How To Lose Weight

First, the brain is effectively wired to protect itself. We need to eat to survive, and we have redundant pathways developed over eons that keep us wanting to eat, pushing us to keep our energy systems filled. If you try to interfere with one, others take over.

But a bigger problem is that the receptors these weight-loss drugs act on don’t just regulate food intake; they’re tied to a lot of other systems. That’s true of rimonabant, a weight-loss drug that the F.D.A. has refused to approve. It works on the brain’s cannaboid receptors, which are involved in eating and the reward system, but also in anxiety, depression and mood.

And this ties into the biggest problem in treating obesity, which is that people are impatient. If someone responds to such a drug, he may lose a pound or so a week. And no matter what the doctor says, he’ll become impatient and take more pills. This may speed up weight loss, but because the drug is also acting on other brain centers, the increased dosage can also induce depression, anxiety, psychosis and suicide.

We have plenty of targets for new drugs. What we need is something more like a smart bomb that zeroes in on a weight-loss target without affecting anything else. Some potential drugs are in the wings, but it will take years before they can be tested in humans. And we’ll probably need combinations of drugs that target systems both in the brain and in the body, because one drug targeting one system probably won’t produce more than a 10 percent weight reduction, which is not enough for someone who weighs 300 pounds.

Unfortunately, for now and the foreseeable future, the best treatment for obesity is prevention.

This entry was posted on Friday, July 17th, 2009 at 10:01 am and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.