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by Robert MacKay, Saturday, 24 January 2015 | Categories: Weight Loss

The Committee for Medicinal Products for Human Use of the European Medicines Agency has recommended Saxenda (Liraglutide) for approval throughout the EU for the treatment of obese and overweight patients.

Saxenda works by activating the GLP-1 receptors in the body and causing us to feel full. Saxenda works as an appetite suppressant and it has proven enormously successful in clinical trials. Many patients have lost significant weight and blood pressure has been brought back under control.

The Online Clinic has been prescribing Liraglutide off-label for a few years as the clinical evidence of weight loss is significant and the side effects are limited. Liraglutide appears to be a very safe medication and the side effects that are common in the beginning (such as nausea) usually disappear with continued use. Using a low dose of the medication for a couple of weeks normally eliminates any incidence of side effects.

The company behind Saxenda will apply for this medication to be prescribed on the NHS but this may not be recommended for approval because of the cost.

Liraglutide is available through The Online Clinic for next day delivery so long as you meet our prescribing criteria. You can register by clicking on the button below.

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by Robert MacKay, Wednesday, 28 August 2013 | Categories: Weight Loss

We have just become aware of a new weight loss medication that is currently in development. The new molecule is known as Beloranib and works in a unique way so, if approved it would be first in class.  Beloranib works by inhibiting a key enzyme known as methionine aminopeptidase 2 (MetAP2). Through targeting this enzyme, Beloranib can reduce the production of fat and enhance the metabolism of fat. This results in a positive metabolic cascade that enables people to lose weight. The 12 week trial on a small patient group led to an average weight loss of 22 pounds. This weight reduction is significantly in excess of the weight loss produced by either Qsymia or Belviq (both of which are now approved in the US). Reductions in body fat and improved cardiovascular risk factors were also observed. The additional benefit over these other medications was that there was a greater degree of tolerability because it appeared to producing nothing in the way of adverse events.

We really need to emphasise that the results we are reporting are from a phase 1b trial and there were very few participants. We have seen this before with other new molecules that go on to produce serious side effects in later trials. We do not want to be in any way dismissive as we have seen nothing but positive data. It is important to remember that this medication is a long way off being licensed. Our estimate would be another 5 years from now before a licensee is issued and assuming all subsequent trials go well.

The downside for patients may be that Beloranib can only be injected. This is likely to be a subcutaneous injection in the same way that Victoza (Liraglutide) is administered. Unlike Beloranib, Victoza is available to prescribe today and many patients are using it with excellent results. To get a prescription for Victoza, please click on the free consultation button below.

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by Marijana Domazet, Wednesday, 24 July 2013 | Categories: Weight Loss

Most of us are used to hearing about unconventional weight loss plans, from various diets to boot camps and unexpected exercise classes. The most recent health scheme attempting to aid individuals in their weight-loss comes from Dubai, where participants are told they will be receiving one gram of gold for each pound that they shed.

The scheme is called Your Weight in Gold, and the participants have been named the “golden losers”. In order to get the payouts, the participants have to take part in a 30-day scheme that coincides with Ramadan, and lose at least 2 pounds in weight. The three individuals who lose the most weight will be considered as finalists competing to win a cold coin, which is worth $5400.

Although it is an interesting idea, we would still be wary of the methods individuals would use to quickly lose weight that may be harmful. Most people do not become obese in 30 days, so their problem will not be solved in 30 days either. While it is encouraging to see that obesity is addressed as an issue across the globe, we also feel that it should not be trivialised through competitions. Having said that, there is evidence that financial incentives work: Here is a link to a study in the US a few years ago that demonstrates positive results.




by Robert MacKay, Tuesday, 16 July 2013 | Categories: Weight Loss

A research team at Imperial College, London, has come up with a novel way of delivering naturally occurring hormones that play a part in the regulation of appetite. Having studied the outcome of patients who have undergone gastric bypass surgery, researchers have discerned that the reduction in appetite and eating pattern observed is likely to be due to a change in the hormone production following surgery. The reduced appetite is not a direct result of the reduced size of the stomach but of the levels of satiety hormones released by the body.

The research team has found a way of mimicking the effects of gastric bypass surgery by introducing the satiety hormones artificially. The hormone would only need to be injected once a week to provide the optimal effect according to initial studies.

If the safety and efficacy of this weekly injection can be established in wider population trials, this could revolutionise the way that we treat obese patients. Gastric bypass surgery is highly effective but it is simply not a practicable solution for everyone who is overweight or obese. This weekly injection may provide the solution but it is many years away from being an approved treatment.

At the current time we have a daily injection called Victoza that can be prescribed off-label for weight loss patients. Victoza contains one of the synthetic hormones contained in the weekly injection about to be trialled by the researchers at Imperial College. To check if you are eligible to be prescribed Victoza, please feel free to take a free consultation.

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We are so often told about the many health benefits of losing weight that it may seem odd to think that there are times when losing weight is only one half of the story. A good example of that comes from studies into weight loss and cardiovascular events. Although weight loss is important in this case, there are few long-term studies that have looked into how weight loss affects the risk of death from cardiovascular events. Now, a recently published study has come out with some unexpected findings.

The study, which was published in New England Journal of Medicine, was a controlled trial that included a total of 5145 patients who were obese and had type II diabetes. They were randomly assigned to either an intervention or a control group. In the intervention group, the participants took part in a weight-loss regime that included decreased caloric intake and increased physical activity. In contrast to that, the control group took part in various sessions that aimed to provide counselling and education about diabetes. The individuals were followed up for an average of 11 years. The key findings indicated that although the intervention group lost more weight within the first year, this weight loss did not seem to have an effect on death from cardiovascular causes, stroke, angina or myocardial infarction.

Although the researchers were initially surprised by the counter-intuitive findings, they attributed the lack of difference between groups to the fact that individuals in the control group having been somewhat more likely to be taking statins. Based on this they recommended that further research consider the role of statins in preventing death from cardiovascular causes.

It is difficult to challenge many of these findings, as the study was highly controlled, with a large sample size and a long period of follow up. One aspect that is particularly worth considering is the fact that the participants in the current study were provided with an on-going intervention throughout the course of the study. This is in stark contrast to past studies that have tended to provide short-term interventions. However, there are also some limitations of the study, such as the fact that the participants were very motivated to lose weight, which may not be the case for everyone that has diabetes.

We think that the study highlights an important issue in research, which is the need to consider what effect medication can have on the outcome of the study. Whilst the findings appear robust, we would also like to stress that they do not suggest that there are no health benefits to losing weight. In fact, their findings suggested several links between weight loss and reductions in depression, urinary incontinence, sleep apnoea as well as improvements in mobility and quality of life. We will be keen to see how the current findings affect research and clinical practice.

You can read more about this study by following this hyperlink.




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