Saxenda: The UK’s New Weight Loss Injection

In January of this year, a new weight loss treatment was quietly approved for use in the UK. Branded under the name Saxenda, this treatment contains the active ingredient liraglutide, and works by making you feel full and satisfied, thereby curbing food cravings.

Previously, liraglutide was only licensed for use as a diabetes treatment. Under the brand name Victoza (and in lower doses) it can be prescribed to people with type 2 diabetes to help them maintain a healthy blood sugar level. When it was discovered that patients were losing weight as a result of taking Victoza, researchers began to explore the potential of liraglutide as a safe weight loss treatment.

Since Saxenda was officially approved for this use in the UK, the treatment has steadily grown in popularity. In August, the Daily Mail published a profile on a UK businesswoman called Caroline Balazs. As explained in the article, Balazs, an aesthetic specialist, has found success with using liraglutide for weight loss and is one of a handful of practitioners in the UK making it available to her patients under the label SkinnyJab Clinics.

With many people likening the treatment to Botox, it’s expected that Saxenda will grow in popularity. But the question is: does it actually work?

How Saxenda Works

Saxenda works by mimicking a hormone made in the intestines called GLP-1 which helps you feel full after eating. In essence, it decreases your hunger and need to eat. This action assists in weight loss, particularly in conjunction with exercise and a healthy diet.

In one clinical trial, it was found that more than 60% of patients lost at least 5% of their weight while taking Saxenda; 31% lost more than 10%. Saxenda has also been shown to reduce blood pressure and lower your risk for cardiovascular disease.

Taking Saxenda Safely

Saxenda is designed for use by people with a BMI over 30, or over 27 if the patient also suffers from a weight-related issue such as high blood pressure. It should be administered once a day, starting with a low dose and building up to a higher dose each week. The treatment is designed to be injected subcutaneously (i.e. under the skin) and is normally administered in the abdomen, thighs or upper arm.

Common side effects of Saxenda include nausea, vomiting, diarrhoea and constipation – although these usually go away within a few weeks. Some people also experience discomfort in their stomach, heartburn, fatigue, dizziness, insomnia and hypoglycaemia. When compared with other weight loss treatments, however, liraglutide tends to be easier to tolerate.

The main thing to bear in mind when taking Saxenda is that you should always obtain it from a licensed clinic or pharmacy, and you should always take it as directed. You should never use more than instructed, and you should never use it without telling your prescribing doctor if you are diabetic. If you have diabetes, you will likely need a different dose to prevent your blood sugar from getting too low. 

At The Online Clinic, we can safely prescribe Saxenda to suitable patients who have completed our online questionnaire. To find out more, click here.

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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.

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.

Psoriasis has been associated in the past with being overweight. A new study has sought to explore this phenomenon further.

Dr. Jensen et al. have thought about expanding this further to see exactly what kind of an impact obesity has on the skin condition whereby a type of white blood cells (T-cells) start, erroneously, to damage normal skin cells. They divided the sample group in two and they asked the first group to continue eating healthily while they gave the second group (the test group) a specific low-energy diet. As predicted, the second group lost more weight and this caused, in turn, an improvement of their psoriasis condition. Researchers measured the improvement by two different means: the Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI).

Findings were significantly different when comparing the second group to the first group through the DLQI. The second group in fact, scored better than the first. However, even though the PASI test showed insightful results (the second group showing more improvements than the first), the findings through this metric were not statistically significant. Therefore, this study should be replicated in order to test out its validity and reliability. The findings also suggest that obesity is not the only factor that affects psoriasis, and that further research is needed to study additional factors that might relieve symptoms of psoriasis on individuals suffering from the condition.

Inasmuch as this study did not reach unanticipated results, it has highlighted that it is important for patients with psoriasis, who are also overweight, to seriously consider reducing their weight, as this is more likely to improve their skin health as well as their general wellbeing.

A little while ago we reported that there was encouraging research carried out to see whether medications containing GLP-1 would be useful in treating obesity. In light of this, we are not surprised to hear about the promising results of a large-scale study.

The phase III trial, which was completed in Denmark, included a total of 846 overweight or obese individuals. The participants were randomly split into three groups who were then treated with 3mg Liraglutide, 1.8 mg Liraglutide or a placebo. The participants were further observed for 12 weeks after the cessation of the programme. The key findings indicated that individuals who received the highest dosage of Liraglutide also had the highest weight-loss. Specifically, 50% of the individuals in the 3 mg group lost at least 5% of their body weight, and 22% lost 10% of their weight during the course of the treatment. Similarly, 35% of individuals in the group that received 1.8mg of Liraglutide lost 5% of their body weight and 13% of the participants in this group lost 10% of their weight. In contrast to this, only 13% of the individuals in the placebo group lost 5% of their weight and 4% lost 10% of their weight. However, across groups it was clear that participants were not able to maintain their complete weight loss once they had stopped their treatment. The combination of these findings led the researchers to suggest that there is potential for Liraglutide to be a useful treatment for weight loss.

The findings from this study are certainly encouraging especially as it was carried out for such a long period of time with low attrition rates of a rather large sample. Moreover, the fact that it was a double blind study and that so many of the results reached statistical significance reflected that there are good reasons to further research this area. However, it also raised important clinical questions that need to be addressed, with dosage and length of treatment appearing as the most obvious ones.

The Online Clinic can prescribe Victoza (Liraglutide) as a weight loss treatment if it is appropriate for you. Some patients have had extremely good results with this product.

Researchers investigating treatments for obesity have long suspected that a combination of hormones could be an effective way to target appetite and food consumption, leading to a loss of bodyweight.  Until now, no human studies had been published to establish whether this is the case so we had to rely on animal studies to attempt to demonstrate the hypothesis.  However, a study with humans was recently carried out at Imperial College London and the researchers presented some encouraging findings at the Society for Endocrinology annual conference in Britain.

The two types of hormones that were studied were Glucagon and Glucagon Like Peptide-1 (GLP-1), which act in complementary ways. While glucagon is known to work by preventing storage of glucose in fat deposits and the liver, GLP-1 tends to lower blood sugar by stimulating the release of insulin. Currently, a GLP-1 analogue is prescribed for obese patients in some clinics (including ours), as a mono therapy following encouraging results in a study published in The Lancet.

The Imperial College study that looked into this was a double blind study that included 16 participants. All the participants were given a sequence of treatments, which were determined at random. The four treatments were; glucagon, GLP-1, glucagon and GLP-1 in combination, and saline as a control and the participants received them all via a drip, which lasted two hours. All the participants were offered food 90 minutes after their treatment was initiated, and the researchers monitored their food intake in each session. They also measured their blood sugar levels and energy expenditures. The key findings indicated that participants consumed 13% less calories after being treated with a combination of both of the hormones than they would have had if they had been treated with saline. No appetite reduction was noted with glucagon alone and a more modest reduction was noted with GLP-1 on its own. This led the researchers to conclude that a combination of glucagon and GLP-1 would be the optimal obesity treatment using this process targeting route. However, the researchers also cautioned that further research would be necessary to see how sustainable the weight-loss would be in the long run. We would also wish to see the results at different dosages of the hormones to establish the optimum levels of each.

Despite its small size, it is clear that the study was well thought out and executed to a high standard. This is to be expected of research at this level, particularly as it comes from Imperial College London, a university known for its excellence in research. What surprised us the most were the high results they reported. We would be keen to read the full publication once it is out, in order to consider any weaknesses that would need to be addressed by future research attempting to replicate the findings.

We are glad that research within this field is underway with human subjects, as we feel that it has been long overdue. From our experience with obese patients, we know how frustrating it can be when there are few treatments from which to choose. Although the combination of GLP-1 and glucagon is not available, we do prescribe Victoza, which contains a GLP-1 analogue, and this has proved to be highly successful in getting patients significantly closer to their target weight.

If you wish to have a weight loss consultation then this can be done online with our clinic. We might be prepared to prescribe a GPL-1 treatment if it is warranted and appropriate.

A recently published study has found that exercising before breakfast aids metabolism and may be more effective than exercising after breakfast. The study, which was published in British Journal of Nutrition, tested 10 men who would be classified as overweight and aimed to consider the participants metabolism.

Essentially, the participants had to take part in three different conditions in a laboratory and be observed for 8.5 hours in total. Each condition was completed two weeks apart and the findings from each condition were compared. In the first condition, the men had to do exercise before having breakfast and were then given blood tests at regular intervals during the observation period. The tests were used to measure the participants’ fat and carbohydrate breakdown as well as the overall energy expenditure. In the second condition the men had to perform exercise after breakfast and were given the same blood tests. Lastly, in the third condition, the men did not perform any exercise but were again given the same blood tests. In addition to a standardised breakfast, participants were also given access to a buffet lunch and told to eat until they felt full. However, unbeknownst to them, the researchers weighed the food before and after in order to calculate how much food had been consumed and what type of food was consumed. The reason for omitting to mention this information to participants before the end of the study was that the researchers were keen to avoid influencing participants’ behaviour in terms of the amount and type of food they chose to consume.

As might be expected, the researchers noted that the exercise conditions provided the largest fat and carbohydrate breakdown and the highest energy expenditure. However, the key finding worthy of further investigation was that the overall energy expenditure was higher, and the breakdown of fat relative to the breakdown of carbohydrates was greater, when men exercised in the morning. As the glycogen levels would be low, this could provide a scientific explanation for the findings. The findings also bear resemblance to previous findings reported in Canada and France.

As the conditions were performed only once, the findings cannot be considered reliable and may be due to chance. Therefore, this would need to be replicated in a larger sample and during a longer period of time before any conclusions can be made. However, this and many of the limitations of both the methodology and the applicability of the current study were acknowledged by the researchers. We agree with the researchers and feel that although the findings cannot be interpreted as definite evidence, the study itself considers an interesting idea and brings instrumental value in guiding future research.

The many benefits of sleep include helping individuals with alertness as well as cognitive abilities such as memory and concentration. We have also previously reported that individuals with a genetic vulnerability for obesity may benefit from getting an adequate amount of sleep. Now a recently published study reports that lack of sleep can increase insulin resistance at a molecular level in healthy individuals.

The study, which was published in Annals of Internal Medicinetested seven young and healthy participants in two different conditions which were then compared. The first condition consisted of the participants getting 8.5h of sleep in bed for four consecutive nights. A month later, the same participants underwent the second condition but this time they had 4.5 hours of sleep for four consecutive nights. On the last night of each condition the researchers gave an intravenous glucose tolerance test to each participant. In addition to that, a biopsy was performed on abdominal fat cells that had been removed from each participant’s navel. These cells were then used to measure how fat cells respond to insulin. In order to make the comparison fair, the researcher ensured that each participant’s food intake was identical in both conditions.

The key findings suggested that the insulin response decreased on average 16 per cent after four consecutive nights of little sleep, whereas the fat cells sensitivity to insulin decreased by 30 per cent. What is most notable is that changes were found in all participants.

Insulin, which is a hormone that helps the body process sugars, is intimately tied to fat cells, which in turn appear to be directly related to metabolic disruption and weight gain. If an individual is unable to process sugars, then more insulin is produced which can lead to various complications.

The researchers have argued that this study supports the link between sleep and diabetes and that it is their hope that sleep becomes included in recommendations alongside diet and exercise.

Although we understand the need for sleep, and have previously recommended that getting an optimal amount of sleep is good for a person’s health, we feel that the researchers’ conclusion may be a bit premature and only applicable to healthy individuals. To our knowledge, these types of studies are still in early stages and this study in particular had a very limited and healthy sample. Moreover, there is no current theory for what underlying mechanism controls the insulin response during sleep. Thus making the findings more descriptive than explanatory. Nevertheless, in the future we would be interested to hear about studies that have considered whether it is possible to reverse this effect with more sleep and in what way (if any) this effect may differ in unhealthy individuals.

We quite often receive approaches from women going through the menopause who are beginning to notice a change in their weight and body shape. Most women attribute this to lifestyle but that is not always the case for post-menopausal women. The menopause causes the body to behave differently: a reduction in the production of certain hormones will cause the body to change shape and for the distribution of fat to alter. Many women will notice that their previous pear-shape transforms into an apple-shape.

What can be done? Well, this is a natural part of aging unfortunately but there is no reason to take this lying down. If you are prepared to consider hormone replacement then you should consult your GP in the first instance to get your hormone levels checked. If appropriate, your GP will prescribe a suitable type of HRT (hormone replacement therapy.) HRT can cause side effects so this option needs to be carefully considered.

We would always recommend that you watch your diet, menopause or not. The first thing to avoid is refined sugar. Cut down your sugar consumption and up your intake of fruit and vegetables. A recent study in the US indicated that a diet rich in fruit and vegetables could help post-menopausal women keep weight gain at bay.

It is very important to resist the temptation to go on a crash diet. This action could send the body on famine alert, so it will store more fat in anticipation of a future period of reduced availability of food – this is a deep-rooted survival mechanism.

Up your levels of aerobic exercise! This will help to increase your metabolic rate and reduce the amount of food intake stored as fat.

Our top tip for anyone looking to lose weight is to look at what you drink as well as what you eat. A lot of flavoured drinks (including so-called health drinks) are full of sugar. Avoid flavoured drinks and stick to water.

It is an observed phenomenon that people tend to put on weight when they get old. This is normally related to a change in the production of hormones by the body. In men, testosterone levels reduce with age and the reduction in testosterone is associated with a gain in weight. Obese men quite often have low levels of testosterone.

We have seen a study that has been trumpeted in the medical press about injecting obese men with slow release testosterone, with a gradual reduction in weight and fatty mass being observed. These results do not particularly surprise us but it is the only long term study that we have seen. The patients were treated over a 5 year period and the average weight loss over that period was 13%.

The form of testosterone that was injected was testosterone undecanoate – this is available in the EU but we do not prescribe it as it really should be done in a face to face environment. We would also recommend that an androgen profile is done before this medication is prescribed.

Yet another frightening new diet has been unleashed on desperate brides to be in the USA: the gruesome K-E diet. 800 calories worth of liquid is pumped via a tube through the nose into the blushing bride’s shrinking stomach so that before her big day, she will stand the chance of losing a whopping 10-20 pounds. Forget Martine McCutcheon and her 4 month plan to get into a healthy sized wedding dress before the day approaches; this is the ultimate quick fix with a 10 day guarantee but comes at a price - $1500.00.

Certain doctors in the States sing its praises, stating that it is designed to burn fat rather than muscle and the feeling of hunger will be absent for the entire 10 day period. Others say that the nasal tube is merely a gimmick and that restricting the diet to 800 calories will cause drastic weight loss in anyone who is used to more than the recommended amount.  The diet is rich in protein and contains no carbohydrates, hence the fat burning results (the body will normally convert sugars into energy rather than fat as this is an easier process.)

One of the side effects of this extreme diet is foul smelling breath so the bride might be well advised to stay away from the groom for the duration of the diet, otherwise her big day might be cancelled.

Police officers here in the UK will soon be required to take annual fitness tests in order to make sure that they are complying with a standardised expected amount of weight loss. The decision was made as a result of figures from a new study which showed that up to three quarters of the force were overweight and obese in certain areas over the UK. So far, weight has never been assessed or taken in consideration for the duration of the officer’s career. The study’s author has suggested that annual fitness tests are a requirement and that today it is more important than ever considering increasingly the police use cars to travel around their cities instead of walking on the beat like they once did thus lending to an unhealthier, more sedentary lifestyle.

Examinations carried out last year revealed that 52% of the male officers were considered overweight and this was also the case for 32% of the female officers. It was reported that among male and female officers, 22% and 32% were obese respectively. 1% of male officers were deemed morbidly obese and among the female officers 2% were considered morbidly obese.

Not only are they setting a bad example for the general public who are also living increasingly unhealthy and sedentary lifestyles but also they are putting an obstacle between themselves and the criminal they are trying to catch, thus putting themselves and their public at risk. This is why the author of the study would like fitness tests to become a mandatory annual event that will involve such tests of strength and stamina as completing an assault course within a certain length of time.

It is not being suggested that the force should be composed of Batman and Robin figures but rather employing men and women who are healthy enough not to be considered putting themselves or their public at risk as a result of how overweight or unfit they may be. We don’t want to have a rant at the police, who have a tough enough job as it is, but some jobs do require a certain level of fitness and pursuing criminals is one of those activities!

A recent study shows the benefit of treating overweight patients with glucagon-like peptide-1 receptor (GLP-1R) agonists, liraglutide and exenatide specifically, regardless of whether or not they have Type-2 diabetes. These drugs mimic a gut hormone which suppresses appetite. The systemic review (literature review) and meta-analysis (interrogation of previously published relevant clinical data) was carried out in Denmark at the University of Copenhagen. It was observed that the participants given the medications with the active ingredients at a clinical relevant dosage had lowered blood pressure and cholesterol levels.

GLP-1R is already in use as a treatment for Type-2 diabetes and this is injected in order to regulate blood sugar levels. The authors searched major medical databases for all studies involving GLP-1R agonists and looked at 25 previous studies involving 6,411 overweight or obese patients who were given GLP-1R agonists (either liraglutide or exenatide) over a period of at least 20 weeks. Some of the patients had diabetes.

The authors state that their study highlights the potential for GLP-1 clinical usage when administered to those with or without diabetes. Positive effects on cholesterol levels and blood pressure readings were also noted as well as a drop in weight. Those in the control groups had been given a placebo or treatment for diabetes such as insulin. Weight loss was noted in both patients with and without diabetes but was more dramatic for those who did not suffer from this illness.

Researchers are looking at the possibility of prescribing the treatment to patients who are overweight and who do not have diabetes but it will take an estimated 2 to 3 years to discover whether or not this is safe. The study’s authors suggest that using this medication is likely to cause nausea and with taking the drug comes the risk of damaging the thyroid and the pancreas. However, the results are still promising and investigation is on-going.

Liraglutide (Victoza) has a head start on the other GLP-1R antagonists having produced significant results including substantial weight loss in previous studies. We believe that Liraglutide is currently undergoing human trials as a weight loss treatment although it is not expected to be available to prescribe any time soon.

However outrageous you might think the Dukan diet is, Pierre Dukan, the nutritionist responsible for this low carb diet, has thought up an even more unfathomable weight loss trick and it involves motivating young people to lose weight or maintain a healthy weight by bringing a weight loss marking system into the classroom! He sent his proposal to the 16 French presidential candidates on Tuesday and titled the short book, ‘An Open letter to the Future President’.

Dukan suggests that the French A- level equivalent, ‘le baccalaureat’, should incorporate an ‘ideal weight’ portion to these final examinations which would necessitate that the student maintained a healthy BMI of between 18 and 25 in order to earn extra points towards their final academic scores. With entrance to French universities entirely dependent on a points system, we can imagine that the pressure would definitely make a success of the proposal but we are not sure about how ethical the system would be if employed.

Dukan charitably suggests that teenagers who are double the healthy weight at the beginning of the two year course would score double the points for losing the weight by the time the marking commences. This is hardly fair on the naturally thin, academic swatters and what sort of bullying would this competitive fixation on weight loss promote at high school level? This sort of system could lead to students having a very dysfunctional relationship with food.

The nutritionist calls on the politicians for help as he fears the increasing obesity epidemic in France is no longer a health problem but a political concern. This we understand, but to take a political problem like this and to play it out in the classroom is irresponsible.

At The Online Clinic we always advise patients that the best way to lose weight and maintain a healthy physique is through an appropriate diet and exercise regime. Where an effort in this direction has failed, we are prepared to prescribe medication to help patients achieve their weight loss goals.

If you live in London or the surrounding area, there is now an innovative fitness programme that has been devised by Lawrence Farncombe, an accredited fitness instructor with many years of experience in helping people achieve their personal goals. This new outdoor group fitness programme is called Modified Strongman Training. Don’t be distracted by the name – you don’t have to be strong or a man to participate but some fitness experience is a must. Modified Strongman Training is a great way to burn unwanted fat – you would have to spend hours doing cardiovascular workouts to achieve the sort of fat burn that you will get in just one session of this programme. This may not be for everyone but if you are looking to burn body fat, this could be an avenue to explore.

Weight loss gum looks set to join the meagre list of weight loss treatments. The gum contains a hormone known as PYY that regulates appetite and energy levels. Administering this hormone into the body as a weight loss treatment was the goal of researchers at Syracuse University, NY.

Previous studies have shown that those who are obese have lower levels of the PYY hormone than those of a normal weight. In study, the hormone was injected and participants of every weight and shape lost weight due to a decrease in appetite.

Initially scientists were concerned about how to administer this hormone but scientists think they have found a way that will allow for the hormone to enter the bloodstream undamaged and that is the carrying of the hormone via vitamin B12.

Phase I trials sought to show that a sufficient amount of the hormone was administered this way and the trial was successful. Until future trials take place, we will have to look forward to the possibility of losing weight while we chew.

The results of this study are published in the Journal of Medicinal Chemistry.

While the geese are getting fat, so too is Martine McCutcheon. In fact she has been ordered to put on as much weight as she can before she embarks on a career enhancing weight loss journey amounting to yet another of her fitness dvd stocking fillers. The idea behind this weight gain is to make the weight loss achieved seem as dramatic as possible as she starts the gruelling work outs at size 16 and finishes a much smaller size 10.

A recent study at Harvard University has found that beginning an exercise regime before a diet commences is the way forward in terms of weight loss and discovered a direct association between exercise and eating habits. They also found that in the long term, exercise will also quell the temptations that we face every day, for example, foods that are high in calories. The study is published in Obesity Reviews.

McCutcheon’s goal to gain weight and then speedily lose it is the sort of diet that is only recommended where a six figure sum of money is being offered. Otherwise, gradual weight loss and a healthy balance of diet and exercise is recommended for lasting effects.

Overweight patients who are referred to Weight Watchers by their doctors will lose twice as much fat as those who try to lose weight with the advice of their doctors. A study carried out last year by the Medical Research Council encouraged GPs to make such referrals. With overweight patients at risk of heart disease, diabetes and stroke, this is the best option for those who are trying to shed stones in a time where only one licensed diet pill is available.

The study carried out last year is published in the Lancet and compared patients who were referred to Weight Watchers with those who received standard care from their doctor in terms of weight loss advice.

772 adults who were overweight were observed for a period of 12 months. One group attended WeightWatchers and the other group followed the care plan that they had arranged with their doctor.

After one year, patients who had been working with weight watchers had lost 5.1kg on average and those who tried to lose the weight independently lost an average of 2.2kg. Those who went to weight watchers were three times more likely to lose 5% of their original body weight than the others.

Waist circumference and fat mass was also substantially lower and these are known to lead to diseases such as diabetes and cardiovascular illness.

A new study shows Liraglutide has definite potential as a weight loss drug for those who are not diabetic. The recently approved treatment for type 2 diabetes has proved itself a successful weight loss treatment. The results of a US based study were presented at the American Diabetes Association where it was explained that the weight loss achieved on this drug far exceeded that which was expected, much to the excitement of the investigators at the University Of Pennsylvania School Of Medicine.

The trial included a run-in phase where participants consumed just 1200 to 1600 calories each day in order to achieve a target weight loss of 5% from the study’s outset. Four to twelve weeks later, the patients were divided into two groups and given Liraglutide or a placebo. This was a 3mg dose (after titration) as opposed to the 1.8 mg that is usually administered for diabetic patients.

The average age of the patients was 46 years and they weighed an average of 106kg. The average BMI was 38. Most patients in the Liraglutide group sustained their run-in weight 56 weeks after the groups were formed: 81% in the Liraglutide group as opposed to only 49% taking the placebo.

Liraglutide also caused a further average weight loss of 6.1% where the majority of patients lost 5 per cent on average. This was a surprise to the team at the University Of Pennsylvania School Of Medicine as all they had expected was that the Liraglutide would function to maintain the weight loss achieved during the run-in phase. There was no further weight loss reported in the placebo group post run-in phase.

There were fewer drop outs than expected with only 25% of participants from the Liraglutide group and 31% from the placebo group leaving the study. The most common complaint was nausea experienced by 48% of the group. The team explain that this reaction is to be expected during the first 4 to 5 weeks. No psychological effects were reported.

Between the weight loss achieved while taking Liraglutide and the reports of its safety and minimal side effects, it seems likely that an application will be made to the FDA (Food and Drug Administration) for its approval as a weight loss drug in overweight patients who are not diabetic.

Many women smoke to suppress their appetite in order to avoid weight gain and it is known that smokers have a lower body mass index than those who do not smoke. Scientists have returned to look at the effect of nicotine on appetite suppression once again.  A study was carried out at Yale University where scientists looked at the effect of nicotine on mice.

The reason that nicotine suppresses appetite is that it becomes attached to receptors in the brain that influence the desire to eat food. Using mice, the scientists were able to figure out which nerves were affected by nicotine. Cytisine was one of the substances used to stimulate weight loss in the mice and interestingly, it is also used as a smoking cessation medication in Eastern Europe. Nicotine has a high affinity with certain receptors in the hypothalamus that control our desire for food.

The effect of nicotine is known to have a long term effect on weight loss. Smokers notoriously keep off the weight they lose when they take up the habit right up until they quit. The average smoker is said to gain approximately 5.5 pounds when they quit.

We are not advocating that people take up smoking to lose weight but this research could lead to an effective medication being produced that mimics the action of the nicotine on the relevant receptors.

According to the latest stats gathered by The Better Life Index, which compared 34 countries on a range of topics such as income, health, housing standards, education and crime, British people are fatter than other countries with similar economies. The 34 countries observed belong to the Organisation of Economic Co-operation and Development (OECD) and the figures are quite revealing.

In terms of health, obesity rates in the UK were shown to be the highest in Europe with one in four people obese and the numbers set to increase over the next decade. The statistics also reveal that obesity levels among certain groups within the population are levelling off; for example, the better off and the more educated. Those who are less fortunate will experience ever increasing obesity rates unless something changes.

Next year GPs shall be paid for advising obese patients to lose weight. This follows a recent study that was presented at a European conference on obesity last week where it was established that those who were obese or overweight were far more likely to lose weight if advised by their doctors and referred to diet clubs by their doctors than if they were trying to diet alone.

The diet clubs were paid for using taxpayer’s money for the duration of the study which at the time caused controversy however, considering that obesity is costing the NHS £6 billion every year, pumping money into such an outlet can only serve to lighten the load of this financial burden in the long run.

Research published in the Journal of General Internal Medicine has shown that those who are obese are more inclined to lose weight with cash incentives but once the incentive is no longer there, the obese go back to their original size and often become even fatter. These incentives are presently in trial on the NHS and the Kent NHS trust, for example, is giving patients up to £3,000 for shifting up to 10 stone as part of their Pound for Pound scheme.

The research was carried out in the U.S with 66 participants studied over 8 months. It was revealed that those who received payment for their weight loss lost, on average, a half a stone more than those who did not receive payment for their efforts. All patients put on weight after the experiment had finished.

Some health officials suggest that this is a dangerous kind of intervention because there is money involved and therefore people may go to drastic lengths in order to lose weight quickly. Considering there is no research to suggest that this weight loss continues or is maintained after the payment ceases, are we just wasting public money on these people? The answer must be an emphatic YES!

Seemingly, sprinkling crystals that emit an odour on your food will be the way forward for weight loss patients. Sensa is the latest weight loss advancement in this form and can be purchased in many flavours including coffee and cheese! It will be available for purchase in the UK in 2011.

Over 1,400 participants who took part in a 6 month trial were said to have lost an average of two stones over a 6 month period. A five year study will commence incorporating 1,000 participants and it is estimated that the crystals could have a lasting impact on the health of the patient and the maintenance of weight loss.

The principle is based around the smell of food. 90% of the experience in tasting food is influenced by the smell of it. Taste can transport messages to the brain indicating that the body is full thus spreading the taste enhancing crystals over food will decrease the desire to eat. It all sounds a little faddy but Sensa could be the answer in this time of doubt regarding the future of weight loss treatments.

Two Blackpool bus drivers have been suspended for their – spare tyres! In order to be deemed as safe to employ again, they have been given four weeks to lose over a half a stone. Failing risk assessments and health and safety assessments, the employer felt something needed to be done. Colleagues report that if the men do not lose the weight, they may be forced into unpaid suspension for the duration of 12 months. It seems one must have to weigh in at 20 stone before such dictatorial regimes are implemented and the implementation is justified by fears over the safety associated with the driver’s seats say Blackpool Transport.

Some employees suggest that this behaviour is discriminatory and heavy handed. Seemingly the company has been trying to get rid of people for some time. They are passing off their terminations as concerns over the medical issues of certain employees.

Blackpool Transport is already under scrutiny over medical related dismissals. Meetings with union representatives will take place over the coming days.

It has started raining again and it has become a little cooler however, a month off going to the gym or breaking your healthy diet to comfort binge will affect your body and produce long lasting results. Dr Torbjorn Lindstrom from the faculty of health sciences at the University of Linkoping, and his team of Swedish researchers discovered that shorter periods of overeating will have longer term effects.

The current issue of Nutrition and Metabolism details their research methods. They took 18 individuals of the same age and all of a normal weight including 12 men and six women. All were placed on a minimum daily exercise routine which did not allow them to take more than 5,000 steps per day. To put this into perspective, generally people who are concerned about their fitness aim to take 10,000 steps per day. The average person wearing a pedometer while going about their daily activities may note that they are walking on average 4,000 and 6,000 steps per day not including sport. You can double this number by doing approximately half an hour to forty minutes of walking outside your daily routine.

The participants also had to increase their daily intake of calories by 70%, bringing their consumption to 5750 calories per day. In order to consume this number of calories, one would have to eat something like 8 meals per day at approximately 700 calories per meal. These individuals put on 14 pounds in one month. Another group of the same age and of normal weights did not change their diet or physical activity.

After 6 months, the group that increased their calorific intake lost 10 pounds on average but after one year they noticed that they still had a 3 pound gain of fat mass. This weight remained despite returning to their low calorie diets and physically active lifestyles.

Two and a half years later, the gain in fat mass on the same individuals was even greater. The average gain was approximately 7 pounds. This was not the case for those who had kept their original dietary habits. They remained the same weight.

The results show that a brief period of binge eating and cutting out recommended levels of physical activity simultaneously, can actually change the composition of the body and make it more difficult to get rid of the weight gained.

Virginia Tech researchers have discovered a safe and successful way of losing extra pounds while maintaining a low calorie diet. They suggest that drinking an 8 ounce glasses of water before each meal will cause fewer calories to be consumed.

The study was carried out for 12 weeks on two groups of overweight people whose ages ranged between 55 and 75 years. One group did not drink water prior to their meals but were also on a low calorie diet. At the end of the 12 weeks, the group not drinking water succeeded in losing 11 pounds whereas the water drinking group lost 15.5 pounds by the end. Unfortunately, the same method of weight loss cannot be used for those aged between 18 and 35 as within this age group water is not so easily retained and goes straight through the stomach.

The researchers had thought that by drinking the 2 glasses of water before the meal, the participants would compensate for the reduced calorie intake at another stage during the day but this was not the case. One year later, it also proved to be a successful way of keeping the weight off over a period of time. These dieters kept on losing weight.

Barry Popkin of the University of North Carolina Nutrition Obesity Research Centre, pleased with the results, whose past research has shown that those who drink more water drink and less sugary/ calorific drinks and eat more fruits and vegetables thus have an overall lower calorie consumption than those who do not drink as much water. Americans drink a staggering 300 calories more per day drinking sugary drinks than they did 30 years ago. They are one of the worst perpetuators in the junk calorie consumption league table but we Brits are not far behind.

More obesity news and this time it is not about suppressing our hunger with medical treatments but actually about what we feed ourselves that may be the answer to beating obesity. Researchers are investigating the effects of certain types of fibre found in particular vegetables and how they help suppress hunger.

Most will be happy to hear that the fibres in question are found in asparagus, artichoke, garlic and chicory – so nothing too vile-tasting! These fermentable carbohydrates in these vegetables activate hormones in the gut which suppress appetite. Due to their ability to produce additional sensitivity to insulin, the fermentable carbohydrates have a positive effect on glucose levels. Finding out more about how these foods affect our bodies may help us to prevent the onset of Type 2 diabetes according to Nicola Guess of Imperial College. The carbohydrates will be given to the participants of the study in the form of a daily supplement.

Dr. Iain Frame of Diabetes UK, states that although it is unlikely that any one preventative measure will be successful, the research being carried out at Imperial College is important and that they may result in innovative ways of preventing Type 2 diabetes.

The scientists of The Institute of Food research have made progress concerning the breakdown of certain fats and satiety. They believe to have found a synergy to break down fat thus allowing paving the way for the possibility of finding ways to slow down the process by which we digest fat and even to create food structures that will make us feel full. Dr Peter Wilde from The Institute of Food Research explains that most of the fat found in processed food is presented in the form of emulsions like ice creams, mayonnaise and yoghurts. Using the knowledge we have of our bodies and how they break down these fats, future research can help us discover how to make fats which break down at a slower rate.

By slowing the digestion of fats, the fatty acids then reach the ileum where they can stimulate hormones that induce satiety. Scientists at The Institute of Food Research are experimenting with the use of protein layers to stabilise the emulsions. The results showed that a normally stable whey protein gets broken down only partially whereas when a surfactant is introduced to the emulsion, the protein layer is broken down more substantially, opening the way for enzymes to break down the fat.

The Institute of Food Research is the only institution carrying out studies on the digestion of emulsions and how they may induce satiety.

Researchers from the University of Cincinnati, in a study they carried out earlier this month, have found that the best way to motivate obese individuals is to emphasise the immediate benefits they will enjoy from exercise and eating right rather than warning them about the more long term effects they are leaving themselves open to by not changing their diets and amending their lifestyle choices.

One of the greatest sources of pain for those who suffer from obesity is the immense strain of weight on the musculoskeletol system. According to Susan Kotowski, study collaborator, increasing the level of focus on the pain reduction benefits associated with exercise and a change in diet, the more motivated sufferers become.

The researchers found that of those involved in the local weight loss programme, 21% felt a considerable relief from pain in the back and lower part of the body after losing ten pounds. Furthermore, the results showed that even the smallest amount of could benefit those who experience great pain daily. The researchers believe that this will influence an entirely different approach to weight loss programs.

So, what is the best way to approach diet and exercise? The media is full of different potions and lotions but how do we pick which one is best for us? Doing a little bit every day and making small changes is the best approach and fad diets do not keep the weight off.

It is said that we should be pumping money into the preservation of ‘wellness’ as well as obesity. An estimated £3 billion is spent by the NHS each year on obesity. By funding anti-obesity campaigns and programs, we are not getting rid of the problem, we are maintaining it. According to Dr. Weiler of Imperial College Healthcare Trust, London, only 1 in 20 people are exercising the recommended daily amount and yet most of the money goes into helping those who already have a weight problem.

A recent survey revealed that one in five children do not receive any encouragement from their parents to join in with after school sports or other physical activities outside of the mandatory physical education classes. But so many factors affect this type of behaviour like psychological factors relating to the parents’ own level of activity, physical situations- such as distance from after school activities, attitudes, socioeconomic status…. the list goes on. This is why campaigns which seek to teach healthy youngsters on a large scale are making giant steps in the eventual combat of obesity.

Vegetarians have reason to feel smug today, after a new study was published showing that eating less meat could be the key to losing weight.

The study, of almost 400,000 adults living in Europe, linked weight gain to eating meat, though the participants were all consuming the same amount of calories. This was particularly noticeable when the participants consumed processed meats such as hams and sausages.

Participants came from 10 different European countries, including the UK. They were weighed and measured at the start of the 5-year study and then filled in a detailed questionnaire on their food habits. They then reported their weight at the end of the study.

Overall, even when calorie intake, physical activity and other factors for weight were taken into account, meat still seemed strongly associated with weight gain. The researchers say that those eating an extra 250g of meat a day, or a small steak, gained an extra 5lb over the course of the study.

The leader of the study, Dr Anne-Claire Vergnaud, said that she would recommend people to ‘control their consumption of meat’ in order to stay a healthy weight, though she did also warn that cutting out meat alone would not on its own be an adequate weight-loss program.

The study seems to debunk the popular Atkins diet, which recommends eating a meat-heavy diet but cutting out carbohydrates.

The scientists have theorised that as meat is high in energy, it alters how the body regulates appetite control, causing the extra weight gain.

The Medical Research Council has said that making the diet club Weight Watchers available on the NHS could be an effective and cheap way of tackling obesity in Britain.

In trials, the program was shown to have a greater impact on changing people’s eating habits than the normal advice and care a GP would provide. 2/3s of Primary Health Care Trusts already offer a 12-week Weight Watchers course to patients, which normally would cost £5 a week.

While the research was paid for by Weight Watchers it was conducted by the MRC and included an assessment of 30,000 people who were  sent on the 12-week course and a trial comparing Weight Watchers with GP-lead services.

Those who took part in the weight loss program lost on average 2.8 kg. In the trial, involving 800 people, after a year those on the program lost on average 7kg, compared with 3.9kg for those who did not. The program participants were also more likely to continue with their diet.

Weight Watchers is thought to be such a success because the companionship and group mentality of it gives dieters extra support and motivation to continue with their diet, as well as encouraging them even if they fall off the wagon occasionally.

The leader of the study, Dr Susan Jebb, said the results were very encouraging. She pointed out that if current obesity trends continue, by 2020 we could be footing an annual bill of £46 billion to deal with the condition, making the program a relatively cost-effective solution.

We have just heard that Novo Nordisk is to reinitiate Phase III clinical trials for Liraglutide as an anti-obesity drug. Liraglutide is already licensed as a treatment for diabetes and has shown great promise as an anti-obesity agent.  A trial in 2009 appeared to demonstrate efficacy and safety. A wider trial of 5000 people is to begin in 2011. The company behind the new drug wanted to wait until they had a marketing authorization for the drug as a treatment for diabetes in the US before it pursued further obesity trials.

Liraglutide is marketed under the name Victoza and is a glugogonlike peptide (GLP-1). Liraglutide appears to be highly effective as a weight loss drug but one likely drawback is that it cannot be taken in tablet or capsule form – it must be injected subcutaneously. This could lead to patient compliance issues but studies are afoot to determine whether the administration regimen can be reduced to once a week.

The study into Liraglutide as a weight loss medication is an exciting development but do not expect it to be licensed before 2013.

A test scheme has shown that dieters who are paid to lose weight are far more likely to succeed than those who are not.

The scheme is called Weight Wins and so far has paid dieters tens of thousands of pounds in a bid to tackle obesity. Dieters sign up for a pound-for-pound scheme, where they get paid for every pound they lose and then are given a cash bonus after a certain number of months if they manage to keep the weight off.

The scheme is supported by the NHS, which means that dieters have access to NHS dieticians and are given help choosing how they want to lose weight.

Those taking part see their rewards vary depending on how long their weight-loss plan is. Monies received ranged from £80 to £3,000. When the program was audited by the independent University of Hertfordshire, it was discovered that the 745 people taking part in the scheme lost 1 stone on average, compared with the 5lb 4 oz lost by those following traditional diet methods without monetary compensation.

45% of patients lost 5% or more of their body weight – the benchmark regulators use to judge whether a scheme or medication is effective – and 1 participant lost 8 stone.

However, a spokesperson for the NHS Eastern and Coastal Kent said that ¾ of participants dropped out of the scheme before it was completed. 

The scheme may seem fairly repellent, but it is likely that if participants do keep the weight off, the taxpayer would actually be better off. The cost of treating obesity-related illnesses is huge and it has been suggested that within 20 years obesity could cripple the NHS.

The Department of Health strategy for tackling obesity has already suggested that financial incentives to lose weight could be introduced. America has already brought in similar schemes and many U.S businesses are giving staff bonuses if they manage to lose weight.

In a statement, a DoH spokesperson said that any nationwide scheme to pay people to lose weight would only be introduced with ‘sound evidence’ to back it up.

Health experts have warned that British women have dangerous diets, with teenagers relying on faddy food plans and pensioners not getting the necessary nutrients.

Scientists reviewed 110 different sets of research into how British women eat and discovered that women in the prime of life are routinely not getting the right nutrition. Girls of school age are also very likely to be missing out on crucial vitamins, with over half of girls aged between 11-18 not getting the recommended intake of minerals.

30% of teenage girls are not getting enough potassium, 16% are lacking iodine and nearly 50% are not getting enough iron.

In older women, zinc deficiency and a lack of vitamin D was a particular problem. Pregnant women need vitamin D to strengthen their unborn child’s bones and ensure that they are not born underweight.

Even as women approach retirement, their diets do not improve. As women get older, they need more vitamin D to prevent brittle bones but the collective research seems to suggest that only a third of women over 65 are getting their recommended daily allowance.

The team behind the review are from the Manchester Metropolitan University and began the study after being commissioned by the Health Supplements Information Service, a independent body.

They concluded that women need to make better food choices to ensure that they are taking in their daily recommended vitamins and suggested that those not following sensible diet plans should round out their diet with daily multivitamins.

There may be a link between weight gain in middle age and dementia, according to scientists from the Boston School of Medicine.

They believe that a paunch in middle age can make otherwise healthy people more likely to develop the condition, which the World Health Organisation estimate is affecting 24.3 people worldwide. They think that there is a link between excess weight and lower total brain volume.

The team studied over 700 volunteers, whose average age was 60. They compared their BMI, waist-to-hip ratio and waist circumference with measures of their brain volume and brain density, amongst other measurements.

The Alzheimer’s Society has said that they are not overly surprised by the research, as it is already known that dementia is related to high blood pressure, cholesterol and diabetes. All three conditions are themselves associated with having a middle-aged spread.

The results are published in the journal, Annals of Neurology.

They have called for more work to be done to be done to investigate the link between obesity and dementia, and further said that research into dementia is ‘drastically underfunded’. In a press release, they called for sufficient research to ‘make the advances necessary’.

Tragic news for the legions of women who have been squeezing themselves into the corset-like anti-cellulite pants which have become so popular – they don’t work.

Nicknamed ‘magic pants’ they promised to help women look thinner, with no extra exercise. Packaging claims that the pants, stocked by M and S, “smooths, slims and shapes’. The company saw customers flock to buy them and sell three times as many as regular pants. John Lewis and Debenhams also stock versions of the knickers.

Which? magazine however say that women are being misled by the packaging. They consulted two plastic surgeons and a dermatologist to see whether the pants, with their special ingredients of aloe vera and caffeine embedded in the fabric, could actually banish cellulite as promised.

They concluded that it was doubtful that the knickers were actually effective and said that any underwear as tight as them would in any case smooth skin. They also questioned whether the magic ingredients were present in sufficient qualities to have any effect.

A spokesperson for Marks and Spencer pointed out that the packaging did not claim to get rid of the cellulite itself, but rather diminish its appearance. She added that the ingredients are widely used in anti-cellulite creams.

If anyone saw the ravaging hoards of women buying up the pants when they were first released, there is no doubt that this will be a huge blow to women eager to look slimmer. Personally, the horror of trying to cram myself into them only to see something in the mirror strongly resembling an over-stuffed sausage skin will live with me for a very long time. I’d take cellulite and giant granny pants over revisiting that particular trauma anytime.

Three health charities have launched a new campaign to raise awareness of the dangers of the ‘spare tyre’, or the area of fat around the waist.

A survey of 2,085 people showed that 97% of people were unaware that there is a link between an over-large waistline and heart disease, although nearly three quarters of those surveyed said they had noticed their own waistlines expanding.

The survey also showed that people generally overestimated the point at which an expanding waistline becomes a risk to health. For women, measurements over over 31.5 inches are a cause for concern, while for men this is 37 inches.

Though a series of studies have been done showing that waist size can be a key indicator of someone’s risk factor for developing a host of diseases, including cancer and diabetes, it is clear that the message has not yet filtered through to the wider public.

Diabetes UK, the British Heart Foundation and Cancer Research are now working together to try to change this. They are hoping to persuade food manufacturers to label food as standard with the ‘traffic light’ labelling system.

They have also launched a series of viral adverts, featuring a rather unpleasant character called ‘Fat’ who apparently enjoys messing with the lives of the overweight (the little evil eyes are particularly disturbing and seems to be modelled on Ross Kemp). Anyone needing a little extra motivation with their diet can see it here

Scientists have discovered that short bursts of exercise are better for our health and weight that long periods of intensive training.

Researchers say that they hope their study will ‘blow away’ the belief that people need to spend long periods of time exercising to stay in shape and shed the pounds.

The results come from a study into ‘high intensity interval training’, done at the McMaster University in Ontario, Canda. Participants were asked to run or cycle at maximum effort for a minute and then rest for a minute, repeating the routine about 10 times.

Volunteers cycled for 60 seconds as fast as possible to reach maximum heart rate. After the exercise, tests showed that their muscles had improved as much as if they had been performing endurance training.  To achieve the same results through endurance training participants would have needed to do 10 hours of moderate-intensity cycling over two weeks.

Professor Martin Gibala, whose findings have been published in the Journal of Physiology, said that it was possible for those trying to stay healthy to achieve more by doing less.

He said it was not clear why high intensity interval training was so productive but said that it seemed to stimuli many of the ‘same cellular pathways’ as other more traditional exercise regimes.

Those trying to lose weight are generally told to avoid alcohol, due to its high calorie content. However scientists from the Brigham and Women’s Hospital in Boston in the U.S have claimed that women who drink moderate amounts of wine are less likely to gain weight than those who stick to mineral water.

Studying data provided by over 19,000 women the scientists discovered over 13 years, all the women tended to gain weight but the 37% of respondents who said they never drank tended to gain the most weight.

The women’s weight also went up or down according to which alcohol they preferred, with those drinking red wine gaining the most weight and those choosing beer and spirits putting on the most.

The results from the study suggest that calories from alcohol are less detrimental to weight than those in other foods. It also could mean that our body’s mechanism for digesting alcohol is more complex than scientists previously realised.

Some researchers have posited the theory that people who regularly drink alcohol will see their liver’s develop a separate pathway to break down alcohol, turning excess energy into heat rather than fat.

The report has been published in the Archives of Internal Medicine. To celebrate its publication, I will be opening a bottle of Merlot, safe in the knowledge that with every slug I’m getting thinner.