Obesity Trends

GLP-1 weight loss drugs like Ozempic and Wegovy are popular with people who want to lose weight. However, there is another class of drugs that could have a similar effect.

Rutgers Health researchers have uncovered mixed outcomes for patients using lisdexamfetamine, a stimulant commonly prescribed for binge eating disorder (BED). 

The study, led by Abanoub Armanious, a master of science student at Rutgers School of Public Health, highlights the complexities of treating the most prevalent eating disorder in the United States, which affects individuals across all racial and ethnic groups.

Lisdexamfetamine, marketed as Vyvanse, initially received FDA approval for Attention Deficit Hyperactivity Disorder. Its subsequent approval for BED was based on its ability to reduce binge eating episodes, making it the sole FDA-approved medication for moderate to severe cases of the disorder in adults. 

However, the study, published in Psychiatry Research Communications, reveals that while some patients report reduced binge episodes and better appetite control, others experience significant side effects and inconsistent results.

"Binge eating disorder is characterized by recurrent episodes of excessive eating accompanied by a loss of control, often coexisting with depression, anxiety, and obesity-related health issues like Type 2 diabetes," Morgan James, assistant professor of psychiatry and senior author of the study, said in a press release. 

Despite clinical trials affirming lisdexamfetamine's effectiveness in some cases, the study emphasizes the lack of patient-centered qualitative data on its use.

Side effects may limit effectiveness

The research involved a thematic analysis of 111 anonymous reviews from self-identified BED patients on Drugs.com. It explored the relationship between patients' perceptions of lisdexamfetamine and their ratings of its efficacy. Findings indicated that higher perceived efficacy was linked to improved focus and fewer side effects, while lower ratings were associated with concerns about diminishing therapeutic effects, insomnia, and afternoon energy loss.

Key challenges identified include the timing of the drug's effects, which often wear off by evening, leaving patients vulnerable to nighttime binge episodes. Additionally, the "crash" as the medication wears off can result in fatigue and irritability. Some patients attempted to adjust their dosage timing to align with their binge hours, but this often led to insomnia and other sleep disturbances.

The study calls for a more nuanced understanding of lisdexamfetamine's effects on BED patients, emphasizing the necessity for targeted treatment options to address this significant challenge in mental health care.

Obesity has been an ongoing struggle for many consumers, and for years, body mass index (BMI) has been the key metric health professionals have used to determine overweight and obesity. 

Now, the Lancet Diabetes & Endocrinology Commission, which includes health experts from 75 global organizations, is calling for a new method of defining and diagnosing obesity that goes beyond just BMI. 

The commission has created a new definition of obesity and new guidelines for diagnosing obesity. The goal is for consumers to better understand their overall health risks and receive the proper care they need. 

“The commission’s report is a major step forward in recognizing obesity as a disease and not merely a risk factor. It also helps clinicians identify individuals who are in need of treatment,” Dr. Robert Kushner, a member of the commission, said in a news release. 

What’s new? 

The researchers explained that relying on BMI alone doesn’t give health care professionals a full picture of consumers’ health. Instead, they suggest doing the following: 

• Getting at least one measurement of body size – waist circumference, waist-to-hip ratio, or waist-to-height ratio – in addition to BMI 

• Getting at least two measurements of body size – waist circumference, waist-to-hip ratio, or waist-to-height ratio – regardless of BMI 

• Getting direct body fat measurements – bone densitometry scan or DEXA – regardless of BMI 

“Relying on BMI alone to diagnose obesity is problematic as some people tend to store excess fat at the waist or in and around their organs, such as the liver, the heart or the muscles, and this is associated with a higher health risk compared to when excess fat is stored just beneath the skin in the arms, legs or in other body areas,” Commissioner Professor Robert Eckel said in a news release. 

“But people with excess body fat do not always have a BMI that indicates they are living with obesity, meaning their health problems can go unnoticed. Additionally, some people have a high BMI and high body fat but maintain normal organ and body functions, with no signs or symptoms of ongoing illness.” 

Pre-clinical obesity and clinical obesity

In addition to these new guidelines, the Commission is recommending two new obesity-related diagnostic categories – pre-clinical obesity and clinical obesity. 

In their report, they define clinical obesity as a standalone illness that’s characterized by both reduced organ function or a reduced ability to engage in regular daily activities. On the other hand, pre-clinical obesity is the early stages of the disease when it remains a risk factor, but all other health markers are in normal range. 

“This nuanced approach to obesity will enable evidence-based and personalized approaches to prevention, management, and treatment in adults and children living with obesity, allowing them to receive more appropriate care, proportional to their needs. 

“This will also save health care resources by reducing the rate of overdiagnosis and unnecessary treatment,” said Commissioner Professor Louise Baur. 

As more and more consumers utilize Ozempic and related drugs to help them lose weight, many may be skeptical or concerned about the potential side effects. 

A recent study conducted by researchers at the University of Alberta, McMaster University, and the Pennington Biomedical Research Center are uncovering another potential side effect of the weight loss drug – loss of muscle mass. 

According to the researchers, any significant weight loss can have this effect on the muscles. However, it’s an important thing for consumers to keep in mind as they embark on their health and wellness journeys. 

“We have to be mindful of the side effects that we are seeing with the new weight loss medications, such as a person eating less while on the medications and not getting the appropriate amount of dietary vitamins and minerals,” said researcher Dr. Steven Heymsfield. 

“Also, when a person loses weight, they are not only losing fat, they also lose muscle. We are looking at how that muscle loss can be better managed with consumption of an adequate amount of protein along with an optimum amount of exercise.” 

Rapid weight loss could lead to rapid loss of muscle mass

In this study, the researchers looked at earlier work that analyzed the effect of weight loss from Ozempic and other similar drugs and the loss of muscle mass. 

The team explained that the loss of muscle mass is measured in fat-free mass. When patients take Ozempic or other similar weight loss drugs, their fat-free mass can range anywhere between 25-39% of total weight lost over 32-76 weeks. 

Comparatively, when consumers lose weight without the assistance of drugs like Ozempic, the loss of muscle mass isn’t as significant. The loss of muscle mass in these cases typically ranges from 10-30%. 

Additionally, the researchers learned that the muscle mass lost from using Ozempic over long periods of time is greater than typical age-related muscle mass loss that happens naturally as consumers get older. 

Risks of muscle mass loss

While the researchers explain that this loss of muscle mass is likely the result of the speed with which consumers have lost a significant amount of weight, and not the drug itself, it’s still an important component of overall health and wellness. 

Some of the health risks of muscle mass loss include: 

• More frequent falls

• Loss of mobility, strength, flexibility

• Heart health risks

• Life expectancy

• Higher risk of infection

• Poorer insulin resistance

“Dismissing the importance of muscle loss can create a disconnect between patients' increased awareness of muscle and the role it plays in health, and clinicians who downplay these concerns, affecting adherence to and the development of optimized treatment plans,” the researchers wrote.

While many consumers have hopped on the Ozempic bandwagon in recent months to help them lose weight, few studies have looked at viable treatment options for children struggling with their weight. 

Now, a new study, known as the SCALE Kids trial, has put the obesity drug, liraglutide, to the test in kids as young as 6 years old. 

Ultimately, the medication was found to be both safe and effective for children between the ages of 6 and 12. 

“Obesity is the most common chronic disease of childhood,” said lead researcher Professor Claudia Fox. “Left untreated, obesity in childhood almost universally persists into adulthood and is associated with significant ill health, including diabetes and cardiovascular disease, and for some, premature death. 

“However, effective treatment options to date are limited,” she said. “The backbone of obesity treatment is lifestyle therapy – changes in diet and physical activity – but when used alone, the effect is modest and, as yet, no medication is approved for the treatment of general obesity in children who are younger than 12. 

“Liraglutide is approved as an adjunct to lifestyle therapy in adults and adolescents with obesity and, in this study, we explored its safety and efficacy in under-12s,” Fox explained. 

A look into the study

The researchers had 82 children involved in the study, all of who were struggling with obesity at the start of the study. In addition to guidance on healthy habits, the kids were divided into two groups – one group of 56 kids received weekly injections of liraglutide, while the remaining 26 kids received a placebo, for 56 weeks. 

At the end of the study, the researchers found that liraglutide was effective at lowering kids’ body mass index (BMI). While weight loss was harder to track, as kids are always growing and changing, the findings point towards overall efficacy in getting kids healthier.  

BMI went down by 5.8% in the children taking liraglutide, while children in the placebo group saw an increase of 1.6% in their BMI. The study also found that over 46% of kids taking liraglutide saw at least a 5% reduction in their BMI, while 8.7% of children on the placebo drug had the same. 

Also of note, the children taking the liraglutide experienced improvements in their blood pressure and blood sugar control – two important markers of metabolic health. 

“Although there is no consensus on the definition of a clinically meaningful BMI reduction in children, a 5% reduction has previously been shown to be associated with improvement in some obesity-related health conditions,” Professor Fox said. 

When the study concluded and the children stopped taking the drug, they experienced increases in weight and BMI. 

Is it safe? 

The majority of children in both groups experienced side effects from the drug, but the researchers believe that the positives outweigh the potential negatives. 

Around 80% of children taking liraglutide and nearly 54% of children taking the placebo experienced gastrointestinal side effects. Ultimately, 10.7% of the kids taking the drug discontinued treatment because of the side effects, which is aligned with the rate of serious side effects in teens and adults. 

“The results of this study offer considerable promise to children living with obesity,” Professor Fox said. “Now with the possibility of a medication that addresses the underlying physiology of obesity, there is hope that children living with obesity can live healthier, more productive lives.”

A new study conducted by researchers from Monash University explored how childhood obesity may impact consumers’ cognitive function as they go into midlife.

After following study participants for three decades, they learned that kids with the strongest physical fitness were likely to become middle-aged adults with the strongest cognitive function. However, they found that the inverse was also true.

“Clusters of low fitness and high obesity in childhood are associated with poorer health outcomes in later life, however their relationship with cognition is unknown,” the researchers wrote. “Identifying such profiles may inform strategies to reduce risk of cognitive decline.” 

Childhood habits can affect long-term health

For the study, the researchers followed over 1,200 participants for 30 years; all of the participants were between the ages of seven and 15 in 1985, and the team tracked their health outcomes through 2019. The children were enrolled in the Australian Childhood Determinants of Adult Health Study, and the team analyzed their waist-to-hip ratio, muscular power, cardiorespiratory fitness, and muscular endurance; the participants also completed cognitive assessments in the final two years of the study. 

The researchers learned that kids with the strongest cardiorespiratory fitness were likely to become adults with the strongest cognitive function. On the other hand, those with the weakest fitness levels during childhood didn’t perform as well on the cognitive assessments in middle age. 

The study showed that better muscular fitness, cardiorespiratory fitness, and a lower waist-to-hip ratio during childhood were linked with improvements in three key areas in middle age: overall cognitive function, processing speed, and attention. 

The researchers explained that these findings are important because they show that habits that are learned during childhood can affect consumers into middle age and beyond. The team said it’s important to identify what factors can influence physical and cognitive health throughout life. 

“Developing strategies that improve low fitness and decrease obesity levels in childhood are important because it could contribute to improvements in cognitive performance in midlife,” said researcher Michele Callisaya. “Importantly, the study also indicates that protective strategies against future cognitive decline may need to start as far back as early childhood, so that the brain can develop sufficient reserve against developing conditions such as dementia in older life.” 

A new study conducted by researchers from Edith Cowan University explored how lifting weights may benefit consumers with obesity who are trying to lose weight. 

One premise of the research is that aerobic exercise may not be possible for everyone. For consumers who are unable to run, jog, or perform other aerobic activities, the researchers say resistance training can be an effective way to become healthier and reach weight loss goals.

“Usually when we talk about obesity, body composition, or weight loss, we only hear about aerobic exercise,” said researcher Pedro Lopez. “This paper shows we can use resistance training and achieve meaningful effects with a diet based on caloric reduction. We can reduce body fat percentage, whole-fat body mass, body weight, and BMI. If you’re comparing the literature, these effects are similar to aerobic exercise with caloric restriction in adults who are overweight or obese.” 

Resistance training has health benefits

For the study, the researchers analyzed data from over 4,100 participants who were part of nearly 120 studies through December 2020. The different studies looked at the ways aerobic exercise, resistance training, and diet all affected health outcomes for those with obesity. 

Ultimately, the researchers learned that weight lifting was effective for those with obesity who were trying to lose weight. Participants had the greatest weight loss outcomes when they were able to cut back on their calories and follow a resistance training program. The team also observed the greatest improvements in body fat percentage and whole body fat mass for these participants. 

When the participants combined both aerobic exercise and resistance training, they were also more likely to have better weight loss outcomes. For those who aren’t able to perform aerobic exercises, or would prefer to have options when it comes to their physical activity, these findings show that resistance training can be a successful option. 

The researchers also learned that following a resistance training routine helped the participants improve their lean muscle mass, which can be difficult – especially when cutting back on calorie intake. The team explained that diet is an incredibly important piece of the weight loss process. 

“If you want to lose weight, you have to reduce your calorie intake,” Lopez said.