New Fat Drug

The Diet Jab That Keeps You Thin

It is always interesting to see what comes top of Google for particular searches. Today's top result for the search term, 'new fat drug' is the Mail Online with an article by Beezy Marsh and Tim Utton -"Miracle anti-fat pill available free on NHS!". The article is not dated, although today's date is prominent at the top of the page and so you could be forgiven for thinking that this is news. However, the article goes on to describe a product called Reductil, which was actually discontinued due to health warnings back in January 2010.
The term 'new fat drug' has a number of potential meanings and is at least a double-entendre, but is nonetheless the sort of search term that could be used by someone seeking a drug to help them to lose weight (as oposed to acquiring fresh fat). Indeed Google respond accordingly.
What this short preamble helps to illustrate is the speed at which new, so-called miracle anti-fat drugs come and then go. This list also includes products including desoxyphedrine, phentermine, diethylpropion, fenfluramine and rimonabant etc.
The latest miracle headline according to the Mail Online reads,
"New diet jab helps obese people lose more than a stone!".
The good news (other than the potential for weight loss) is that the article is actually dated, so that we know that it was published more recently than the "Miracle anti-fat pill!" item.
The obesity market is massive and so any new wonder drug that actually works is obviously going to do handsomely. But haven't we heard it all before? Surely this time the new 'diet jab' will make us all lose a stone? Well, it would appear that yet again the jury is out. Writing for MedPage Today, F. Perry Wilson, MD, is an assistant professor of medicine at the Yale School of Medicine.

Scales Slewed? 

Refering to "a slew of news reports about the "SCALE" study touting the injectable medication liraglutide, now being marketed by Novo Nordisk as Saxenda", in his article Prof Wilson points out a number of potential areas of concern with regard to the data supporting the view that the new 'diet jab' will lighten our loads. The main points that he makes are as follows:
1. There is a huge financial incentive for companies to "crack the obesity market".
2. Patients should not heed headlines too closely.
3. The weight loss exhibited by the diet jab was originally noted as a "happy accident" side-effect.
4. The news outlets appropriately report that a 5Kg loss of weight over a year carries a $1,000 price tag.
5. There are a number of questions relating to the clinical trial that all the claims are based on. These include the following:
a) Statistical analysis and editorial assistance for the manuscript were provided by the Drug Company (Novo Nordisk).
b) Selective use of different statistical models to compare data (specifically lack of use of standard deviation to show the room for error).
c) Lack of information on how well 'blinded' the study was. For example, were patients aware that they were on just a placebo?
d) The patients who were on the drug probably knew it - due to the nausea caused.
e) Do people lose weight simply because they feel sick?
f) Potential lax research oversight in some countries.
g) Weight comes back on when you stop using the drug - so potentially a life-long drug.
So, much more work still needs to be done and time will tell as to whether the diet jab will help to keep us all thin. Prof Wilson says that "the elephant in the room" is the lack of comparative data with other treatment options - specificaly bariatric surgery. However, bariatric surgery is clearly not the only other option and although it may be effective at treating the symptoms it does not treat the root causes associated with over-eating.
For many people over-eating is a form of addiction, often triggered by refined foods such as sugar and flour and this needs to be treated at the psychological as well as the physical level.

Effective Treatments for Weight Loss

The weight of evidence supporting the psychological approach including mutual aid groups for all types of addictive behaviours is now at a level where they have government backing - see Scientifically-informed Recovery from Addiction, by Harvard University Professor John Kelly.

The external opening of the back passage, the rectum. Full medical glossary
A disorder caused by insufficient or absent production of the hormone insulin by the pancreas, or because the tissues are resistant to the effects. Full medical glossary
One of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body. Full medical glossary
A viral infection affecting the respiratory system. Full medical glossary
Excess accumulation of fat in the body. Full medical glossary