolic requirements (positive energy balance), we are designed to store that excess energy; and we are very good at storing. We store this energy in the fat cells (adipocytes) as an emergency reserve for when we hit hard-times when food availability is scarce. The problem in today’s society is that most of us have a constant availability of energy-dense food; making it more common to be in energy excess.

When we have less calories being consumed than what we need to fuel all the body’s metabolic processes (negative energy balance), we convert the stored fat into usable energy, and consequently lose weight. While our body does sense the positive energy balance, it is designed to be more sensitive to gauging when we are in a negative energy balance. Our body senses the change in energy intake and the decreasing fat stores, and brings out the artillery to defend our energy stores – this is the Famine Reaction. Our body is constantly changing our physiology in response to challenges to the status quo; the body works constantly to keep the oxygen concentration in the blood at an optimal level, to keep a constant and optimal body temperature, and a constant and optimal amount of sugar in the blood. Our body’s regulatory systems also work hard to defend our energy stores if it senses we are continually in negative energy-balance (i.e., dieting). One major metabolic compensatory as part of the “Famine Reaction” is a decrease in the body’s resting metabolic rate (energy expended while at rest to maintain the basic functioning of our major organs). Given that resting metabolic rate is determined largely by body size and composition, it is expected to decrease with weight loss. However, during dieting, resting metabolic rate has been reported to decrease to a greater extent than that expected from changes in body composition, a phenomenon termed ‘adaptive thermogenesis’. This leads to markedly reduced efficiency of weight loss.

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Vegetarian Diet More Effective For Weight Loss

MedicalResearch.com Interview with:

Hana Kahleova, MD, PhD</strong> Director of Clinical Research at Physicians Committee for Responsible Medicine Physicians Committee for Responsible Medicine Charles University in Prague

Dr. Kahleova

Hana Kahleova, MD, PhD
Director of Clinical Research at Physicians Committee for Responsible Medicine
Physicians Committee for Responsible Medicine
Charles University in Prague

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The vegetarian diet was found to be almost twice as effective in reducing body weight, resulting in an average loss of 6.2kg compared to 3.2kg for the conventional diet. Using magnetic resonance imaging, we studied adipose tissue in the subjects’ thighs to see how the two different diets had affected subcutaneous, subfascial and intramuscular fat.

We found that both diets caused a similar reduction in subcutaneous fat. However, subfascial fat was only reduced in response to the vegetarian diet, and intramuscular fat was more greatly reduced by the vegetarian diet.

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Re-Operations After Gastric Band Surgery Are Common and Costly

MedicalResearch.com Interview with:

Andrew Ibrahim, M.D., M.Sc</strong> Institute for HealthCare Policy and Innovation University of Michigan

Dr. Ibrahim

Andrew Ibrahim, M.D., M.Sc
Institute for HealthCare Policy and Innovation
University of Michigan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The laparoscopic gastric band was approved by the FDA in 2001 and widely adopted for the surgical treatment of morbid obesity. Reported rates of reoperation to revise or remove the device ranged from 4 to 60 percent in small scale studies, but no population estimates in the United States existed.

In a review of Medicare Claims data between 2006 and 2013, we observed that reoperation was common with 18% of patients requiring at least one reoperation. More over, we found that on average, patients who did need a reoperation often underwent an average of 3.8 additional procedures. Taken together, nearly half (47%) of the $470 million paid by Medicare for device related procedures was for reoperations.

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Sustained Contact With Dietician Improves Maintenance of Weight Loss

MedicalResearch.com Interview with:

Corrine I. Voils, PhD Research Career Scientist, William S Middleton Veterans Memorial Hospital Visiting Professor of Surgery, University of Wisconsin-Madison

Dr. Corrine Voils,

Corrine I. Voils, PhD
Research Career Scientist, William S Middleton Veterans Memorial Hospital
Visiting Professor of Surgery, University of Wisconsin-Madison

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Weight loss interventions can help people lose weight, but most people tend to regain weight after a weight loss period. There is a need to identify effective strategies to help people maintain weight loss. We found that an intervention focused on maintenance behavioral skills that was delivered primarily by telephone reduced weight regain compared to usual care over 56 weeks.

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Losing Some Weight May Reduce Risk of Endometrial Cancer

MedicalResearch.com Interview with:

Juhua Luo, PhD Associate professor of epidemiology and biostatistics Indiana University School of Public Health

Dr. Juhua Luo

Juhua Luo, PhD
Associate professor of epidemiology and biostatistics
Indiana University School of Public Health

MedicalResearch.com: What is the background for this study?

Response: We already know obesity increases risk of endometrial cancer. However, information on whether weight loss reduces risk of endometrial cancer is limited.

MedicalResearch.com: What are the main findings?

Response: Women losing 5% or more weight reduced risk of getting endometrial cancer by 29%. This was observed for any weight loss but risk was even lower for obese women with intentional weight loss. Obese women intentionally losing their weights by 5% or more reduced risk of getting endometrial cancer by 56%.

MedicalResearch.com: What should readers take away from your report?

Response: Among post-menopausal women, intentional weight loss reduces risk of getting endometrial cancer, especially for obese women. Our findings suggest that weight loss in postmenopausal women may not be too late for potential health benefit.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Additional research on intentional weight loss in relation to risk for other obesity-related cancer types and for mortality from cancer or other diseases are needed.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Intentional Weight Loss and Endometrial Cancer Risk

Juhua LuoRowan T. ChlebowskiMichael HendryxThomas RohanJean Wactawski-WendeJ, Cynthia A. ThomsonAshley S. FelixChu Chen, …

JCO Jan 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Government Endorsed DASH Diet Voted Best Overall

MedicalResearch.com Interview with:

Janet M. de Jesus, M.S., R.D. Program Officer, Implementation Science Center for Translation Research and Implementation Science (CTRIS) National Heart, Lung, and Blood Institute

Janet de Jesus

Janet M. de Jesus, M.S., R.D.
Program Officer, Implementation Science
Center for Translation Research and Implementation Science (CTRIS)
National Heart, Lung, and Blood Institute

MedicalResearch.com: What is the background for the DASH diet? What are the main components?

Response: The DASH eating plan was created for a clinical trial funded by the National Heart, Lung, and Blood Institute (NHLBI). DASH stands for Dietary Approaches to Stop Hypertension. The goal of the original DASH trial was to test the eating plan compared to a typical American diet (at the time in the 1990s) on the effect of blood pressure.

The DASH eating plan is rich in fruits, vegetables, and whole grains. It includes low-fat dairy products, poultry, fish, legumes, vegetable oils, and nuts; and limits intake of sweets and sugar-sweetened beverages and high-fat meats. The eating plan is a good source of potassium, magnesium, and calcium. The DASH eating plan was shown to reduce blood pressure and improve lipid profiles.

A second DASH trial, “DASH-sodium,” showed that adding sodium reduction to the DASH eating plan reduced blood pressure even more.

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Early Weight Loss Predicts Who Will Successfully Lose Weight With Liraglutide

MedicalResearch.com Interview with:

Ken Fujioka M.D. Director of the Center for Weight Management Scripps Clinical Department of Endocrinology La Jolla CA

Dr. Ken Fujioka

Ken Fujioka M.D.
Director of the Center for Weight Management
Scripps Clinical Department of Endocrinology
La Jolla CA

MedicalResearch.com: What is the background for this study?

Response: Obesity is an odd disease that has many causes (overeating, underactivity, the patient being placed on a medication that drives up weight and a whole lot of other causes that result in a higher weight) so trying to find the right treatment, in this case a weight loss medication, for a particular patient is not an easy task. If there is a way to find out if you’ve picked the right medication (a weight loss of at least 5%) then this can help you decide whether you should keep the patient on the medication or stop the medication.

There are two huge benefits to this:
1. Is that you find your responders (patients) that will go on to lose weight and do well and 2. When you stop the medication in the non-responders you eliminate any potential adverse events from the weight loss medication.
Thus this study was designed to find out if early weight loss can predict who will go on to lose a significant amount of weight on Liraglutide.

And yes those who lose weight go on to lose weight.

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FTO Gene Make Obesity More Likely But Doesn’t Prevent Weight Loss

MedicalResearch.com Interview with:

Prof. John C. Mathers Director, Human Nutrition Research Centre Institute of Cellular Medicine and Newcastle University Institute for Ageing Newcastle University Biomedical Research Building Campus for Ageing and Vitality Newcastle on Tyne

Prof. John C. Mathers

Prof. John C. Mathers
Director, Human Nutrition Research Centre
Institute of Cellular Medicine and
Newcastle University Institute for Ageing
Newcastle University
Biomedical Research Building
Campus for Ageing and Vitality
Newcastle on Tyne

MedicalResearch.com: What is the background for this study?

Response: More than 90 different genetics variants are associated with body fatness and, of these, the FTO gene has the biggest effect. People who are homozygous for the unusual variant of FTO i.e. carry two copies of the risk allele, are on average 3kg heavier than those not carrying the risk allele. In addition, they have 70% greater risk of being obese. Since the FTO gene is associated with being heavier, we wondered whether it made it more difficult for people to lose weight.

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JAMA Study Looks At Comparable Effectiveness of Four Weight Loss Medications

MedicalResearch.com Interview with:

Siddharth Singh, MD, MS Postdoctoral Fellow, NLM/NIH Clinical Informatics Fellowship Division of Biomedical Informatics Clinical Assistant Professor of Medicine, Division of Gastroenterology, Department of Internal Medicine, University of California San Diego, La Jolla

Dr Siddharth Singh

Siddharth Singh, MD, MS
Postdoctoral Fellow, NLM/NIH Clinical Informatics Fellowship
Division of Biomedical Informatics
Clinical Assistant Professor of Medicine, Division of Gastroenterology, Department of Internal Medicine,
University of California
San Diego, La Jolla

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Singh: Over the last 4 years, four new medications have been approved for long-term use for weight loss by the FDA. We sought to evaluate the comparative effectiveness and tolerability of these medications through a systematic review and network meta-analysis. Based on 28 trials in over 29,000 overweight or obese patients, we observed that magnitude of weight loss achieved with these agents is variable, ranging from 2.6kg with orlistat to 8.8kg with phentermine-topiramate. Over 44-75% of patients are estimated to lose at least 5% body weight, and 20-54% may lose more than 10% of body weight; phentermine-topiramate was the most efficacious, whereas lorcaserin was the best tolerated.

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