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Despite the existence of a set of conservative and surgical treatment methods of obesity, none of them can be regarded as highly effective. Diseases related to obesity confirm extreme relevance of further study of all links of obesity pathogenesis that would help not only to optimize the obesity treatment, but also prevent the development of complications, arising as a result of excess body weight.

Acomplia drug is the first cannabinoid receptor antagonist, the pharmacological effect of which directly depends on anatomical localization of action.

Acomplia drug not only blocks endocannabinoid receptors of the hypothalamus, thereby reducing the appetite but also blocks adipocytes activation that leads to lipogenesis inhibition, insulin resistence reduction and decrease of atherogenic lipoprotein fractions.

Eliminating adverse effects of endocannabinoid system hyperactivity, Acomplia drug contributes to weight loss, improvement of lipid profile and respectively, glycemic control in patients with diabetes.

Systemic action of Acomplia drug grows with increase of dosage, however prolonged elimination half-life of active substance Rimonabant (from 5 to 9 days in young patients and up to 15 days in older patients) allows to take Acomplia drug in fixed dosage – 20mg a day.

Taking into account that concentration of active substance Rimonabant in the blood plazma starts to increase 1-3 hours after solubility of Acomplia drug in gastrointestinal tract, dosing regimen of Acomplia drug presupposes the use of one diet pill Acomplia 20mg before breakfast, once a day.

Significant Acomplia drug interactions with: antidiabetic drugs, oral contraceptives, statins, anticoagulants and antiarrhythmic medications have not been registered.

However, it should be noted that data about drug interactions and pharmacological safety of Acomplia drug were obtained in clinical trials of Acomplia, conducted under the supervision and control of specialists. So, before you include Acomplia drug in the combination of drug therapy, it is necessary to consult a professional health worker.

Favorable effect of Acomplia drug on the metabolic status of a patient (lipid spectrum) is the main distinctive feature of Acomplia drug from other drugs for weight loss ultimately, this predetermines the choice of Acomplia drug for obesity treatment, including patients with diabetes.

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The nine states that surpass the 30 per cent obesity rate were found to be: Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, and West Virginia.

On its Obesity webpage, the CDC describes American society as “obesogenic”, where people live in environments that promote over-eating, unhealthy food, and physical inactivity.

The latest evidence appears to reinforce this: in just one year, since 2009, the number of states with an obesity prevalence of 30 per cent or more has tripled to nine, according to the CDC’s second MMWR “Vital Signs” report, released on Tuesday.

Moreover, not one state has met the Healthy People 2010 national goal of 15 per cent adult obesity prevalence, and only two, the state of Colorado and the District of Columbia report an obesity prevalence under 20 per cent (18. and 19.7 per cent respectively).

CDC Director Dr Thomas Frieden told the press that obesity is still a major public health concern in the US, and if we don’t continue to address this with intensive and comprehensive efforts, we will see more and more people getting sick and dying from obesity-related causes “such as heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of death”.

The CDC report shows that based on self-report data, an additional 2.4 million adult Americans (aged 18 and over) entered the obese category between 2007 and 2009, representing a rise of 1.1 per cent.

Obesity-related medical costs are also high, says the report, estimating the total cost in 2008 at 147 billion US dollars, with obese people costing an extra 1,429 dollars each to treat compared to people of normal weight.

The report bases its findings on new figures from the Behavioral Risk Factor Surveillance System (BRFSS). This system yields state-level public health data and gives states a way to monitor their progress toward the national Healthy People goals.

The system gets it data from telephone surveys: about 400,000 people are surveyed for the obesity data. They are asked to give their height and weight over the phone. From this the survey calculates their BMI (Body Mass Index, the weight in kilos divided by the square of the height in metres).

A BMI of 30 and over counts as obese: and this would include for instance a woman 5 foot 4 inches tall (1.63 m) weighing 174 pounds (79 kilos) or more, or a man 5 ft 10 ins tall (1.78 m) weighing 209 pounds or more (95 kilos).

But the CDC reckons that the BRFSS obesity estimates are under-representative: true obesity prevalence is higher than their figures suggest because research shows that in telephone surveys, men and women often say they are taller and weigh less than they really do.

Dr William Dietz, director of CDC’s Division of Nutrition, Physical Activity and Obesity, says that is why estimates based on the the BRFSS data suggest an overall national level of 26.7 per cent, which is 7.2 lower than the 2007-2008 estimate of 33.9 per cent (nearly 73 million Americans) that is based on NHANES (National Health and Nutrition Examination Survey) data, where people’s height and weight are actually measured rather than self-reported.

Using the BRFSS data CDC researchers also reported how obesity rates vary among different parts of the American population, for example:

Non-Hispanic blacks had the highest overall obesity rate at 36.8 per cent.

Among non-Hispanic black women, the obesity rate was even higher at 41.9 per cent.

Among Hispanics the obesity rate was 30.7 per cent.

Among non-high school graduates the rate was 32.9 per cent.

The Southern states had an obesity prevalence of 28.4 per cent.

In the Midwest, the obesity rate was 28.2 per cent.

Dietz said that obesity is a complex issue that requires action at both the personal and the community level.

“People in all communities should be able to make healthy choices, but in order to make those choices there must be healthy choices to make,” he said, explaining that to address the issue we have to change communities so that people are surrounded by environments where the easiest path is to eat healthy food and be active.

The CDC also refers to two recent reports: The Surgeon General’s Vision for a Healthy and Fit Nation 2010, and the 2010 report from the White House Task Force on Childhood Obesity, both of which highlight a cluster of three actions to tackle the obesity crisis, with a need to address:

Both diet and exercise,

Work across multiple settings (eg medical, workplace, community) and multiple sectors (eg industry and government), and

Change individual behaviors in tandem with the environments and policies that influence them.

In support of this last point, there is evidence from research that encouraging physical activity (for example through increased access and improved community design), and healthy eating (eg improved access to supermarkets offering healthy foods, fruits and vegetables), are linked to real increases in physical activity and dietary improvements.

Correction: this article amended 22.00 PDT to add the paragraph listing the nine states that surpass the 30 per cent obesity rate, apologies to our readers, this was inadvertently missed out in the first issue.

“State-Specific Obesity Prevalence Among Adults – United States, 2009.”
CDC: Morbidity and Mortality Weekly Report (MMWR), August 3, 2010 / 59 (Early Release); 1-5.

Source: CDC.

Correction: this article amended 22.00 PDT to add the paragraph listing the nine states that surpass the 30 per cent obesity rate, apologies to our readers, this was inadvertently missed out in the first issue.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Only Asian youth’s and non-Hispanic white boys’ rates declined after peaking in prevalence of severe obesity.

The authors explain that while obesity may be dropping for some ethnic groups, this is not occurring among African-American and American-Indian girls.

The researchers said that their aim was to investigate trends in prevalence of high Body Mass Index (BMI) from 2001 to 2008, and to assess racial/ethnic variations.

They gathered data from 8,283,718 fifth-, seventh- and ninth graders who had undergone California’s school-based BMI screening during the 2001-2008 period.

The researchers found that:

Obesity rates continued to rise for African-American and American-Indian girls throughout the whole period

Obesity rates for Hispanic girls leveled off after 2005

Non-Hispanic Caucasian girls’ obesity rates peaked in 2005 and then dropped to 2001 prevalence levels

Obesity rates stayed the same for Asian girls

Obesity rates for non-Hispanic Caucasian boys peaked in 2005, and then dropped to 2001 levels

Hispanic and Asian boys’ obesity rates dropped after 2005, but stayed above 2001 levels

Obesity rates for American-Indian boys peaked in 2007

The authors concluded:

On the basis of statewide California data, prevalence of high BMI is declining for some groups, but has not declined for American Indian and black girls. These trends portend greater disparities over time, particularly in severe obesity. Interventions and policies that are tailored to the highest risk groups should be pursued.

“Disparities in Peaks, Plateaus, and Declines in Prevalence of High BMI Among Adolescents”
Kristine A. Madsen, MD, MPH, Ashley E. Weedn, MD, Patricia B. Crawford, DrPH, RD
PEDIATRICS August, 2010. doi:10.1542/peds.2009-3411

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

The evidence of increasing racial disparities for obesity underscores the need for more tailored intervention programs and policies that target high-risk groups, the authors conclude.

The study, which is the first to find significant differences in obesity trends over time by race and ethnicity, appears online in the journal Pediatrics. It also will be published in the September 2010 print issue of the journal.

“While the decline and stabilization of obesity among certain groups is encouraging, we are seeing an increase in disparities that is troubling, especially among the most severely obese youth,” said first author Kristine Madsen, MD, MPH, an assistant professor of pediatrics at UCSF. “As our country becomes increasingly diverse, it is critical that we act quickly to address these disparities.”

Madsen and her co-authors examined trends in the prevalence of high body mass index (BMI) among Hispanic, non-Hispanic white, Asian, black, and American Indian adolescents in California from 2001 through 2008. BMI is a measure of body fat based on a person’s height and weight that is commonly used to screen for obesity. Generally, children are considered obese if they have a BMI at or above the 95th percentile, and severely obese if their BMI score is at or above the 99th percentile.

The data revealed that obesity rates at the 95th percentile declined or stabilized among a number of groups during the time period studied. Among white and Asian girls and boys, obesity rates peaked in 2005, then declined over the next three years, with 2008 rates coming in at 12 percent for white youth and 13 percent for Asians. Overall rates for Hispanic youth also peaked in 2005 and then leveled off at 26 percent through 2008; although Hispanic boys did show a small decline on their own. Rates among black boys stayed at the same level each year.

However, from 2001 through 2008, the prevalence of obesity continued to climb for black and American Indian girls, reaching 22 percent and 23 percent, respectively. Furthermore, these two groups were more than three times as likely as white girls to be severely obese, with a BMI at the 99th percentile.

When comparing groups at the 99th BMI percentile, the researchers found that only Asian youth and white boys showed any signs of decline after 2005. All other groups – including Hispanic boys and girls, white girls, black boys and girls, and American Indian boys and girls – peaked in 2005 and then remained at a plateau through 2008.

“When you look at the very heaviest end of the spectrum, the picture is pretty bleak, and we do not yet know if severe obesity rates for these groups will remain at a plateau or continue to increase,” Madsen added.

The researchers analyzed the health records of more than eight million fifth-, seventh-, and ninth-grade students in California who underwent the state’s mandatory school-based BMI screening. Among the students studied, 46.4 percent were Hispanic, 32.8 percent were white, 12.6 percent were Asian, 7.7 percent were black, and 0.5 percent were American Indian.

According to the researchers, the study’s large and highly diverse group of subjects is a unique strength. And, although the data were confined to one state, the results show population level trends that are applicable elsewhere, since about one in eight children in the United States currently live in California.

“We need to focus on implementing real change in the places where kids spend most of their time – at home, at school and in the after-school arena – to encourage healthier habits and reduce consumption,” Madsen said. “Priorities must be reconsidered so that health is not an afterthought.”

Co- authors on the paper include Patricia Crawford, DrPH, RD, of the Dr. Robert C. and Veronica Atkins Center for Weight and Health at University of California, Berkeley; and Ashley Weedn, MD, of the Department of Pediatrics at University of Oklahoma.

The research was supported by grants from the Robert Wood Johnson Foundation, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the American Heart Association.

Source:
Kate Vidinsky
University of California – San Francisco

The research is intended to increase understanding of how and why preadipocytes, or pre-fat cells, either lie dormant, copy themselves or turn into fat. But the findings eventually could lead to a way to freeze these early cells in their current state before they can ever become the basis of fat tissue, according to Ohio State University researchers.

Every human body needs fat to store and produce energy, but in excess, the tissue made up of fat cells begins to secrete molecules that send out complicated signals. This process can lead to inflammation and, in turn, to insulin resistance or diabetes, and contributes to the development of other diseases.

The scientists focused on three proteins that are known to have an impact on the fate of preadipocytes – one protein that influences inflammation; another that drives the creation of fat cells; and a third that is involved in the proliferation, or copying, of almost all cells in the body.

A series of differential equations determined how the complex interactions among these three proteins would likely affect what happens to pre-fat cells, including conditions most associated with quiescence, or keeping those preadipocytes from turning into fat.

A better appreciation of this process could help researchers more fully understand the causes of disorders associated with excess fat, including obesity and insulin resistance.

“A potential benefit of figuring out this process is to see how we could manipulate certain parameters to arrest cells in this quiescent region, and that could have an effect on obesity,” said Huseyin Coskun, a visiting assistant professor in the Department of Mathematics at Ohio State and lead author of the study.

“Obesity is certainly related to the types and amounts of foods people consume. But how the body responds to this can differ from one person to another, and could be related to some abnormalities in these protein interactions. The amount consumed may not be the only reason behind obesity. With this study, we started to understand how protein levels and complex molecular interactions in the body may influence the development of fat cells.”

The research is published in a recent issue of the Journal of Theoretical Biology.

Coskun, a mathematician, began this project by reading hundreds of journal articles about the biology behind the transition of preadipocytes into adipocytes, or fat cells. He identified 16 proteins that appeared to be the most active in the process.

He and the research group, a team of math and biology experts, narrowed that number to three high-impact proteins as a starting point. Coskun then designed differential equations based on the biological model that would show how the pre-fat cells behaved under a variety of conditions, depending on the proteins’ activity.

The three proteins are NF-kB, PPAR-gamma and cyclin D. NF-kB initiates inflammation in tissue. PPAR-gamma must be present for adipogenesis, or the creation of fat cells, to occur. And cyclin D is responsible for cell proliferation, or copying and growth, in almost all cells, including pre-fat cells and fat cells.

“The three target proteins of this initial model are the most commonly studied, but their mutual relationships in relation to the creation of fat cells are still not well-known, so we are putting their roles together to see how they contribute to fat cell determination for the first time, as far as we know, in the literature,” Coskun said.

The mathematical equations in which these three protein levels were manipulated resulted in a model that helped define the conditions under which pre-fat cells would remain dormant, start copying themselves or turn into fat cells. Two-parameter bifurcation curves are used for interpretation of model outcomes, which itself is a novel approach in terms of mathematical terminology.

The main parameters driving this model were two substances that affect the target proteins: a protein called IkB, which inhibits the inflammatory NF-kB protein, and the concentration of a chemical stimulant, called a mitogen, that stimulates production of cyclin D.

According to the model, if the level of IkB is high and the level of the cyclin D stimulant is low, the pre-fat cells remain dormant. The model then shows what is called a “curve of uncertainty,” which predicts the circumstances that are required for preadipocytes to either remain dormant or proliferate in their current state. The region of uncertainty then determines the conditions for coexistence of a pair of these three states: differentiation and quiescence, or proliferation and differentiation.

The researchers also conducted preliminary experiments to test the model’s outcomes by exposing mouse cells to TNF-alpha, a mitogen that stimulates cyclin D. They found that the concentrations of the proteins in those cells generally behaved as the model suggested they would. In addition, previous research reports of similar experiments also support the model’s outcomes, Coskun said.

He noted that more experiments are needed to further test the model, which also could be expanded to add more proteins to the equations.

Co-authors on the study, all from Ohio State, included Taryn Summerfield of the Department of Obstetrics and Gynecology, Douglas Kniss of the departments of Obstetrics and Gynecology and Biomedical Engineering; and Avner Friedman of the Mathematical Biosciences Institute and the Department of Mathematics.

Source:
Huseyin Coskun
Ohio State University

The study was the work of senior author Dr Ruth Loos, group leader in Genetics in the MRC Epidemiology Unit at the Institute of Metabolic Science, based at Addenbrooke’s Hospital in Cambridge, and colleagues, and was published online on 31 August in the journal PLoS Medicine.

Among the factors driving the worldwide obesity epidemic are a shift in diet as we eat more energy-dense foods high in fat and sugar, particularly in more westernised societies, and a tendency to be less active as our lifestyles become more and more sedentary.

However, scientists believe genes also play a role in that people with such a predisposition who live in an environment with easy access to labour-saving devices and energy-dense foods tend to be more prone to obesity.

Loos and colleagues wrote that while previous genetic studies have shown that a number of genes increase susceptibility to obesity, this is the first to examine the effect of a physically lifestyle on such a predisposition.

So far, recent genome-wide association studies have found 12 DNA variants or “snips” (SNPs, short for single-nucleotide polymorphisms), that are linked to increased BMI.

BMI is short for body mass index, which equals a person’s weight in kilos divided by the square of their height in metres. A BMI of 25 to 29.9 is classed as overweight, and a BMI of 30 or more is classed as obese.

For their study, Loos and colleagues looked for these same 12 variants in the genomes of over 20,000 people aged 39 to 79 years who were taking part in the European Prospective Investigation of Cancer (EPIC)-Norfolk study.

They worked out a “genetic predisposition score” for each person depending on how many of the 12 SNPs they found in his or her genome.

As part of the EPIC study the participants had filled in questionnaires about their lifestyle and from their responses the researchers were able to calculate how physically active each participant was.

They then used statistical models to look at how the interaction between the genetic predisposition scores and physical activity linked to BMI and obesity risk, assuming an “additive effect” for each “snip” or DNA variant.

The results showed that each additional BMI-increasing snip was linked to a 0.154 increase in BMI (equivalent to 445g or 1 lb in body weight for a person who is 1.70m or 5 ft 7 in tall).

However, the link was much stronger in inactive people than in active people (0.205 vs 0.131 increase in BMI per snip respectively, translating to an equivalent of 592 g per snip and 379 g per snip respectively for a 1.70 m tall person).

A similar pattern was found in obesity risk: taking the population as a whole, each snip increased the odds of obesity by 1.116-fold, but in physically inactive people, each snip increased the odds of obesity by 1.158-fold, whereas in their physically active counterparts, each snip only increased the obesity risk by 1.095-fold, representing a 40% lower increase.

The researchers also confirmed these cross-sectional observations (ie data based on a “single snapshot” of participants’ lives) by looked at trends over time, and established that over an average follow up of 3.6 years, “physical activity modified the association between the genetic predisposition score and change in BMI”.

Loos and colleagues concluded that, basing the estimates on how many of the known 12 recently identified “snips” people carry, living a physically active lifestyle is linked to a 40 per cent reduction in the genetic predisposition to common obesity.

These findings suggest that while increased physical activity benefits everyone in terms of reducing obesity risk, it would seem that the genetically predisposed benefit even more, challenging a widely held popular view that if you have obesity-related genes then there is no point in doing exercise because you will become obese anyway.

“Physical Activity Attenuates the Genetic Predisposition to Obesity in 20,000 Men and Women from EPIC-Norfolk Prospective Population Study.”
Shengxu Li, Jing Hua Zhao, Jian’an Luan, Ulf Ekelund, Robert N. Luben, Kay-Tee Khaw, Nicholas J. Wareham, Ruth J. F. Loos.
PLoS Med 7(8): e1000332, Published online 31 August 2010.
DOI:10.1371/journal.pmed.1000332

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

A recent study conducted by the Departments of Psychiatry and Biomedical Engineering at the University of Cincinnati College of Medicine, examined the effects of stress on the meal patterns and food intake of animals exposed to the equivalent of everyday stress on humans. The results suggest that, not only does stress have an impact on us in the short term, it can cause metabolic changes in the longer term that contribute to obesity. The study was conducted by Susan J. Melhorn, Eric G. Krause, Karen A. Scott, Marie Mooney, Jeffrey D. Johnson, Stephen C. Woods and Randall R. Sakai at the University of Cincinnati College of Medicine, Cincinnati, OH. Their study was published in the American Journal of Physiology – Regulatory, Integrative and Comparative Physiology.

The Study

Previous studies have found that meal patterns (number, duration and size of meals) can affect metabolism. Studies of both humans and animals have shown that taking fewer and larger meals promotes the gain of fat mass and can increase triglycerides, lipids and cholesterol independent of total caloric intake. Conversely, weight gain–even while overeating–can be prevented by consuming smaller, more frequent meals. Whether social stress alters the microstructure of food intake, however, was unclear.

The current study used the visible burrow system (VBS), an animal model of chronic social stress, which has been shown to produce stress-associated behavioral, endocrine, physiological and neurochemical changes in animals. Long-Evans rats (90 days old) were individually housed for three weeks prior to the experiment. During this habituation time, they were briefly anesthetized and implanted with a unique subcutaneous microchip just behind their ears which allowed for identification and monitoring of feeding behavior. Meal pattern characteristics were measured for seven days during habituation. Data were calculated for each animal for each day and then averaged together to provide an overall habituation measure as a baseline for all of the conditions.

For the experiment, rats were formed into colonies, composed of four males and two females, and matched with a control group. Within a few days, all colonies formed a hierarchy which established the dominance of one male and the subordination of the other three males. Each colony had equal hours of light and darkness. Meal pattern characteristics were calculated for each animal on a daily basis. As documented by behavioral video analysis and microchip data, both subordinate and dominant rats reduced their initial food intake and body weight compared to the habituation period and as compared to the control group. After the hierarchy was stable, however, the dominant rats recovered their food intake relative to the control animals, while the subordinate rats continued to eat less by reducing their number of meals. Furthermore, although rats are nocturnal animals, the subordinate rats ate primarily during lighted periods, indicating a shift in circadian behavior.

The Result

After two weeks, the male rats were individually housed for a three-week recovery period and allowed to eat freely. Compared to the control group, both dominant and subordinate rats over-ate during the recovery period, but the dominant animals ate more frequently, while the subordinate animals ate larger meals, but less frequently. The dominant rats gained weight and lean mass, but only as comparable to the control group, while the subordinate rats gained significant fat in the visceral (belly) region. Throughout the recovery period, subordinate rats continued to overeat, eat longer meals and gain fat, suggesting long-term, deleterious metabolic changes.

Interestingly, the study results suggest that the signals controlling ingestive behavior become impaired or are overridden during social stress. Hypothalamic neuropeptide Y (NPY) is a well-known chemical messenger within the hypothalamus that stimulates food intake in times of negative energy balance, possibly by increasing meal size. In this case, NPY did not mediate the consumption patterns of the animals during the VBS period.

Conclusion

This is the first study of its kind to examine meal patterns in real-time during exposure to chronic social stress and during a subsequent recovery period, as well as to begin to evaluate the neuroendocrine and neurochemical underpinnings of the altered ingestive patterns observed. Stress and recovery induced changes in animals’ body weight and composition and the alterations in meal patterns observed may have contributed to these physiological changes.

Stress is experienced by animals and humans on a daily basis and many individuals experience cycles of stress and recovery throughout the day. If, following stress, we consume larger and less frequent meals, the conditions are favorable for weight gain–especially in the abdomen. We know that belly fat, as well as stress, contributes to the development of cardiovascular disease, immune dysfunction and other metabolic disorders. Further studies using the VBS model will help us understand the relationship between stress and obesity and help us treat and prevent the development of these diseases.

Source:
Donna Krupa
American Physiological Society

This sobering news underscores the need for National Childhood Obesity Awareness Month. Congress established the observance in a resolution passed unanimously earlier this year, seeking to “raise public awareness and mobilize the country to address childhood obesity.” A wide array of organizations have joined together as the National Council on Childhood Obesity Awareness Month, educating parents, policy makers and others about the problem and encouraging preventive action on childhood obesity.

Such advocacy is needed more than ever, in light of a study conducted by Daniel O’Connor, Ph.D., and Joseph Gugenheim, M.D. and presented in June at the 57th Annual Meeting of the American College of Sports Medicine. Researchers compared the measured height and weight of 1,430 children at an orthopedic clinic with the values their parents reported. “Parents tend to overestimate boys’ height and underestimate girls’ height,” said O’Connor, “and this error was larger when the reporting parent was the opposite sex of the child. Almost half of the parents underestimated their child’s weight, and errors in reporting weight tended to be larger for girls and increase with age.” Ethnicity played a role, with African-American and Hispanic parents making larger errors than Caucasian, non-Hispanic parents, and weight errors were larger in children who were overweight or obese.

According to O’Connor, “The most striking finding was that using the parent-reported values to compute BMI and obesity status, following [Centers for Disease Control] guidelines, resulted in about one in five obese children 21 percent being missed in the count and not identified as obese.”

Even without adjusting for underreporting, conventional estimates of childhood obesity are startling. During the past four decades, obesity rates have soared among all age groups, increasing more than fourfold among children ages six to 11. More than 23 million children and teenagers (31.8 percent) ages two to 19 are overweight or obese, a statistic which health and medical experts say constitute an epidemic.

The scope of the problem and its impact on health care costs and individual quality of life propelled Congress to take unanimous action. Congresswoman Marcia L. Fudge (D-OH) co-sponsored the House legislation with Congresswoman Kay Granger (R-TX). Rep. Fudge said, “Nothing can be more important than protecting the health and well-being of our children for years to come. I look forward to parents, health care providers, educators, civic leaders and organizations joining the effort to end childhood obesity.” Rep. Granger said, “Childhood Obesity Awareness Month supports the goals of families, schools, and communities who are working to ensure we raise a healthier generation. If we keep our kids healthy now it will alleviate a major burden on our health care system while giving millions of young people the opportunity to live longer, healthier lives.”

The National Council on Childhood Obesity Awareness Month encourages individuals and organizations to do whatever they can to build understanding of the causes and implications of childhood obesity and to earnestly seek solutions to stem the epidemic. While the focus now is on September as National Childhood Obesity Awareness Month, the effort must be sustained and widespread, according to organizers.

Source: American College of Sports Medicine

Behavior modification, including diet and exercise, has long been considered the standard of care in managing obesity. The benefit of adding specific pharmacotherapies to a rigorous BMOD program has not been extensively evaluated. COR-BMOD was designed to test this hypothesis by evaluating Contrave in a setting conducive to maximum weight loss in which patients used the medication as part of a broader weight-loss effort. Participants in both groups received diet and exercise counseling during 28 small group sessions with one or two professionals, each lasting 90 minutes, over the course of the year-long trial.

“There is no magic bullet for the treatment of obesity. For some patients, effective and sustainable treatment is going to require a multi-modal approach which may include a combination of behavior modification and pharmacotherapy,” said Thomas Wadden, Ph.D., lead investigator and Professor of Psychology in Psychiatry at the University of Pennsylvania School of Medicine and Director of the Center for Weight and Eating Disorders. “This study clearly demonstrates that when Contrave is added to a state of the art diet and exercise regimen, patients can achieve significant incremental weight loss.”

Results showed that the addition of Contrave to intensive behavior modification was also associated with statistically significant greater improvements in markers of cardiometabolic risk, including waist circumference, triglycerides, high density lipoprotein (HDL) cholesterol and fasting insulin. The most common adverse events included nausea, headache, constipation and dizziness. Observed adverse events were, in general, consistent with the other studies within the COR program and with the safety profile of the constituent components.

“Medication alone may not be the answer for the majority of obese patients, so it’s important that we understand the benefits of a multi-modal weight loss program,” said Michael Narachi, CEO of Orexigen. “The results from this study reinforce our belief that a weight management strategy, addressing both the biological and behavioral drivers of obesity, can be successful.”

Study Design

COR-BMOD was a 56-week placebo-controlled, double-blind, randomized trial that enrolled overweight and obese adults. A total of 793 patients were randomized to receive either Contrave32 + BMOD or placebo + BMOD in a 3:1 ratio. Nine sites in the United States participated in the study.

About Contrave

Contrave is an investigational combination therapy believed to address both physiological and behavioral drivers of obesity. The two components of this combination therapy act in a complementary manner in the central nervous system. The central pathways targeted by this treatment are involved in controlling the balance of food intake and metabolism, and regulating reward-based eating behavior. In clinical trials, Contrave was shown to help obese patients initiate and sustain significant weight loss, improve important markers of cardiometabolic risk and increase ability to control eating. The U.S. Food and Drug Administration (FDA) has tentatively scheduled a Division of Metabolic and Endocrine Drug Products Advisory Committee meeting on December 7, 2010 and the Prescription Drug User Fee Act (PDUFA) action date has been set for January 31, 2011.

About the Contrave Clinical Development Program

All four trials in the COR Phase 3 program (COR-I, COR-II, COR-BMOD and COR-Diabetes) were randomized, double-blind, placebo-controlled trials. The co-primary endpoints were the proportion of patients achieving at least 5% weight loss and percent change in body weight compared to placebo. Secondary endpoints included multiple measures of cardiometabolic risk, quality of life, control of eating, and glycemic control. Contrave was generally well tolerated. The safety and tolerability profile of Contrave in the clinical development program was consistent with the safety profile of the constituent components, which have been in use for other indications for over 20 years. The most frequent treatment-emergent adverse events in patients treated with Contrave were nausea, constipation, headache, vomiting and dizziness. Treatment with Contrave was not associated with increases in adverse event reports of depression or suicidal ideation compared to placebo. Mean blood pressure with Contrave was generally unchanged from baseline to endpoint. Placebo patients experienced decreases in blood pressure from baseline to endpoint of approximately 2mmHg. Greater weight loss correlated with greater reductions in blood pressure in both Contrave and placebo patients, suggesting that the expected relationship between weight loss and blood pressure was maintained. Importantly, normal circadian blood pressure patterns were preserved with Contrave. There was an increase in pulse of about one beat per minute in patients taking Contrave. Serious events were reported infrequently and included events of cholecystitis (Contrave 0.2%, PBO <0.1%), seizure (<0.1%, 0%) and major cardiovascular events (<0.1%, <0.1%).

Forward-Looking Statements

Orexigen cautions you that statements included in this press release that are not a description of historical facts are forward-looking statements. Words such as “believes,” “anticipates,” “plans,” “expects,” “indicates,” “will,” “intends,” “potential,” “suggests,” “assuming,” “designed” and similar expressions are intended to identify forward-looking statements. These statements are based on the Company’s current beliefs and expectations. These forward-looking statements include statements regarding the anticipated action date for the FDA to complete its review of the Contrave NDA, the potential for, and timing of, approval for Contrave and the Company’s belief that a weight management strategy, addressing both the biological and behavioral drivers of obesity, can be successful and may offer patients lasting success. The inclusion of forward-looking statements should not be regarded as a representation by Orexigen that any of its plans will be achieved. Actual results may differ from those set forth in this release due to the risk and uncertainties inherent in the Orexigen business, including, without limitation: the uncertainty of the FDA approval process and other regulatory requirements; the therapeutic and commercial value of Contrave; reliance on third parties to assist with the development of Contrave; the potential for adverse safety findings relating to Contrave; and other risks described in the Company’s filings with the Securities and Exchange Commission. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof, and Orexigen undertakes no obligation to revise or update this news release to reflect events or circumstances after the date hereof. Further information regarding these and other risks is included under the heading “Risk Factors” in the Company’s Quarterly Report on Form 10-Q, which was filed with the Securities Exchange Commission on May 10, 2010 and is available from the SEC’s website and on our website under the heading “Investor Relations”. All forward-looking statements are qualified in their entirety by this cautionary statement. This caution is made under the safe harbor provisions of Section 21E of the Private Securities Litigation Reform Act of 1995.

Source: Orexigen Therapeutics, Inc

View drug information on Naltrexone Hydrochloride Tablets.

In a pilot research study, University of Cincinnati (UC) researchers found that 21 percent of participants in a local dietary weight loss program reported significantly less pain in the lower extremities and back after losing an average of 10 pounds. Additionally, study participants reported a 20 to 30 percent reduction in overall bodily pain after weight loss.

Researchers say their results indicate that even small weight loss can relieve pain and reduce the burden excessive weight puts on the musculoskeletal system.

“By focusing on an immediate benefit that can be felt – like pain reduction – instead of the future health impact of obesity, weight loss programs may be able to inspire overweight individuals to lose weight,” says Susan Kotowski, PhD, study collaborator and director of the Gait and Movement Analysis Laboratory in the UC College of Allied Health Sciences.

Kotowski and colleague Kermit Davis, PhD, report their findings in the August 2010 issue of the journal Work.

According to the Centers for Disease Control and Prevention (CDC), 44 million Americans are considered clinically obese. Since 1975, the number of obese Americans has risen from 47 percent to 66.3 percent. Previous studies have estimated obesity-attributable medical expenditures in the United States at $75 billion, with half of these costs financed by Medicare or Medicaid.

“Obesity has become a national health crisis, but compliance for weight loss programs is notoriously poor. One potential reason for this is that current programs target long-term diseases, with little direct relevance to the person’s current health status,” adds Davis, senior author of the study and director of the Low Back Biomechanics and Workplace Stress Laboratory at the UC College of Medicine’s environmental health department. “Our study results challenge people to rethink the way they structure weight loss programs.”

For this pilot study, UC researchers partnered with a Cincinnati-based weight loss clinic to recruit study volunteers. Thirty two women between the ages of 22 and 76 participated in the study and data was collected over the course of a 12-week dietary weight loss regimen.

Researchers collected baseline individual weight and musculoskeletal pain data related to nine body regions: neck, shoulders, elbows, hands and wrists, upper back, lower back, hips, knees and lower legs and feet. Participants were then tracked each week to record any weight loss and asked to rate their pain on a scale of zero to 10 every other week.

Significant associations were found between weight loss and overall pain reduction, as well as pain reduction in the elbow, hip region and upper and lower back.

Researchers say these preliminary results could have ramifications for companies with a high prevalence of overweight workers with musculoskeletal problems – particularly in industries that require manual or repetitive weight-bearing labor.

“From an ergonomics perspective, we can only do so much to alter the work environment to remove body stressors,” explains Kotowski. “Excess weight adds additional stress to the musculoskeletal system and that can only be relieved through weight loss.”

Source:
Amanda Harper
University of Cincinnati Academic Health Center