A New Generation of Weight Loss Drugs Makes Bold Promises, But Who Really Wins

In the months after having her second child, Sarah found herself fed up. The 40-year-old Seattle resident was cutting carbs and sugar, and exercising regularly, but couldn’t seem to shed the pounds she had put on during pregnancy. So when an email newsletter mentioned a new weight-loss drug called Wegovy, Sarah decided to give it a try. Eight months later, she is out more than $10,000—and down more than 60 lbs.

“Wegovy made losing weight almost effortless,” Sarah, whose name has been changed to protect her identity, told Quartz. “I’m not hungry often anymore and it doesn’t take any willpower to eat less. I simply don’t have any desire to overeat.”

Sarah is one of 125,000 US-based patients now taking Wegovy (whose generic name is semaglutide), a member of a new class of weight-loss drugs. These drugs work differently than the appetite suppressants popular among previous generations of dieters. They are also hitting the market at a different moment: one in which people are more eager than ever for realistic, science-based methods for addressing excess weight, even as a growing faction of activists and doctors voice skepticism of weight as an accurate measure of health.

A new class of weight-loss drug

In the mid-1990s, experiments on Gila monster venom found it contained hormones that could help lower blood sugar. That led to the diabetes drug Ozempic, which ultimately went on the market in 2018. People on that drug discovered a funny side effect: They lost weight.

In 2021, that same compound was approved by the US Food and Drug Administration (FDA) under the name Wegovy for the express purpose of weight loss. Drugs like Wegovy work in more complex ways than simply suppressing appetite, and promise fewer (though not zero) side effects.

Like Wegovy, many of these drugs were originally approved for other conditions; liraglutide (brand name Saxenda for weight loss) was also originally approved as a diabetes drug (Victoza). In fact, semaglutide and liraglutide work similarly in the body: They’re known as GLP-1 receptor agonists because they activate receptors for the glucagon-like peptide-1 (GLP-1) hormone, reducing appetite by slowing digestion and the rate at which the body takes up glucose.

Perhaps most important, the new drug promise significant weight loss. “The previous weight loss drugs were just modestly effective,” says John Buse, an endocrinologist at the University of North Carolina School of Medicine. The average patient would lose 5% of their body weight, in some cases up to 8%. But with semaglutide, he says, “we’ve gotten the kind of weight loss that makes people pay attention: 10-15% of body weight. That’s the average weight loss—half of people are losing more than that. It’s a gamechanger in the conversation…now that we have medicines for which a substantial proportion of patients can expect to lose 30 to 50 lbs.”

In one 68-week pre-approval clinical trial, patients on Wegovy did indeed lose 14.9% of their body weight on average, compared with 2.4% for people on a placebo. (Although, as several writers and scholars have pointed out, the study was funded by Novo Nordisk, which makes Wegovy.) Given the average weight of trial participants—100 kg, or 220 lbs.—that meant weight loss of about 15 kg, or 33 lbs. Other drugs in development have had similar results. In a recent trial for one called tirzepatide from Eli Lilly, more than half of patients lost at least 20% of their body weight—50 lbs. in many cases.

What it takes to lose weight

This new class of drugs is entering a market that at first glance seems ripe for breakthrough. According to the US Centers for Disease Control and Prevention (CDC), 42% of Americans—70 million people—meet the criteria for obesity (having a BMI of 30 or more). At one point or another, most of those people will try a diet and exercise regimen to lose weight.

But a growing body of research shows that diets are not an effective way to lose weight and keep it off. “Obesity is a complex disease… ​for most people, lifestyle modifications, diet, and exercise are just not enough,” says Katherine Saunders, a doctor at the Comprehensive Weight Control Center at Weill Cornell Medicine and co-founder of Intellihealth, an app-based platform that brings evidence-based obesity treatment to patients.

In part because of that complexity, bariatric surgery has since 2009 been considered the standard of care for patients looking to lose a substantial amount of weight. But these procedures can be invasive and expensive, and can come with significant and long-lasting complications.

The dearth of other options leaves some patients and doctors excited about this new generation of drugs. “Right now, the field is really looking for more efficacy, number one. People will do almost anything to lose weight,” says Buse. “We have more than just surgery now for promoting substantial weight loss. The most exciting thing is that obesity is on the ropes.”

A complicated picture

While hopes are high, the realities of taking these drugs can be more complicated for patients. There are often side effects—the most common for semaglutide and liraglutide are diarrhea, vomiting, and nausea. On Wegovy, Sarah says she’s experienced diarrhea so severe that a few times she had to delay her next dose.

Physicians can sometimes gloss over or downplay those effects. But a visit to dedicated Reddit pages for these drugs shows whole communities of patients struggling to adhere to the regimen when they’re feeling sick, and seeking support from a community to understand whether what seems like a severe reaction is normal. (Novo Nordisk did not respond to a request for comment.)

How well a patient can tolerate a drug “is something we think about quite a lot,” Saunders says. “We always start with lower doses and increase gradually as tolerated. Everyone is different. We keep in close touch with the patient and monitor them closely.”

And while these new drugs are relatively well-studied, there are still unknowns. They seem to help patients keep weight off more reliably than diet and exercise alone, but those benefits fade after people stop taking the drugs, and patients do often regain weight. There are also questions about long-term effects. In 1997, weight loss drug fenfluramine/phentermine (fen-phen) was pulled off the market after it was found to cause heart problems. More recently, Belviq (lorcaserin), which the FDA approved for weight loss in 2012, was pulled from the US market in 2020 because long-term use was found to increase the incidence of various types of cancers.

Even if a patient does want to go on one of these drugs, she might not be able to. Many patients keen to try Wegovy can’t access it at the moment, due to a supply chain issue that its manufacturer doesn’t expect to resolve until later this year. Even then, most US health insurers, including Medicare, do not cover drugs like Wegovy, and paying out of pocket can cost thousands of dollars per month. After Sarah’s doctor told her she doesn’t prescribe Wegovy, Sarah secured a prescription through an online health provider; she pays for it out of pocket.

The lack of insurance coverage is in spite of the fact that the American Medical Association declared obesity to be a disease in 2013. “The conversation around insurance coverage needs to be had with insurance companies, but also with employers,” says Kimberly Gudzune, the medical director for the American Board of Obesity Medicine. “It needs to be seen as an investment in your workforce.” The Treat and Reduce Obesity Act, which would expand Medicare to include obesity treatments, has been introduced to US Congress every year since 2012, but has never passed.

America’s love/hate relationship with weight

Though excess body fat was once considered a sign of wealth or fertility, over the past century a stigma has developed against larger bodies. Today doctors associate excess weight with medical conditions like heart disease, cancer, type 2 diabetes, sleep apnea, osteoarthritis, and depression. Studies also show that life is harder when you move through the world in a larger body. Fat people are less likely to be hired for a job, are paid less, are less likely to get married, and are less likely to be happy (though not if they’re living around other fat people). One 2006 study found that 46% of respondents would rather give up one year of life than be obese; 5% said they’d rather lose a limb.

The current state of research makes it impossible to unravel the full complexity of weight and health, but the conversation is starting to accommodate more nuance. Ubiquitous metrics such as body mass index are increasingly understood to be unreliable indicators (though doctors often still use them), and even the language around larger bodies is under review. Many physicians use “obese” to describe people who have excess weight or a BMI over 30, but activists are shying away from the word. “The reason…we are reluctant to use the words ‘overweight’ and ‘obesity’ is that they are made up, they can change,” says Tigress Osborn, a fat activist and chair of the National Association to Advance Fat Acceptance.

In fact, some research suggests that fat may have a protective effect on the body. “The body’s weight-regulating mechanism is about survival. It’s a system with more moving parts than we understand,” says Marilyn Wann, a fat activist and author of the book Fat!So? “Trying to remove weight from an individual or from the population is like trying to take a sledgehammer to the weather—we don’t know the unintended negative consequences we’re going to create.”

There are signs that in the future physicians may be more accepting of bodies of different sizes. But as weight loss drugs get more effective and more available, those cultural gains for body positivity (or body neutrality, or fat acceptance) may also be called into question.

A new relationship between doctors and patients

Overweight patients who come to see Shelly Crane might have an experience they’ve never had before. “I don’t initiate a weight-loss conversation with a patient,” says Crane, a family physician at Advocate Aurora Health in Milwaukee, Wisconsin. Most weight-loss programs come with more risk of harm than good, she says, and there’s not enough evidence that people who do lose weight are healthier in the end.

Crane doesn’t regularly prescribe new drugs for weight loss, though she says more patients are coming in and asking for them lately. Instead, she prefers to keep conversations focused on goals of care. “Patients say, ‘I know I need to lose weight,’ and I say, ‘Why do you think you need to lose weight? What would change in your life if your weight was lower?’” That gives her an opening to talk about health more broadly—how is the patient’s sleep? Their diet? Their mobility? “I try to stay in my sphere of what I’m able to do as a family doctor and really address the root of the health issue as much as I can.”

Crane was drawn to this approach by listening to her patients talk about experiencing size discrimination, and by following the work of fat activists such as Ragen Chastain and Aubrey Gordon. Though she’s been trained in a more integrative style of medicine, her approach toward body acceptance was also shaped by her discovery of intuitive eating during medical school. Since then, she’s been working on deprogramming herself and her colleagues from anti-fat bias.

Crane is part of a burgeoning movement among doctors to improve the treatment of larger patients. For some, that means skipping the dreaded weigh-in, a practice that is somewhat controversial within medicine. Medical organizations like the Association of American Medical Colleges also offer guidelines to reduce anti-fat bias among clinicians.

For doctors, the updated approach at least engenders trust, which can in turn get patients to seek medical care more frequently and improve their overall health. At most, it broadens the definition of what “healthy” means, and looks like.

Some fat activists see this shift as an important step. “The thing we hear most often from the public is, ‘I thought I had this thing, but all the doctor wanted to talk to me about is weight loss, and now the thing is worse,’” Osborn says. “It’s progress to have people in the medical establishment recognizing that there are other healthcare concerns besides weight, if weight is a healthcare concern.”

The hope is that this evolution continues. Activists want more people, in the medical profession and outside of it, to respect their autonomy. That becomes even more pressing in a possible future filled with weight-loss drugs—a future where a person can simply take a drug and stop being fat. “The ease with which I could become smaller—why should I? That should be up to me. Just like, if you believe it’s a medical disorder, the treatment I choose should be up to me,” Osborn says. “Like with anything else, if you believe fat is a disorder, we should let people decide whether people will get treated or not.”

“Fatness isn’t a problem to be solved in and of itself. It is not the root cause of all ills, as much as [medicine] would like to think it is,” Crane says. “We can help people live full, rich lives when we focus on goals of care and not on weight.”

By Alexandra Ossola

Source: A new generation of weight loss drugs makes bold promises, but who really wins? — Quartz

More contents:

Could Contact Lenses Be The Ultimate Computer Screen?

Imagine you have to make a speech, but instead of looking down at your notes, the words scroll in front of your eyes, whichever direction you look in. That’s just one of many features the makers of smart contact lenses promise will be available in the future.

“Imagine… you’re a musician with your lyrics, or your chords, in front of your eyes. Or you’re an athlete and you have your biometrics and your distance and other information that you need,” says Steve Sinclair, from Mojo, which is developing smart contact lenses. His company is about to embark on comprehensive testing of smart contact lens on humans, that will give the wearer a heads-up display that appears to float in front of their eyes.

The product’s scleral lens (a larger lens that extends to the whites of the eye) corrects the user’s vision, but also incorporates a tiny microLED display, smart sensors and solid-state batteries. “We’ve built what we call a feature-complete prototype that actually works and can be worn – we’re soon going to be testing that [out] internally,” says Mr Sinclair.

“Now comes the interesting part, where we start to make optimisations for performance and power, and wear it for longer periods of time to prove that we can wear it all day.” Other smart lenses are being developed to collect health data. Lenses could “include the ability to self-monitor and track intra-ocular pressure, or glucose,” says Rebecca Rojas, instructor of optometric science at Columbia University. Glucose levels for example, need to be closely monitored by people with diabetes.

“They can also provide extended-release drug-delivery options, which is beneficial in diagnosis and treatment plans. It’s exciting to see how far technology has come, and the potential it offers to improve patients’ lives.”Research is underway to build lenses that can diagnose and treat medical conditions from eye conditions, to diabetes, or even cancer by tracking certain biomarkers such as light levels, cancer-related molecules or the amount of glucose in tears.

A team at the University of Surrey, for example, has created a smart contact lens that contains a photo-detector for receiving optical information, a temperature sensor for diagnosing potential corneal disease and a glucose sensor monitoring the glucose levels in tear fluid. “We make it ultra-flat, with a very thin mesh layer, and we can put the sensor layer directly onto a contact lens so it’s directly touching the eye and has contact with the tear solution,” says Yunlong Zhao, lecturer in energy storage and bioelectronics at the University of Surrey.

“You will feel like it’s more comfortable to wear because it’s more flexible, and because there’s direct contact with the tear solution it can provide more accurate sensing results,” says Dr Zhao.

Despite the excitement, smart lense technology still has to overcome a number of hurdles. One challenge will be powering them with batteries these will obviously have to be incredibly tiny, so will they deliver enough power to do anything useful? Mojo is still testing its product, but wants customers to be able to wear its lenses all day, without having to recharge them. “The expectation [is] that you are not consuming information from the lens constantly but in short moments throughout the day.

“Actual battery life will depend on how and how often it is used, just like your smartphone or smartwatch today,” a company spokesperson explains. Other concerns over privacy have been rehearsed since Google’s launch of smart glasses in 2014, which was widely seen as a failure. “Any discreet device with a forward-facing camera that allows a user to take pictures, or record video, poses risks to bystanders’ privacy,” says Daniel Leufer, senior policy Analyst at digital rights campaign group, Access Now.

“With smart glasses, there’s at least some scope to signal to bystanders when they are recording – for example, red warning lights – but with contact lenses it’s more difficult to see how to integrate such a feature.” Aside from privacy worries, makers will also have satisfy worries over data-security for the people wearing the lenses. Smart lenses can only fulfil their function if they track the user’s eye movements, and this plus other data could reveal a great deal.

“What if these devices collect and share data about what things I look at, how long I look at them, whether my heart rate increases when I look at a certain person, or how much I perspire when asked a certain question?” says Mr Leufer. “This type of intimate data could be used to make problematic inferences about everything from our sexual orientation to whether we’re telling the truth under interrogation,” he adds.

“My worry is that devices like AR (augmented reality) glasses, or smart contact lenses, will be seen as a potential trove of intimate data.” For its part, Mojo says all data is security-protected and kept private. Additionally there are concerns about the product that will be familiar to anyone who wears regular contacts. “Any type of contact lens can pose a risk to eye health, if not properly cared for or not fitted properly.

“Just like any other medical device, we need to make sure the patients’ health is the priority, and whatever device used has benefits that outweigh the risk,” says Ms Rojas, from Columbia University. “I’m concerned about non-compliance, or poor lens hygiene and over-wear. These can lead to further complications like irritation, inflammation, infections or risks to eye health.” With Mojo’s lenses expected to be used for up to a year at a time, Mr Sinclair admits this is a concern.

But he points out that a smart lens means it can be programmed to detect whether it’s being cleaned enough and even to alert users when it needs replacing. The firm also plans to work with optometrists for prescription and monitoring. “You don’t just launch something like a smart contact lens and expect everyone’s going to adopt it on day one,” says Mr Sinclair. “It’s going to take some time, just like all new consumer products, but we think it’s inevitable that all of our eye wear is eventually going to become smart.”

By : Emma Woollacott

Source: Could contact lenses be the ultimate computer screen? – BBC News

Critics by Phase1vision

With wearable technology becoming more and more mainstream, some companies are pushing the limitations even further by developing smart contact lenses. These lenses may boast a wide variety of benefits and futuristic features thanks to computer vision. Below, we’ll discuss smart contact lenses and how computer vision may allow them to be the next greatest advancement in technology.

Smart contact lenses are similar to traditional contact lenses in that they sit on the surface of your eye, are virtually undetectable, and improve your vision. However, smart contact lenses also contain a small digital screen that can display information over your normal field of vision. They provide the possibility for augmented reality without bulky glasses frames.

Computer Vision refers to the use of a camera in conjunction with a processing unit, which allows a computer to observe and make sense of the world around you. In the case of smart contact lenses, a microchip processes the images captured by a tiny camera within the lens and uses that data to display helpful information over your normal field of vision.

Manufacturers are using computer vision to monitor what you see through your normal eyesight and make changes and improvements to the world around you. The camera in the lens determines what it is you’re seeing, and a wearable computer processing unit analyzes the image and takes pre-set actions. Without computer vision, smart contact lenses would be less of an augmented reality experience and more randomly displayed information over the world you see.

Producers of smart contact lenses are aiming for some awe-inspiring possibilities. For example, your eye focusing naturally on an object in the distance can quickly be picked up by a smart contact lens, allowing for a zoom effect akin to that on a camera lens. Companies are also aiming to allow for night vision when the camera detects a lack of light around you, auto-focusing, and even walking or driving directions appearing over your intended route as you navigate sidewalks and streets.

Many experts believe that the future of wearable technology is smart contact lenses. If your company is working on applications for smart lenses or is producing them, check out our wide array of computer vision cameras that can improve your product and expand the possibilities.

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Diabetes Fast Facts

Here’s a look at diabetes, a disease that affects millions of people around the world. Diabetes is characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. The disease can lead to serious complications such as blindness, kidney damage, cardiovascular disease, limb amputations and premature death.

Facts

People with diabetes or certain other underlying medical conditions are more likely to become severely ill if infected with Covid-19, according to the CDC. Worldwide, the number of people living with the potentially fatal disease has quadrupled since 1980, to around 422 million, according to the World Health Organization (WHO).

37.3 million people in the United States have diabetes, about 11.3% of the population. 8.5 million (23%) of adults with diabetes are undiagnosed. Diabetes was the eighth leading cause of death in the United States in 2020, according to provisional data from the National Vital Statistics System.

There are several types of diabetes: Type 1, Type 2 and gestational diabetes. Prediabetes occurs when blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes. Before developing Type 2 diabetes, people almost always have prediabetes. Research has shown that some long-term damage to the body may occur during prediabetes.

Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells, the only cells in the body that make insulin. This form of diabetes usually strikes children and young adults. Only 5-10% of people with diabetes have Type 1. Risk factors for Type 1 diabetes may be autoimmune, genetic or environmental. There is no known way to prevent Type 1 diabetes.

Type 2 diabetes occurs when the body does not produce enough insulin or the cells do not use insulin properly. Type 2 diabetes is the most common form of diabetes and in adults, it accounts for about 90% to 95% of all diagnosed cases of diabetes. It is associated with older age, obesity, family history, physical inactivity and race/ethnicity.

It is more common in African Americans, Latino Americans, American Indians, Asian Americans, Native Hawaiians and other Pacific Islanders. Type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently.

Gestational diabetes is a form of glucose intolerance diagnosed during pregnancy. It affects about 4% of all pregnant women. A diagnosis of gestational diabetes doesn’t mean that a woman had diabetes before she conceived, or that she will have diabetes after giving birth.

Other types of diabetes result from genetic conditions, surgery, medications, infections and other illnesses. Such types of diabetes account for 1% to 5% of all diagnosed cases.

Possible Symptoms

Frequent urination
Excessive thirst
Unexplained weight loss
Extreme hunger
Sudden changes in vision
Numbness in hands or feet
Tiredness
Dry skin
Slow healing wounds
Frequent infections

Complications

Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes. The risk for stroke is two to four times higher among people with diabetes. People with diabetes are at high risk for high blood pressure.

Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years. Diabetes is the leading cause of kidney failure. Between 60% and 70% of people with diabetes have mild to severe forms of nervous system damage or neuropathy.

US Diabetes Statistics

1.4 million new cases are diagnosed every year in the United States.

In 2019, about 96 million people aged 18 or older had prediabetes.

About 286,000 people under 20 years old have diabetes.

$327 billion – Cost to treat diabetes in the US in 2017.

Timeline

1921 – Insulin is discovered by Drs. Frederick Banting and Charles Best.

November 16, 2012 – The CDC releases a report showing that 18 states had a 100% or more increase in the prevalence of diabetes from 1995 to 2010. Forty-two states saw an increase of at least 50%.

January 17, 2014 – For the first time, US surgeon general’s report on the health consequences of smoking includes data that indicates smoking can cause diabetes, as well as erectile dysfunction, rheumatoid arthritis, macular degeneration, ectopic pregnancies and impaired immune function. Smokers have a 30% to 40% increased risk of developing Type 2 diabetes compared with nonsmokers.

May 4, 2015 – A study published in the Journal of Clinical Investigation detects a possible connection between diabetes and Alzheimer’s disease.

September 28, 2016 – The Food and Drug Administration approves a so-called artificial pancreas. The first-of-its-kind device, the size of a cell phone, monitors and treats patients with type 1 diabetes, also known as juvenile diabetes.

September 28, 2017 – The FDA approves the “first-ever continuous blood sugar monitoring device” that doesn’t require patients to prick their fingers for blood samples.

December 2, 2019 – An estimated 18% of adolescents ages 12 to 18 and 24% of young adults ages 19 to 34 in the United States have prediabetes, according to a JAMA Pediatrics study covering 2005-2016.

May 15, 2022 – In its biannual Diabetes Report Card, the CDC notes a decrease in newly diagnosed cases of diabetes after almost two decades of continual increases. In 2019, the number of newly diagnosed US adults decreased from a high of 9.3 per 1,000 in 2009 to 5.9 per 1,000 adults.

By:

Source: Diabetes Fast Facts – CNN

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Restricting Calories Leads To Weight Loss, Not Necessarily The Window of Time You Eat Them In

1

Results of a new weight loss study were published this week, leading to headlines proclaiming intermittent fasting “isn’t a magic diet trick after all”.The researchers aimed to test whether adding a restriction on what time of day you were allowed to eat (or not) to the usual low calorie (or kilojoule) diet led to greater weight loss compared to just following a low calorie diet. They recruited 139 adults whose average weight was 88 kilograms and age 32 years.

The participants were randomised to follow either the low calorie diet that had reduced their usual daily energy intake by 25%, or the same low calorie diet with the addition of a time period during which they were allowed to eat in an eight-hour window between 8am and 4pm each day.This approach is called “time-restricted eating” or a “16-hour intermittent fast”. Both groups received support from health coaches to follow their diets for 12 months.

Results showed that after one year, people in both groups lost 7-10% of their baseline body weight. While the low calorie group lost an average of 6.3 kilograms, the low calorie plus time restricted eating group lost 8 kilograms. Although there was a 1.8 kilogram difference between the groups, it was not a statistically significant difference.

Participants in both groups also had better blood sugar and blood fat levels and improved insulin sensitivity, but again there was no significant differences between groups.

1. It wasn’t based in the US

Most intermittent fasting studies have been conducted in the United States. This trial was done in China and recruited people in Guangzhou, so it provides important data using a culturally sensitive, prescribed calorie restriction over 12 months.

2. It showed small extra time restrictions on eating don’t make much difference

In their normal lives, the participants in Guangzhou had a usual window for daily eating of about 10.5 hours. Studies in other populations, particularly the US, show about 90% of adults have an eating window of 12 hours, with only 10% of adults having an overnight fasting period greater than 12 hours.

For more than 50% of people in countries like the US, the overnight fast is less than nine hours, meaning they eat over a 15 hour time period each day. So in the current study, the time restriction on eating was only minor – at about two hours less per day than what’s usual for people in China. This would not have been too big a difference from usual.

The researchers also reported that in China, the biggest meal is usually eaten in the middle of the day, so that was not influenced by the time restriction. In countries where the evening meal is the biggest or people snack all evening, then time restriction may still be a beneficial way to reduce intake.

A 2020 review of 19 studies that used time-restricted intermittent fasting found it was an effective treatment for adults with obesity, leading to greater loss of body weight and body fat, with significantly lower systolic blood pressure and blood glucose.

3. It showed support is imperative

Both groups in this trial were given a lot of support to adhere to the kilojoule-restricted diet. They were provided with one meal replacement shake per day for the first six months, to make it easier to follow the kilojoule restriction and help improve adherence to the diet.

They also received dietary counselling from trained health coaches for the 12 months of the trial. They received dietary information booklets that included advice on portion size and sample menus. They were encouraged to weigh foods to improve their accuracy in reporting kilojoule intakes and were required to keep a daily log with photographs of foods eaten and the time, using the study app.

They also received follow-up calls or app messages twice a week and met with the health coach individually every two weeks for the first six months. In the second six months, they continued to fill out their dietary records for three days per week and received weekly follow-up telephone calls and app messages and met with a health coach monthly. They also attended monthly health-education sessions.

This was a lot of support and is very important. Receiving long-term support to achieve health behaviour changes typically achieves a weight loss of 3–5% of body weight, which significantly lowers risk of weight-related health conditions, including a 50% lower risk of developing type 2 diabetes over eight years.

4. Even with good adherence, individual weight loss varies

Individual weight loss responses were very variable, even though adherence was high in this trial.

About 84% of participants adhered to the prescribed daily calorie targets and time restricted eating period. Weight loss at 12 months varied from 7.8 to 4.7 kilograms in the low calorie only group, and 9.6 to 6.4 kilograms in the low calorie plus time-restricted eating group.

As we have seen many times previously, this study confirms there is no one best diet for weight loss. It also shows small decreases in the window of time you’re eating probably won’t make a difference to weight loss.

By:

Laureate Professor in Nutrition and Dietetics, University of Newcastle

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Hydrogel Injected Into Fat Stores Fights Obesity From Within

Next-generation therapies that fight obesity could come in many forms, but one example from Nanyang Technological University that uses a unique combination of light and metabolic function to break down fat has some unique advantages.

The team’s solution consists of a hydrogel that can be injected into fat deposits and subjected to near-infrared light, with obese mice showing up to a 54-percent fat reduction following treatment.

The function of this new technology hinges on a protein called TRPV1, which plays an important role in our metabolism. This protein can trigger the conversion of white fat, the type that stores excess calories in beer bellies and love handles, into brown fat.

This is the type of fat that the body readily burns for energy and warmth, and as such a lot of anti-obesity research focuses on therapies that can initiate this conversion.


TRPV1 activity also promotes the breaking down of fat droplets into fatty acids that can be used by the converted brown fat to burn calories, or be broken down in the bloodstream through a process called lipolysis. Further, the protein stimulates the secretion of a hormone that improves metabolism of glucose and lipids in the liver and muscles, while also improving insulin sensitivity.

Setting out to develop a therapy that targets TRPV1, the researchers created a hydrogel containing copper sulphide nanoparticles that activates the protein in response to light, and a drug approved by the FDA that can stimulate browning of fat tissues.

A biocompatible polymer was also added to keep the hydrogel in a gel-like state after injection, slowly releasing its contents over several days. Obese mice with hallmarks of metabolic disease had the hydrogel injected into their subcutaneous fat, with near-infrared light then shone onto the site of the injection for five minutes.

This took place each day for three days, followed by four days of rest, for a two-week period, leading to a 5.5-percent reduction in the animals’ body weight, compared to a 9.5-percent increase seen among a control group.  The treated mice also showed a 40-percent reduction in subcutaneous fat, a 54-percent drop in visceral fat, a 54-percent reduction in cholesterol and 65-percent drop in insulin resistance.

“Through lab experiments, we found that this approach not only resulted in 40 to 54 per cent fat reduction in obese mice, but also significantly improved their metabolism, which is key to reducing the risk of metabolic conditions such as heart disease, stroke and type 2 diabetes,” said study author Chen Peng.

“Though this method makes use of heat converted from near infrared light to burn subcutaneous fat, we found no thermal injury to the skin.” The scientists still have much to do to convert these promising results into therapies to tackle obesity and metabolic dysfunction in humans.

However, the early signs indicate that it could come to fill a gap in existing treatments for these conditions that carry a risk of side effects or are prohibitively expensive. “All FDA-approved medications for obesity indirectly act on the brain to suppress appetite or on the digestive system to reduce fat absorption,” said Peng.

Most of them have been withdrawn from the market due to their serious side effects. Procedures performed in clinics to remove fat in targeted areas have shown to be effective, but they come with risks and high cost, and do not improve body metabolism. In contrast, our therapeutic approach focuses on remodeling white fat tissue, which is the root of the evil.”

Source: Hydrogel injected into fat stores fights obesity from within

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