Is This the Weight Loss “Magic Bullet?”

Evolution of Fat Humans
What would Darwin think? Have we evolved into homo lipidicus?

Compare photos of a crowded beach or stadium from 50 years ago to similar photos of today. You’re likely to notice some very stark differences. At least one of them should shock and terrify you.

First, you might notice that food and beverages were smaller in the photos of yesteryear, and that fewer people seemed to be eating. Maybe.

Second, you’d notice that most people were dressed a bit less provocatively than today, particularly at the beach. Far less pseudo-nudity and a somewhat more modest approach to public attire.

But the most stunning difference would be the physical condition of large swaths of the people in those respective photos. Take a look at 2 such photos, side-by-side:

Beach Picture Comps Fat

It doesn’t take much to realize that there are far more unhealthy people in the Coney Island photo than the Brighton Beach photo. What happened to humanity in just 4 decades?

To be fair, there was certainly more social pressure to avoid public semi-nudity if you were obese or overweight in 1976 than there is now. But the visual percentages are staggering.

So how did we get here? Since this piece is really about a weight loss “miracle drug,” I’ll be brief.

The content and quality of the food we eat is garbage when compared to 1976, and corporate and government interests are not only fine with it, they’re profiting handsomely. I will address this bastardized disaster in another piece.

We consume about 400 calories/day LESS than we did in 1976, about 2,180 calories today versus 2,590 in 1976 (totals are averaged and include alcohol and sweets.) But the percentage of fresh foods versus processed foods have skewed in favor of processed foods over the 4 decades since virtually everyone on the beach looked better than we do now!

Between “research” scientists who are almost literally “on the take” from massive food conglomerates to those companies finding ways to process sugar to bypass our natural means of appetite control to the fancy subliminal odors used in food to the slick advertising intended to best our remaining defenses, we never really stood a chance. It’s like they’ve all been working together to fatten us up for a culling by some alien, fat-loving race of carnivores. Ugh.

Which brings me to the real topic of this piece. For years, humans have wished they could take a “wonder drug” that would help them avoid overeating and stay slim. Some “magic bullet” to somehow keep the fat off their asses – and everywhere else!

Now, science may actually have exactly that.

Belviq Lorcaserin Weight Loss Drug
Is this the “magic bullet” dieters have been dreaming of?

Lorcaserin, which is a a selective serotonin 2C receptor agonist that modulates appetite, has shown promise in it’s ability to help overweight or obese patients manage their weight. It’s cardiovascular safety remained a question.

Until now, apparently.

In a study, recently published in the New England Journal of Medicine, Lorcaserin not only proved effective for support of weight loss over both a 1 year and 40 month period, it apparently led to a lower incidence of major cardiovascular incidents in the medication group versus the control/placebo group!

The study, titled Cardiovascular Safety of Lorcaserin in Overweight or Obese Patients, included over 12,000 participants. They were screened for previous cardiovascular disease and after eliminating those unsuitable for the trial, the researchers had a control group of 5,083 patients and a Lorcaserin group of 5,135 patients.

All participants underwent a medical standard weight management program, with counseling on diet and exercise, with access to a registered dietitian. They were not forced to follow any specific diet plan and did not engage in in-residence exercise and nutrition management. In other words, this wasn’t “the Biggest Loser.” They lived their lives and attended the study for regular testing and follow-up.

The results of the study were fairly remarkable. Of the Lorcaserin group, 38.7% lost 5% or more of their starting body weight after one year. The control group showed a 5% loss rate of 17.4%. So the Lorcaserin group succeeded at more than double the rate of the placebo group.

At 40 months, the rate of weight loss success remained, with more than double the number of participants continuing to lose weight at a steady pace.

On the cardiovascular risk side, things were just as interesting, if not more. The problem that most weight loss drugs suffer from is negative side effects, mostly cardiovascular in nature. Lorcaserin seems to have dodged that particular bullet, however.

At 1 year, the Lorcaserin group had somewhat better values with respect to cardiac risk factors, including heart rate, blood pressure, glycemic control and lipid values, than the placebo group. Over the first year and at the 40 month point, the incidence of cardiovascular events was virtually the same in both groups.

In other words, no additional risk of cardiovascular events from the use of Lorcaserin. The only negative for Lorcaserin? Apparently, 13 members of that group developed hypoglycemia versus only 4 from the control group.

“The history with weight-loss agents has been very challenging,” lead investigator Erin Bohula, MD, DPhil (Brigham and Women’s Hospital, Boston, MA). “There have been a number approved for use and then found to have major safety signals and removed. And obesity is clearly a global problem—the rates overall have tripled in the last 40 years. In the US, for example, obesity rates are around 40% so it is a major problem. This is the first time in a rigorous outcomes study we’ve been able to document cardiovascular safety, and for that reason I think it is a milestone and it’s important for patients and providers.”

“I think it is the thing everybody has been looking for,” the chair of Britain’s National Obesity Forum, Tam Fry, who wasn’t involved with the research, told Britain’s Press Association.”I think there will be several holy grails, but this is a holy grail and one which has been certainly at the back of the mind of a lot of specialists for a long time.”

The drug is available in the United States. The cost is between $220 and $300 per month. While there remain a number of issues with losing weight in this fashion – no significant improvement in metabolic rate or quality, no improvement in body composition beyond weight reduction and no long-term studies about other impacts of the drug on the body – this might be what some obese and overweight people have been looking for.

This might actually be a “magic bullet” of sorts. Or, it could just be another example of biomedical slight-of-hand. Keep your eye on the magicians on this one!

Keep the faith and keep after it!

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