Weight Loss

Adults using semaglutide as first obesity medication achieve greater weight loss, study finds

A recent study has indicated that adults commencing semaglutide as their initial treatment for obesity experience more substantial weight reduction compared to those who had previously used other obesity medications. This research, published in the journal Diabetes, Obesity and Metabolism, was conducted by Andres J. Acosta, MD, PhD, and his team at the Mayo Clinic in Rochester, Minnesota. It marks the first investigation into how prior use of anti-obesity drugs influences weight loss outcomes with semaglutide.

The retrospective cohort study analysed data from 305 adults treated at a Mayo Clinic centre from 2021 to January 15, 2023. Participants, who had an average age of 49 and were predominantly female (73%), received once-weekly subcutaneous injections of semaglutide (Wegovy, Novo Nordisk). The research team monitored body weight changes from baseline at 3, 6, 9, and 12 months after initiating treatment. Additionally, blood pressure and laboratory values were assessed at baseline and after one year.

Of those studied, 76% had not previously used any obesity medication before starting semaglutide, while 24% had used another obesity drug. Among the latter group, 28% had been treated with the GLP-1 receptor agonist liraglutide (Saxenda, Novo Nordisk), and 72% had used a non-GLP-1 obesity medication.

The findings revealed that those who were new to obesity medications and started with semaglutide saw a 14.3% reduction in body weight by 12 months, compared to a 10.6% decrease in those who had used other obesity treatments prior (P = .01). Despite similar proportions of both groups achieving at least 5% and 10% body weight loss, those new to obesity medication were significantly more likely to lose at least 15% (48% vs. 21%; P = .02) and at least 20% (27% vs. 4%; P < .01) of their body weight.

The analysis also showed a distinct pattern in weight loss during the first six months, where those without prior obesity medication use consistently lost more weight than those who had previously used liraglutide or other non-GLP-1 obesity drugs. By nine and twelve months, while weight loss among previous liraglutide users remained lower, those who had used other non-GLP-1 medications achieved similar weight loss to the semaglutide-naive group.

An interesting finding was that adults not previously on obesity medications exhibited a significant reduction in HbA1c levels at 12 months compared to their counterparts who had used such medications before (P < .001), although no other significant differences in metabolic outcomes were noted.

The study highlights a potential issue where prior usage of specific obesity treatments like liraglutide might lessen responsiveness to new medications such as semaglutide. The researchers suggested that these findings underscore the necessity for precision medicine in obesity management, advocating for treatment plans tailored to individual genetic backgrounds, environmental factors, and prior medication history to optimise effectiveness, reduce unnecessary drug exposure, and consider financial impacts on patients.

This study opens the door for further prospective research to explore and confirm the differential impacts of switching obesity medications and to enhance the understanding of optimal treatment strategies in obesity management.

Melatonin offers new hope for obesity prevention according to recent studies

Recent collaborative research spearheaded by the University of Granada (UGR) has unveiled significant findings regarding the use of melatonin in the prevention of obesity. This research, conducted by a team comprising experts from UGR’s Department of Pharmacology, the Federico Olóriz Neurosciences Institute, the Biosanitary Institute of Granada, and the University of Qatar, has shown promising results in mitigating the risks associated with visceral obesity. This type of obesity is especially concerning as it involves fat accumulation deep within the abdomen, surrounding vital organs, thus posing heightened health risks.

The studies, which were led by Professor Ahmad Agil of UGR and published in the well-regarded journals Antioxidants and Biomedicine & Pharmacotherapy, employed a methodical approach to their experimentation. Using adult rats with obesity and diabetes of both sexes, the research demonstrated that chronic administration of melatonin at a dosage of 10 mg/kg of body weight per day over three months is significantly more effective in preventing obesity compared to short-term treatments. Notably, the treatment resulted in a reduction of visceral fat by approximately 3%. Moreover, the studies highlighted melatonin’s ability to alleviate muscle-fibre atrophy associated with obesity, transform muscle fibre types into a more oxidative and slower phenotype, and increase mitochondrial activity and content—factors which collectively contribute to the observed reduction in weight gain among the treated rats.

An intriguing aspect of the research involved combining melatonin treatment with exposure to slightly cold water, around 17°C, which simulates the average sea temperature. This combination was found to further enhance weight loss, suggesting a potential new approach to managing obesity in humans.

Professor Agil underscored the growing prevalence of obesity, overweight, and type 2 diabetes across both developed and developing nations. He attributed these conditions to poor adaptation of the human genome to current environmental factors that include sedentary lifestyles, consumption of hypercaloric diets, and exposure to persistent artificial light which disrupts natural circadian rhythms and reduces endogenous melatonin levels.

To counter these challenges, Professor Agil recommends several lifestyle adjustments based on individual circadian rhythms. During the day, he suggests exposure to natural light, engaging in physical activity, opting for low-calorie, unprocessed diets, and incorporating thermogenic spices in meals while avoiding snacks between meals and reducing the use of insulating clothing and heating in homes. At night, recommendations include sleeping in complete darkness, avoiding blue light-emitting devices before bedtime, and practising fasting to boost melatonin levels naturally. For older adults and those suffering from obesity, Professor Agil advises the administration of melatonin under medical supervision.

The overarching goal of these studies is to integrate strategies like melatonin administration and intermittent fasting into medical practices to address the complex challenges posed by ‘diabesity’—a confluence of diabetes and obesity—and its associated complications, such as hepatic steatosis, hypertension, and lipid disorders. The research builds on 13 years of prior studies which have consistently shown that pharmacological use of melatonin can serve as a viable strategy in treating central obesity and its related complications. Moreover, melatonin has been found to activate brown fat and enhance the conversion of subcutaneous fat to a more metabolically active form, thus promoting the formation of beige fat cells from mesenchymal stem cells in humans.

These findings not only reaffirm the potential of melatonin in treating visceral obesity but also highlight the necessity for further clinical trials to confirm its efficacy in human subjects. Encouraging results from existing human trials support the progression to more extensive studies focusing on melatonin’s role in maintaining mitochondrial homeostasis and potentially slowing or halting the progression of obesity and its complications through prolonged pharmacological use.

The research has received funding from the SAF2016-79794-R project of the Ministry of Science, Innovation and Universities and is also supported by the European Regional Development Fund (ERDF).

Study reveals sweeteners do not elevate hunger while aiding in blood sugar reduction

In a groundbreaking research endeavour, the substitution of sugar with both artificial and natural sweeteners has been shown to not increase hunger levels in individuals, whilst also facilitating a reduction in blood sugar levels. This discovery comes from a rigorous double-blind randomised controlled trial, which observed that foods containing sweeteners do not lead to heightened appetite sensations or alter appetite-related hormone reactions compared to their sugary counterparts. Notably, this substitution offers additional advantages, such as the lowering of blood sugar levels, a crucial factor for individuals at risk of developing type 2 diabetes.

The incorporation of sweeteners as a sugar substitute in food products has sparked considerable debate, with prior studies providing inconclusive evidence regarding their potential to stimulate appetite. However, this recent study, adhering to the highest standards of scientific proof, delivers compelling evidence that sweeteners and sweetness enhancers do not adversely affect appetite. Moreover, they play a significant role in reducing sugar intake.

Conducted under the auspices of the University of Leeds in collaboration with the Rhône-Alpes Research Center for Human Nutrition, this study forms part of the extensive research undertaken by the SWEET consortium. Comprising 29 European partners from research, consumer, and industry sectors, the consortium aims to investigate the long-term benefits and possible risks associated with the transition to sweeteners and sweetness enhancers, focusing on public health and safety, obesity, and sustainability. The research received funding from Horizon Europe.

Catherine Gibbons, the study’s lead author and an Associate Professor at the University of Leeds’ School of Psychology, stressed the importance of reducing sugar intake in combating the escalating prevalence of obesity-related metabolic diseases like type 2 diabetes. She noted that removing sugar from foods without offering a substitute could potentially compromise taste and heighten cravings for sweet foods, thus making adherence to a low-sugar diet challenging. The substitution of sugars with sweeteners and sweetness enhancers in food products represents a prevalent dietary and food manufacturing strategy to diminish sugar consumption and enhance the nutritional value of commercial foods and beverages.

Graham Finlayson, Principal Investigator and Professor of Psychobiology at the University of Leeds, highlighted the scrutiny that the use of sweeteners and sweetness enhancers has attracted, including claims linking their consumption to adverse health outcomes. These reports have muddled public perception, particularly among those at risk of metabolic diseases, about the safety of these substances.

“Our study provides essential evidence supporting the daily use of sweeteners and sweetness enhancers in managing body weight and blood sugar levels,” Finlayson stated.

This pioneering study, a first of its kind, examined the impact of consuming biscuits infused with either sugar, the natural sugar alternative Stevia, or the artificial sweetener Neotame on a group of 53 adult men and women with overweight or obesity issues. Prior research on sweeteners and sweetness enhancers predominantly utilised beverages as a medium and seldom included participants with overweight or obesity or both sexes. Moreover, these studies usually focused on a single sweetener, primarily aspartame, against a control, with very few examining the effects of repeated daily consumption of a known sweetener or sweetness enhancer as part of a regular diet.

The trial, executed at the University of Leeds and the Rhône-Alpes Research Center for Human Nutrition in France between 2021 and 2022, involved participants aged between 18 to 60, all with overweight or obesity. It comprised three two-week consumption phases, with participants consuming biscuits containing different fillings: sugar, Stevia, or Neotame, with intervals of 14-21 days between each phase.

The initial and final days of these phases were conducted in a laboratory setting. Participants, after an overnight fast, provided blood samples to establish baseline glucose, insulin, and appetite-related hormone levels. They were also asked to evaluate their hunger and food preferences. Following the biscuit consumption, participants rated their fullness over several hours, and measurements were taken for glucose and insulin levels, along with ghrelin, glucagon-like peptide 1, and pancreatic polypeptide – hormones linked to food consumption.

The findings indicated no significant differences in appetite or endocrine responses between the sweetener types and sugar. However, insulin levels, measured two hours post-consumption, along with blood sugar levels, were observed to decrease.

Professor Anne Raben, joint co-ordinator of the SWEET project from the University of Copenhagen, Denmark, remarked, “The findings affirm that sweeteners are a beneficial tool in reducing the consumption of added sugar without triggering a compensatory increase in hunger or energy intake. This supports the effectiveness of sweeteners in managing appetite, energy, and weight.”

Artificial intelligence discovers potential plant extracts for obesity treatment

In an innovative study utilising artificial intelligence (AI), researchers have identified two plant-based compounds with the potential to act as GLP-1 agonist weight loss medications. This significant finding will be presented at the European Congress on Obesity (ECO 2024), set to take place in Venice from 12th to 15th May, 2024.

GLP-1 (Glucagon-like peptide-1) receptor agonists, such as semaglutide and tirzepatide, have proven highly effective in aiding weight loss. These agents work by emulating the effects of the GLP-1 hormone, which interacts with receptors in cells to diminish appetite and hunger sensations, decelerate gastric emptying, and enhance satiety following meals.

Despite their efficacy, the quest for alternatives is imperative, according to Elena Murcia from the Structural Bioinformatics and High-Performance Computing Research Group (BIO-HPC) & Eating Disorders Research Unit at the Catholic University of Murcia (UCAM), Spain. She notes the presence of side effects associated with current GLP-1 agonists, including gastrointestinal discomfort and mental health fluctuations, such as anxiety and irritability. Moreover, discontinuation of these treatments often leads to weight regain.

A significant limitation of current GLP-1 agonists, which are peptide-based, is their susceptibility to degradation by stomach enzymes, necessitating administration via injection rather than oral intake.

The search for non-peptide alternatives has recently identified two promising synthetic compounds, TTOAD2 and orforglipron. However, Murcia and her team are driven to discover natural counterparts that might offer similar benefits with potentially fewer side effects and simpler administration methods.

Employing high-performance AI techniques, the team embarked on a quest to identify non-peptide, plant-derived compounds capable of activating the GLP-1 receptor. Their investigation began with a virtual screening of over 10,000 compounds, aiming to pinpoint those that could bind to the GLP-1 receptor. Subsequent AI analyses assessed the similarity of these bonds to the natural interaction between the GLP-1 hormone and its receptor. This led to the selection of 100 compounds for further visual scrutiny to evaluate their interaction with crucial receptor residues.

A mathematical approach involving Venn diagrams helped distil the search to 65 potential GLP-1R agonists, among which “Compound A” and “Compound B” showed strong binding affinity to critical receptor sites, akin to the synthetic compounds TTOAD2 and orforglipron.

These compounds, derived from commonly known plants with historically recognised metabolic benefits, are currently under laboratory examination. Pending patent approvals, further specifics about these plants and compounds remain confidential, with aspirations for future pill-form administration.

Murcia highlights the nascent stage of developing these natural source-derived GLP-1 agonists. Should the AI-predicted efficacy be validated through in vitro studies and subsequent clinical trials, these compounds could offer new therapeutic avenues for obesity management.

She further emphasises the advantages of computer-based research methodologies, including cost and time efficiency, the capacity for rapid large-scale data analysis, experimental design flexibility, and pre-emptive ethical and safety risk assessments. These simulations exploit AI capabilities to tackle complex challenges, providing invaluable preliminary insights in the quest for novel pharmaceutical solutions.

Very low calorie diets safe for teens with obesity when monitored by a dietitian, study finds

In recent findings set to be unveiled at the European Congress on Obesity (ECO) in 2024, researchers assert that stringent low-calorie diets, when under the vigilant oversight of seasoned dietitians, hold promise for adolescents grappling with moderate to severe obesity.

The study, originating from Australia, explored the viability and tolerance of very low energy diets (VLEDs) among teenagers, revealing an overall positive reception despite some experiencing adverse effects. VLEDs, characterised by a daily intake of 800 calories or less through specialised meal replacements like bars and shakes, aim to fulfil essential nutrient needs while offering an alternative path to weight loss. This approach is particularly geared towards young individuals who have found little success with traditional diet and exercise regimens, presenting a potential prelude to a more balanced diet without resorting to bariatric surgery.

Historically, the application of VLEDs in youth has been approached with caution due to scant data concerning potential side effects—ranging from headaches and fatigue to muscle cramps and digestive issues—and their impact on overall growth, cardiac health, and psychological well-being. This hesitancy underscores the significance of the study conducted by Dr. Megan Gow and her team at the Children’s Hospital Westmead Clinical School, affiliated with The University of Sydney, Westmead, Australia.

The research delves into the initial phase of the “Fast Track to Health” study, specifically the first four weeks during which participants engaged in a nutritionally balanced VLED to initiate weight loss. The cohort, comprising 141 adolescents aged 13 to 17 years with obesity and at least one obesity-related complication (e.g., hypertension, insulin resistance, or dyslipidemia), was divided to receive either four Optifast meal replacement products daily alongside low carbohydrate vegetables and a teaspoon of vegetable oil or a similar regimen with three meal replacements and one solid meal of lean meat and vegetables.

Support was provided through weekly consultations with a dietitian, with assessments at baseline, weekly intervals, and a comprehensive survey to gauge the diet’s acceptability, detailing aspects the participants found favourable or unfavourable.

Despite prevalent side effects, the adherence rate was notably high, with an average weight loss of 5.5kg observed across participants. The majority reported experiencing multiple side effects, including hunger, fatigue, headaches, and gastrointestinal disturbances, with the incidence peaking in the first week. Interestingly, a correlation was observed between the early onset of side effects and more substantial weight loss, hinting at higher compliance with the dietary restrictions.

Feedback on the VLED’s practicality and enjoyment yielded mixed reviews, with the structured nature and the tangible outcomes of weight loss cited as positives, whereas the restrictive diet and the palatability of meal replacements drew criticism.

The findings advocate for the short-term safety and potential acceptability of VLEDs under professional guidance for adolescents with significant obesity challenges. Dr. Gow emphasises the necessity for further research to pinpoint those who would benefit most from this approach. She advocates for the incorporation of VLEDs into clinical guidelines for managing severe obesity and related health issues in young people, positioning it as a preliminary step before considering medication or surgery.

Adolescents and their guardians are encouraged to consult healthcare professionals to explore suitable treatment avenues for obesity.

This study not only sheds light on the pragmatic aspects of implementing VLEDs among adolescents but also underscores the importance of professional oversight and the need for a broader discourse on obesity management in younger populations.

Weight-loss pharmaceuticals could spur 1% increase in US GDP, Goldman Sachs suggests

In a recent analysis, Goldman Sachs posits that the extensive deployment of innovative weight-loss medications across the United States has the potential to catalyse a significant uplift in the country’s Gross Domestic Product (GDP) by as much as 1% in the forthcoming years. This optimistic forecast is grounded in the anticipation that a reduction in obesity-related health issues could substantially enhance productivity within the workforce.

The market for these weight-loss medications is anticipated to burgeon, potentially reaching a staggering $100 billion annually by the decade’s end. Leading this burgeoning sector are pharmaceutical giants such as Novo Nordisk, the manufacturer of Ozempic, and Eli Lilly, the producer of Mounjaro. Both companies are at the forefront of developing a category of drugs known as GLP-1 agonists, which have garnered significant interest from various pharmaceutical firms. The projections by Goldman Sachs suggest that consumer uptake of GLP-1 agonists could surge, varying from 10 million to an ambitious 70 million by the year 2028.

The economists at Goldman Sachs elaborate on the potential economic ramifications of this increase in GLP-1 usage, linking it directly to anticipated declines in obesity rates. Citing academic research, they highlight the dual challenge posed by obesity: affected individuals are less likely to be employed and exhibit lower productivity levels when they are in the workforce. According to their analysis, an increase to 30 million users of weight-loss drugs could potentially boost the US GDP by 0.4%, with the potential for a 1% increase if user numbers reach 60 million.

However, the report has not been without its critics, especially from advocates of the body-positivity movement, who may view the report’s implications with scepticism or concern.

Moreover, the report underscores a broader wave of healthcare innovation, particularly highlighting the role of artificial intelligence (AI) in drug discovery processes, combined with the impact of GLP-1 agonists. Together, these advancements could elevate the US GDP by an additional 1.3%, translating to an economic boost of approximately $360 billion per annum at current exchange rates. The potential increase could range from 0.6% to 3.2%, with the effects expected to be more pronounced in the US compared to other developed nations, which generally exhibit better health outcomes.

In parallel, research into weight-loss drugs is expanding to explore their efficacy in treating a range of conditions, from alcohol dependency to dementia. Medications such as Ozempic and Wegovy, which contain the drug semaglutide, and another medication, liraglutide, used under various brand names for both diabetes and weight loss, have seen a surge in popularity. This is partly due to their proven capability to assist individuals in shedding more than 10% of their body weight. The potential for these drugs to confer additional health benefits is being actively investigated in new clinical trials, signalling a promising horizon for medical research and public health.

The delicate balance of preserving muscle mass in the age of weight loss pharmaceuticals

As the global population turns increasingly towards medications like Ozempic for weight loss solutions, a growing concern has emerged regarding the side effect of muscle loss associated with these treatments. This phenomenon has sparked a multifaceted response from various sectors aiming to mitigate this undesired outcome, thereby enhancing the overall health benefits of weight management efforts.

Luxury fitness centres are now tailoring strength-training regimes specifically for individuals utilising these medications, with the promise of maximising health results. These programmes are designed not just to counteract muscle degradation but to optimise the physical wellness journey of their clients. Concurrently, nutritional experts and bespoke meal delivery services are stepping up to formulate high-protein diet plans that support muscle maintenance amidst weight loss.

Pharmaceutical giants, including Eli Lilly, are at the forefront of innovation, developing drugs that offer a dual approach to weight loss by facilitating fat reduction while safeguarding or even augmenting muscle mass. Eli Lilly’s collaboration with BioAge Labs on the experimental compound azelaprag exemplifies this cutting-edge research. Azelaprag seeks to mimic the effects of exercise-induced hormones that play a critical role in muscle metabolism, offering hope for a more balanced fat-to-muscle loss ratio in patients taking drugs like Mounjaro and Zepbound.

Further expanding its arsenal, Eli Lilly’s acquisition of Versanis Bio introduces a novel approach to muscle preservation through bimagrumab, a drug that targets receptors involved in muscle and fat regulation. This promising development is backed by research suggesting enhanced muscle growth upon receptor blockade.

Clinical trials are also exploring combinations of existing weight loss drugs with new treatments to address the muscle loss conundrum. One such study involves the pairing of bimagrumab with semaglutide, the active ingredient in Ozempic, to investigate its potential in mitigating frailty in adults with obesity. Additionally, the FDA’s recent approval of a trial for a compound aimed at older adults signifies a proactive approach to preventing muscle deterioration alongside fat loss in this vulnerable demographic.

Despite the promise of these emerging treatments, their availability to the general public is anticipated to be several years away. This delay underscores the importance of immediate, accessible strategies for muscle preservation. Experts highlight the critical nature of maintaining muscle integrity, especially for older adults and postmenopausal women, who face a higher risk of frailty and osteoporosis with muscle loss. The consensus among healthcare providers is that a combination of protein-rich diets and strength training exercises remains a fundamental remedy against muscle depletion.

Capitalising on this need, companies are introducing products and services tailored to individuals on weight loss medications. From protein shakes designed to complement these drugs to specialised fitness programmes and nutritional counselling aimed at enhancing protein intake and mitigating malnutrition risks, the market is rapidly adapting.

Innovative telehealth solutions like Noom’s Muscle Defense programme, which integrates fitness guidance with dietary tracking, and fitness platforms such as Obé Fitness’s MuscleGuard, exemplify the digital response to this challenge. Additionally, initiatives like LifeTime Fitness’s clinic pilot in Minnesota, which combines personalised training with access to compounded weight loss medications, signal a growing trend towards holistic health solutions that encompass both pharmaceutical and lifestyle interventions.

While specialised programmes offer valuable support for muscle preservation, the essence of combating muscle loss lies in fundamental lifestyle adjustments. Incorporating moderate strength training and a balanced, protein-rich diet into one’s routine can be a pragmatic and effective strategy for those navigating the complexities of weight loss medications.

Losing weight through dance could beat conventional workouts

Traditional exercise routines, often recommended for shedding weight, can pose challenges in maintaining enthusiasm and commitment. Their repetitive and solitary nature, coupled with the physical exertion required, can make them less appealing over time.

Contrastingly, dancing emerges as a potent alternative for weight loss, according to recent research findings. Its inherent enjoyment and the opportunity for social engagement it provides set it apart from conventional exercise forms.

A meta-analysis examining 10 studies focusing on dance’s impact on individuals with overweight and obesity revealed significant health benefits. Regular dancers demonstrated marked improvements in body mass index (BMI), waist circumference, body fat percentage, and total fat loss, compared to non-dancers. These findings were published in the journal PLOS ONE.

The studies encompassed a variety of dance styles, including step-aerobic, cheerleading, creative, Zumba, bhangra, traditional, dance video games, square dance, simplified dance, and aerobic fitness dance. The frequency of dance sessions varied, with most participants dancing three times a week, except for square dancers (five times a week) and bhangra dancers (twice a week). Session durations ranged from 40 to 90 minutes, and the studies lasted from four weeks to one year.

Adherence to an exercise program is crucial for its success, and dancing’s entertainment value might significantly enhance this adherence. Dr. Jagdish Khubchandani, a public health professor at New Mexico State University not involved in the study, highlighted the motivational challenges of traditional exercises, often perceived as arduous and demanding in terms of time, physical effort, and financial resources.

Stephanie Escobedo, founder of Through the Body, a dance and fitness company, and not a participant in the research, echoed this sentiment. She emphasised the importance of finding an enjoyable exercise form for consistent engagement.

Dr. Menka Gupta, a functional medicine doctor at NutraNourish, remarked on the dance’s dual physical and mental health benefits. Beyond improving BMI, dance activities can elevate mood, reduce stress, and enhance sleep quality, thanks to the dopamine release associated with pleasure.

Dr. Khubchandani also referenced studies indicating dancing’s potential to enhance executive function, offering both physical and psychological advantages.

When it comes to choosing the most beneficial dance form, Dr. Gupta advises selecting one that resonates personally, ensuring long-term commitment and consistency. For older individuals or those preferring lower intensity, she recommends ballroom dancing for its social, balance, posture, and cardiovascular benefits.

Dr. Gupta particularly praises Zumba for its mental sharpness benefits, incorporating high-intensity interval training that fosters cognitive skills like decision-making and spatial recognition.

Escobedo supports the health benefits of various dance forms, highlighting ballet for muscle strength, balance, posture, and cardio endurance, and modern/contemporary dance for agility and core strength. She notes that popular cardio dance classes can contribute significantly to weight loss and overall fitness, offering a more enjoyable alternative to routine exercises.

Finally, Dr. Gupta stresses the emotional connection aspect of dance, sharing her personal preference for Zumba and Bollywood dancing, which evoke nostalgic childhood memories and connections.

In summary, dance not only serves as an effective exercise alternative for weight management but also offers diverse physical, mental, and emotional benefits, making it a comprehensive fitness choice.

Fasting regimen proves effective against obesity-induced cognitive decline

Researchers have recently explored the beneficial effects of intermittent fasting (IF) on neuroinflammation and cognitive decline in a study published in Nutrients. They focused on mice subjected to a high-fat diet (HFD) and examined the impacts of IF on brain health, particularly in the context of diabetic encephalopathy.

Obesity and type 2 diabetes (T2D) are known for their adverse effects on cognitive functions, including memory impairment. These conditions often lead to increased permeability of the blood-brain barrier (BBB), worsening neuroinflammation and memory issues. The disruption in the hippocampal BBB is now seen as an early indicator of diabetes-related cognitive decline.

The study highlighted the role of two proteins, lipocalin-2 (LCN2) and galectin-3 (GAL3), in obesity and T2D-related chronic inflammation. These proteins are believed to be involved in activating harmful immune responses in the diabetic brain through BBB leakage.

The researchers used a mouse model to understand how chronic IF could counteract neuroinflammation caused by LCN2 and GAL3, as well as reduce adipose tissue inflammation. Mice were divided into three groups: normal diet, high-fat diet, and high-fat diet followed by intermittent fasting. The IF group first received an HFD for eight weeks, followed by a regimen of alternating fasting for 22 weeks.

Various tests were conducted, including EchoMRI for body fat measurement, insulin and glucose tolerance tests, and enzyme-linked immunosorbent assay (ELISA) for assessing serum protein levels. Additionally, apoptosis in white adipose tissues (WATs) was measured using the TUNEL assay, and the extent of BBB leakage in the hippocampus was also examined.

The study revealed that mice on a high-fat diet showed increased body weight, body fat, impaired glucose tolerance, and adipocyte death, alongside elevated levels of LCN2 and GAL3. However, intermittent fasting led to significant weight loss, improved insulin resistance, and reduced inflammation in the adipose tissue. This intervention also decreased serum levels of LCN2 and GAL3, reducing BBB leakage, neuroinflammation, and memory deficits.

In conclusion, the study posits that IF could be an effective alternative to continuous caloric restriction. It may improve insulin resistance, reduce adipose tissue inflammation, and mitigate metabolic dysfunctions in obesity and T2D, thereby protecting against cognitive impairment and memory deficits. The findings open new avenues for research into IF as a therapeutic strategy for managing obesity and T2D-related brain health issues.

Oxford study shows doctors’ communication style crucial for patient weight loss success

A groundbreaking study from the University of Oxford, recently published in the Annals of Internal Medicine, has revealed that the manner in which doctors communicate with patients about obesity plays a pivotal role in their weight loss success. This innovative research delves into the nuances of communication, showing that not only do the words doctors use matter, but also their tone and delivery have a profound impact over both short and long-term patient outcomes in a medical setting.

Conducted by the Nuffield Department of Primary Care Health Sciences, the study analysed 246 recordings of consultations and discovered that even subtle elements like the choice of words and vocal tone significantly affect patient responses. The findings have emerged amidst obesity treatment guidelines urging doctors to initiate weight loss discussions and suggest weight loss services. However, effective communication on this front occurs for only about 5% of those affected annually, indicating a significant gap between policy and practice.

Many doctors express reluctance to broach sensitive topics like obesity due to fears of offending patients or feeling uncertain about handling such discussions. From the patients’ perspective, negative experiences stemming from certain tones or word choices can inadvertently harm the doctor-patient relationship.

This research, funded by the National Institute for Health and Care Research School for Primary Care Research and Foundation for the Sociology of Health and Illness, utilised conversation analysis techniques on audio recordings from the BWel trial. In this trial, doctors offered patients referrals to a 12-week weight loss programme, and the researchers observed how different communicative approaches – categorised as ‘good news’, ‘bad news’, or neutral – influenced patient engagement and satisfaction.

Statistical analysis revealed that patients were more likely to enrol in, attend, and lose more weight in programmes when the referral was framed as ‘good news’. Specifically, 83% of patients offered programmes in a positive light attended, compared to only 50% for neutrally framed offers. Those who received ‘good news’ also lost about half a stone (3.6kg) more compared to the ‘neutral’ or ‘bad’ news groups.

Dr Charlotte Albury, the study’s lead author, emphasised that framing weight loss conversations positively encourages patients to participate more actively in programmes, yielding better weight loss outcomes. She noted that while both ‘neutral’ and ‘negative’ framings led to similar levels of programme acceptance and weight loss, the ‘good news’ approach stood out for its effectiveness.

The study identified specific characteristics of ‘good’ and ‘bad’ news delivery. In the ‘good news’ approach, doctors focused on the benefits of weight loss in an optimistic manner, confidently shared advantages, and communicated fluently and cheerfully. In contrast, the ‘bad news’ framing centred on health issues related to overweight and emphasised patient effort, often marked by slower delivery and hesitations. The neutral approach maintained a steady tone without leaning towards either benefits or issues.

Dr Albury highlighted the importance of these findings for medical professionals, suggesting that adopting a ‘good news’ approach could significantly enhance patient motivation and success in weight management. By transforming discussions into positive and empowering dialogues, doctors can effectively encourage patients to adopt healthier lifestyles.

Swiss pharmaceutical giant Roche enters obesity drug race with $2.7 billion Carmot deal

Swiss pharmaceutical giant, Roche, has announced a significant strategic move in the obesity treatment market with its $2.7 billion acquisition of Carmot Therapeutics, a U.S.-based obesity drug developer. This places Roche among leading contenders like Novo Nordisk and Eli Lilly in the weight-loss drug sector. Carmot’s flagship product, CT-388, a once-a-week dual GLP-1/GIP receptor agonist injection similar to Lilly’s Mounjaro, has shown promise in Phase I trials and is poised for Phase II testing. Its market introduction is anticipated in the 2030s.

The move has generated optimism, reflected in a 2.4% rise in Roche shares, as the weight-loss drug market, potentially worth $100 billion, appears to have room for multiple players. Roche’s Teresa Graham, head of the pharmaceuticals division, expressed ambitions beyond merely competing on price, envisioning CT-388 as a leading obesity drug in its class.

This acquisition marks Roche’s re-entry into the GLP-1 field, following a previous exit in 2018 when subsidiary Chugai sold experimental drug rights to Lilly. The Carmot deal, expected to conclude in early 2024, includes additional payments of up to $400 million subject to achievement of certain milestones.

The deal is part of Roche’s broader strategy, under new CEO Thomas Schinecker, to diversify its therapeutic fields and rejuvenate its development pipeline, especially after setbacks in Alzheimer’s and cancer immunotherapy. Besides the Carmot acquisition, Roche recently committed $7.1 billion for rights to a new drug for inflammatory bowel disease.

Carmot, founded in 2008, has a portfolio of various gut-hormone drug candidates, in both pill and injectable forms, designed to treat obesity in patients with and without diabetes. This acquisition underlines Roche’s commitment to expanding its presence in the evolving field of obesity treatment.

Japan’s healthcare system to include new obesity treatment in insurance coverage

Japan’s healthcare system is set to introduce a novel obesity treatment covered by public medical insurance starting Wednesday (22nd of November, 2023), marking the first such inclusion in thirty years. Wegovy, produced by the Danish firm Novo Nordisk, will be accessible under the national health insurance following its approval for manufacture and sale in March.

The treatment contains semaglutide, a GLP-1 receptor agonist that not only enhances insulin production and lowers blood sugar but also suppresses appetite by inducing satiety and curbing cravings.

Coverage is specifically tailored for patients who are significantly overweight or have weight-related health complications such as high blood pressure, hyperlipidemia, and Type 2 diabetes, and who have not seen results from lifestyle changes alone. Criteria for eligibility include having a Body Mass Index (BMI) of 35 or above, or a BMI of 27 with associated comorbidities.

Wegovy is administered weekly through self-injection, with a monthly supply consisting of four pens. The cost varies according to the dose, from ¥1,876 (£9.99) for the smallest dose to ¥10,740 (£57.19) for the highest.

The drug joins Ozempic, also a GLP-1 receptor agonist with semaglutide by Novo Nordisk, on the market. While Ozempic targets Type 2 diabetes at lower doses, Wegovy is dosed higher specifically for weight loss.

Despite its medical purposes, there’s growing concern over Wegovy’s use for aesthetic weight loss, leading to potential drug shortages for those in medical need. This has prompted Japanese medical bodies to warn against such misuse, especially with the trend of “medical diets” offered by clinics to individuals without obesity or diabetes.

Research has pointed out the risk of severe gastrointestinal issues with these medications, a concern highlighted in the Journal of the American Medical Association. Yet, Novo Nordisk has cited an August report claiming Wegovy can cut the risk of major adverse cardiovascular events by 20% in adult individuals with overweight or obesity.

Previously, Japan’s insured treatment for obesity was limited to Mazindol, introduced in 1992, designated for severe obesity and capped at three months of use due to addiction risks.