Weight loss - the old and the new

We all know the facts: Over two thirds of Americans are overweight. Half of them (one third of Americans) are medically obese, which places them at high risk for the development of premature heart attacks and a variety of other serious medical conditions.

The main cause of obesity is overeating, even more so than lack of physical activity.

The most effective way to lose weight is portion control, and with it comes the control of caloric intake.

But portion and calorie intake control is a tough job. It’s a “full time job,” and it takes willpower and discipline.

So what do you do when the brute force approach doesn’t work for you?

The New York Times Business section of February 16^th had an interesting article on the possible approval by the FDA of a new appetite suppressant, Qnexa (U.S. to Review Diet Treatment Once Rejected).

The use of appetite suppressants for the treatment of obesity has a long history. Medications like phentermine, Tenuate and Xenical have been used for years (we all remember the fen-phen period, of which phentermine emerged as the surviving drug…).

More recently, metformin (used in diabetes) has been used in some cases, and a combination of phentermine and certain antidepressants has been shown to be more effective than phentermine alone.

What’s new about Qnexa is not really new. The proposed drug is a combination of two well known medications now widely used: phentermine, the familiar appetite suppressant, and topiramate (Topamax) which is most commonly used for migraine prophylaxis.

Topamax, like most other drugs has a long list of side effects, one of which is weight loss. So physicians who treat obesity, have now begun using Topamax “off label” for it’s weight loss side effect, in combination with phentermine. The combination appears to be very effective.

Diabetes and memory loss – If I were a mouse…

In diabetics, blood sugar levels that are persistently high, low, or widely fluctuating are an indication that the diabetes is not under control. Diabetes, especially when uncontrolled, is a known cause of progressive memory loss. Besides making sure that your diabetes is under control, what else can you do to protect against memory loss?

Many of us drink coffee to feel more energetic, help us think more clearly,  or work more efficiently. But does regular coffee, or decaffeinated coffee help memory or prevent memory loss? 

Studies in specially bred mice, done several years ago, suggested very strongly that coffee enhanced memory. When mice drank the equivalent of five caffeinated cups of coffee a day over several weeks, their memory was far superior to those who drank plain water.

For those who think 5 cups of caffeinated coffee a day is too much, what about decaf?

A more recent study done on the same type of mice, showed similar results.

So what about man?

Several uncontrolled studies in man suggest that caffeine slows age-related memory loss. One study, done in Portugal, showed that people with Alzheimer’s had consumed less coffee than their non-Alzheimer counterparts.

So where do we go from here?

Meet you at Starbuck’s tomorrow morning, and bring your mouse with you.