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Potential Qnexa Users Better Off With a Salad Spinner and Walking Shoes

UPDATE 7/17/12: Qnexa was approved by the FDA on July 17, 2012. This marks the second weight loss drug approval in 2012; the first weight loss drugs approved since Alli in 1999. The prescription drug will be sold as Qsymia.

The inmates are running the asylum. Reversing an earlier decision, the medical experts on FDA’s Endocrinologic and Metabolic Drugs Panel cleared the way for approval of the new diet drug Qnexa. Qnexa (PHEN/TPM) is a combination of phentermine and topiramate (PHEN/TPM). Topiramate is used to treat seizures and prevent migraine headaches and phentermine is approved for the short-term treatment (i.e. a few weeks) of obesity. PHEN was half of PHEN/FEN, the discontinued diet drug that led to valvular heart disease and potentially fatal pulmonary hypertension, primarily in women. Qnexa is indicated for “BMI greater-than or equal to 27 kg/m2) with weight-related co-morbidities such as hypertension, type 2 diabetes, dyslipidemia, or central adiposity (abdominal obesity),” the group with the highest heart disease risk.

The panel decided that the complications of obesity outweighed the risk of heart problems. It’s hard to believe they were swayed by the research. The 2010 study published in the Lancet reported that people who took the highest dose of Qnexa (not the lower approved dose) lost at least 10% of their body weight and showed improvements in their risk cardiac factors. Clinical trials by the manufacturer showed 45% of subjects treated at the low dose lost > 5% of baseline body weight following one year of treatment. No one seems to care that we’re talking about a 10 to 15 pound weight loss on a 200 pound person. Do we need a drug for that, especially one that comes with heart disease risk? No matter because the results showed statistical significance in a placebo control study.
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Intuitive Eating Shifts the Paradigm of Dieting

At any point in time, one in three women and one in five men in the United States are on some kind of diet. Most dieters opt for traditional programs that count nutrients or servings of food or actually specify which foods to eat. Those diets produce short-term weight loss, but two or three years later, 95 percent of traditional dieters regain the weight. But the diet industry manages to hold on because hope springs eternal in the human breast.

Research shows that starvation, whether from natural causes or intentional dieting, increases the risk of overeating and binge eating disorder (binge eating disorder is a distinct entity and not the same as overeating.) On-again, off-again dieters regain lost weight by over-eating in-between periods of restrictive dieting. The human body is simply programmed to respond to starvation by hoarding food when it becomes available.

On-again, off-again dieters develop a “dieting mindset.” They lose touch with their thresholds for taste and fullness. For example, when normal eaters eat sweets or a meal, they cross over a threshold and lose their desire for more sweets or food. Chronic dieters, on the other hand, learn to ignore those signals. They decide when, what, and how much to eat based on whether they are on or off a diet. That leaves them susceptible to eating in response to external cues, like TV commercials and food pushers, and to non-food cues such as boredom and unpleasant feelings.
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Mary Hartley’s Plate for National Nutrition Month


This is Gypsy Soup, Cheesy Cornbread, and fat-free milk. It is a typical lunch or dinner.  I don’t distinguish between the two. Most of my food is eaten from a bowl, not a plate. I typically eat soups, ethnic dishes and full meal salads; I rarely eat meat with a side and I cook from scratch.
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Dr. Oz’s Raspberry Ketones Dismissed by Dietitian as TV Hype

Is Dr. Oz more showman than doctor? His theatrical endorsement of dubious weight loss products points to the former. On his show this week, in a 75-second segment, he introduced a ‘revolutionary metabolism booster that you’ve never heard of’: raspberry ketones. While displaying a generic purple jar of capsules, Dr. Oz said, “I have vetted these; I’ve looked at them carefully; I am absolutely enamored. I know they work.” His segment assistant Lisa Lynn, a supplement-selling personal trainer, was by his side, along with a morbidly obese woman who had “tried everything.” Was Dr. Oz laying it on thick for a questionable product? No, not when you consider Dr. Oz is on TV.

Raspberry ketones are compounds that give red raspberries their aroma. In the US, they are used primarily in the food flavor industry. In Japan, however, raspberry ketone capsules are used as a weight loss supplement. Raspberry ketones are not to be confused with blood ketones produced in diabetes and on very low carbohydrate diets.

The hypothesis is that raspberries ketones affect biological activities that alter lipid metabolism. That fat-blasting claim rests on two small mice studies that show when mice are fed a high-fat diet supplemented with raspberry ketones they gain less body fat than expected. But be clear: raspberry ketones have not been studied in humans and they have not been proven to work. To be fair, Dr. Oz said, “There have not been a lot of human studies, but animal studies are favorable.” Somehow, for me, that got lost in the hype.
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In February, Men Must Face the Facts of Heart Disease, too

Heart disease happens when a number of ‘risk factors’ add up. Some of the risks – gender, genetics and age – are uncontrollable; but others – smoking, inactivity, excess weight, high blood cholesterol, high blood pressure, and diabetes – are within our control. The key to preventing heart disease is to eat a healthy diet, get regular exercise, maintain a healthy weight, and take medications as prescribed. Use this Heart Attack Risk Assessment from the American Heart Association to find your risk for heart disease.

Men Need Help

Women take much better care of themselves. They might be programmed in to the system through OB-GYN care or maybe it’s taking care of the kids, but women visit their doctors for checkups, while men do not.

Over the past ten years, men have gotten fatter while women have stayed the same. In 2000, 27.5% of men were obese, but in 2010, it was 35%. In women, the obesity level remained stable at 33%. Along with obesity, men have more diabetes and high blood pressure, which places them at much greater risk. To their credit, men now smoke and binge drink less and they’re a bit more active. (1)
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