Weight Loss Blog

The first potential new prescription weight-loss pill in more than a decade works, according to FDA staff who also flagged safety concerns that Wall Street deemed benign enough to bet the drug will ultimately hit pharmacy shelves.

The review from U.S. Food and Drug Administration staff on Tuesday, contained in documents released ahead of an FDA advisory panel meeting later this week, sent drugmaker Vivus’ shares up as much as 19.7 percent.

“The topics the FDA raised are in line with what we expected,” Leerink Swann analyst Steve Yoo told Reuters. He said “the likelihood of a positive panel vote has increased, which in turn increases the likelihood of approval.”

The potential market for Vivus’ experimental Qnexa is huge. More than two-thirds of American adults are overweight or obese (http://link.reuters.com/vup37m) and other attempts at diet drugs have fizzled.

If Qnexa wins the FDA’s seal of approval, analysts estimate it could take in nearly $689 million in sales by 2014, according to consensus forecast data from Thomson Reuters. The biotech’s current market cap is $931.5 million.

Current prescription and over-the-counter weight-loss drugs took in just $381.5 million in 2009, according to IMS Health.

Vivus wants to market Qnexa for adults to use along with diet and exercise. FDA staff reviewers said Qnexa clearly helped people shed pounds but pointed to possible side-effect issues, such as the impact on heart rate, depression and pregnancy.

On Thursday, an FDA panel of outside experts will discuss the safety issues and offer advice on whether to approve Qnexa. The agency will then make the final approval decision, which Vivus expects by October 28.

FDA usually, but not always, follows the advice of its expert panelists.

Whether the FDA ultimately approves the once-a-day pill could signal how the agency plans to assess the latest crop of obesity medicines after years of failed attempts and safety woes.

The FDA decision is also a clear test of the nearly 20-year-old biotech, which has seen its stock surge ahead of what could be a major product for the company since its only other U.S. drug was approved in 1996. Rivals are also eyeing the impact of Vivus’ review on their own pending diet drugs.

Anticipation has boosted shares of the Mountain View, California-based company. It has seen its shares more than double in the past year. Shortly before the close of trading on Tuesday, Vivus stock was up $1.88 or 17.7 percent at $12.53 on the Nasdaq, off an earlier high at $12.75.

It is unclear how much further the company’s shares could rise or where they could settle after the panel votes on Thursday. Analyst estimates for fair value ranged from $9 to $20.

JPMorgan analysts, echoing others, said the FDA staff’s assessment was “far more benign than most were expecting” and therefore was likely to boost Vivus shares.

ADJUSTING NOTORIOUS ‘FEN-PHEN’

Vivus is trying to improve on the notorious “fen-phen” diet drug by combining one of its ingredients — the appetite suppressant phentermine — with the anti-seizure drug topiramate. Fen-phen’s other ingredient, fenfluramine, was pulled from the market after being linked to serious heart valve problems.

All three doses of Qnexa were “efficacious for weight loss,” FDA staff reviewers said. But they added that there are five areas of safety concerns, including the effect on pregnant women and psychiatric side effects such as depression.

Attention span, memory and language problems as well as increased heart rate in Qnexa patients are also potential safety issues, the staff said in documents posted on the FDA’s website (http://r.reuters.com/fuf37m). The potential for increased body acids was also a concern.

Analysts said they were not especially surprised or concerned about the safety issues. JPMorgan analysts downplayed the slight increase in heart rate, given the drug’s “significant improvements” of other related cardiovascular measures such as blood pressure.

But Favus Institutional Research LLC analyst Elliot Favus said the FDA’s documents were “just a laundry list of safety concerns,” adding that approval seemed unlikely.

FDA and its advisers’ action of Vivus’ drug could also signal what lies ahead for Arena Pharmaceuticals and Orexigen Therapeutics, two other obesity pill makers that have rival products up for U.S. review later this year.

Arena shares were up 11 percent, while Orexigen were up about 20 percent.

Currently available prescription diet pills include Abbott Laboratories’ Meridia, which carries warnings about high blood pressure and a risk of heart attack and stroke in some patients, and Roche Holding AG’s Xenical, which causes liver problems, uncontrolled bowel movements and gas.

Vivus’ ability to make its case to the FDA and its advisers is also a significant hurdle for the biotechnology company and its chief executive officer, Leland Wilson.

Qnexa would be the second U.S. drug for the company. Its erectile dysfunction suppository Muse won clearance in 1996 and took in $15.8 million in net U.S. revenue in 2009.

Vivus is working on another ED drug known generically as avanafil as well as other potential products for diabetes and sleep apnea.

Can Qnexa Be the Next Big Diet Pill?

Two Old Drugs Make One New Diet Pill - New Combination Pill for Weight Loss Shows Promise

Patients taking a novel diet drug that combines the stimulant phentermine with the anticonvulsant topiramate lost an average of 37 pounds over a year with significant improvement in a number of heart risk factors, according to an announcement Vivus, the developer of the drug.

In a trial known as EQUIP, which involved more than 1,200 morbidly obese patients, patients who received the drug, which has the brand name Qnexa, lost weight at every tested dose, but significant weight loss — 14.7 percent on average — occurred at the highest dose.

Results from a second trial involving 2,487 overweight and obese patients with hypertension, hyperlipidemia, or type 2 diabetes, known as CONQUER, showed an average weight loss 30 pounds with full dose of the drug combination.
Read the rest of this entry »

Patients who’ve lost weight after bariatric surgery breathe easier and take 50 percent fewer prescription breathing medications, a new study finds.

Researchers reviewed the medical records of 320 patients for one year before and after they had bariatric surgery at Henry Ford Hospital in Detroit. The patients filled a total of 324 prescriptions for breathing medications in the year before surgery, and 154 prescriptions in the year after surgery.

“Not only do patients breathe easier, less money is spent on prescription health-care costs,” study author Dr. Naveen Sikka said in a news release. “Better quality of life, possible reduction of chronic breathing problems, including asthma, and lower health-care costs significantly benefit patients and help to reduce the national health-care crisis.”

“Some obese patients develop asthma, while others are treated for breathing problems with medications typically used for asthma. The results of this study bring us closer to determining if weight loss can improve asthma long-term,” Dr. Andrew Weinstein, vice chair of the Asthma and Respiratory Disease Committee of the American College of Allergy, Asthma & Immunology, said in the news release.

Having Surgery to Help With Weight Loss

Six years ago, St. Alexius Medical Center and Mid Dakota Clinic teamed up to design the PrimeCare Surgical Weight Loss Program. Since it was founded, the program`s two surgeons have now performed 1,000 weight loss surgeries.

When discussing the option of weight loss surgery, doctors first look at the patient`s body mass index, or BMI. It`s a number calculated by their height and weight. Candidates for surgery have a BMI greater than 40, or greater than 35 if they have another medical condition associated with their weight.

Hope White Bear loves to walk. But it didn`t always come easily. Before gastric bypass surgery last month, White Bear struggled to walk up stairs, and circled store parking lots to find the closest space.

“Because I have osteoarthritis in both knees, it really limited my mobility of walking, being able to walk long distances, short distances, without it hurting,” said White Bear. “Right there is where it stopped me from living.”
Read the rest of this entry »

OBESITY surgery is soaring in popularity, but figures show for the first time that the benefits of the procedure for the average patient fall far short of the costs, making simpler alternative treatments better value for money.

A quarter of Australians over 18 were estimated to be obese in 2007-08, an 8.4 percentage point increase on three years earlier. Demand for obesity surgery is rising even faster.

But figures to be released today show that while it costs $10,935 to give one patient gastric banding surgery — by far the most common anti-obesity operation — the procedure saves only $7567 over the patient’s remaining lifetime on average, costing the system $3366 overall.

The analysis, commissioned by Medibank Private, found better value in drug treatments for obesity, which cost $1566 for a benefit of $2174 per patient over their remaining life.

Best of all were lifestyle programs teaching patients how to eat and exercise better.

Despite their lower success rate — 11 per cent for lifestyle programs, compared with 8 per cent for drugs and 28 per cent for surgery — their much lower cost meant they were the most cost-effective, achieving a benefit of $2846 for a cost of just $1081.

The research, carried out by consultancy firm KPMG Econtech, found the only patients for whom obesity surgery might be cost-effective were the most severely obese.

Like other funds, Medibank Private is experiencing soaring claims for obesity surgery.

The number of its members claiming for gastric banding or gastric bypass surgery has nearly doubled in just two years, from 1752 in 2006-07 to 3484 in 2008-09.

Over the same period, benefits paid out by Medibank for obesity surgery also soared, trebling from $9.46 million in 2004-05 to $30.2m in 2008-09.

Julie Andrews, Medibank’s executive general manager, health management, said the growth in obesity and bariatric surgery was “alarming”.

Health fund NIB recently announced it was cutting entitlements for obesity surgery from two of its products, but a Medibank spokesman said his fund had no intention of following suit.

Federal Health Minister Nicola Roxon said it was “clear that we have a problem in this country with overweight and obesity”.

“One of the most important initiatives that we are trying to put in place is Australia’s first dedicated Preventative Health Agency,” Ms Roxon said.

Drastic obesity measure - surgery for overweight teens

A leading children’s doctor has called for public hospitals to perform bariatric surgery on morbidly overweight adolescents to tackle the obesity epidemic.

The Children’s Hospital at Westmead’s sleep physician Associate Professor Dominic Fitzgerald said the surgery should be offered to teens who had tried and failed other medical therapies.

Doctors are already finalising guidelines on making such surgery available to obese teenagers, with their findings to be presented to the State Government later this year.

Would you let your child undergo the surgery? Tell us below

“(Obesity) has become such a crisis that governments are struggling to develop a comprehensive strategy to deal with the problem across the age spectrum,” Professor Fitzgerald wrote in the Medical Observer journal.
Read the rest of this entry »

Having two obese parents may substantially raise a child’s risk of becoming obese, with mom’s weight playing a particularly important role, a new study suggests.

UK researchers found that among more than 7,000 2- to 15-year-olds in a national study, those who had two obese parents were 12 times more likely to be obese than children with two normal-weight parents. That was with factors such as socioeconomics — gauged by parents’ jobs — and ethnicity taken into account.

Mothers’ weight showed a particularly strong association with children’s weight, the study found.

The findings, published in the American Journal of Clinical Nutrition, are not the first to connect parents’ obesity to their kids’ risk, or to highlight the role of mothers’ weight. What’s different is that the researchers had measurements of parents’ weight and height, and did not have to rely on self-reports.

“The main contribution is that we had objective measures, and that allowed us to be confident that the mother-child association is stronger than the father-child association,” senior researcher Dr. Jane Wardle, a professor of clinical psychology at University College London, told Reuters Health by email.

The results are based on data from 4,432 UK families who took part in an annual national health survey between 2001 and 2006. A study nurse measured each participant’s weight and height, and parents and children were classified as normal-weight, overweight, obese or severely obese based on their body mass index — a measure of weight in relation to height.

In 38 percent of the families, at least one parent was obese, while 8 percent had two obese parents. Only 14 percent of families were headed by two normal-weight parents.

Child obesity was uncommon in families with two normal-weight parents, at roughly 2 percent. But in families with two obese parents, 22 percent of kids were also obese; when both parents were severely obese, 35 percent of children were obese.

Paternal and maternal weight were each connected to children’s risk of being obese. Among children with an obese father, 12 percent were obese themselves, versus 4 percent of those with normal-weight fathers. Of children with an obese mother, 14 percent were obese, compared with 3 percent of kids with a normal-weight mother.

When the researchers did a statistical analysis controlling for the other parent’s weight, they found that mothers’ weight showed a statistically stronger association with children’s weight than did fathers’.

The reasons for that finding are not certain, according to Wardle. However, she said, mothers may be relatively more important because their weight and diet during pregnancy affect fetal development — and may, research suggests, help set a child’s future appetite regulation and weight.

Mothers’ weight may also be a bigger factor than fathers’ because moms are typically the ones who take charge of the children’s diets, Wardle and her colleagues note.

“Given that rates of severe obesity are rising rapidly in many countries,” Wardle and her colleagues write, “effects on childhood obesity are likely to be dramatic.”

They say their findings highlight the importance of intervening early to prevent the “intergenerational transmission” of obesity.

Parents who are obese, Wardle said, should be aware of their children’s increased risk and try to encourage healthy eating and regular exercise. That, she noted, includes improving their own lifestyle habits so they can serve as a role model for their kids.

Parents’ actions can rub off on impressionable children, and apparently, so can their weight. According to new research, having two obese parents may significantly raise a child’s risk of becoming obese, with mother’s weight playing a particularly important role.

During the study, published in the American Journal of Clinical Nutrition, researchers evaluated more than 4,400 families in the U.K. who took part in the annual national health survey between 2001 and 2006. After being measured for weight and height, parents and children were classified as normal-weight, overweight, obese or severely obese based on their body mass index – the measure of weight in relation to height.
Read the rest of this entry »

A variant of an obesity gene carried by more than a third of the U.S. population also reduces brain volume, raising carriers’ risk of Alzheimer’s disease, U.S. researchers said on Monday.

People with a specific variant of the fat mass and obesity gene, or FTO gene, have brain deficits that could make them more vulnerable to the mind-robbing disease.

“The basic result is that this very prevalent gene not only adds an inch to your waistline, but makes your brain look 16 years older,” said Paul Thompson, a professor of neurology at the University of California Los Angeles, who worked on the study published in Proceedings of the National Academy of Sciences.

Brains generally shrink with age.

The study compared brain scans of more than 200 people and found consistently less tissue in the brains of people who carry the “bad” version of the FTO gene compared to non-carriers.

On average, people with the obesity variant of the FTO gene had 8 percent less tissue in their frontal lobes — sometimes referred to as the brain’s “command center.” They also had 12 percent less tissue in their occipital lobes, which is the part of the brain that processes vision and other perceptions.

Thompson said reduced brain volume raises a person’s risk for Alzheimer’s disease by reducing the amount of brain reserve a person has to compensate if the brain plaques linked to Alzheimer’s form. Stroke can also reduce brain tissue, depleting the brain’s reserve.

DIET AND EXERCISE

The added brain risk means it is more important for people who carry the FTO gene to eat a low-fat diet and exercise regularly, he said.

A 2008 study of Amish people who had the FTO risk gene but were physically active found they weighed about the same as non-carriers, suggesting that physical activity can overcome a genetic predisposition to obesity.

People with two copies of the FTO gene variant on average weigh nearly 7 pounds (3 kg) more and are about 70 percent more likely to be obese than those who do not have the gene.

“In all the maelstrom of activities you do, exercise and a low-fat diet are genuinely saving your brain from both stroke and Alzheimer’s,” Thompson said.

For the study, Thompson’s team compared magnetic resonance images taken of the brains of 206 healthy people between age 55 and 90 at 58 centers. The centers were taking part in the five-year Alzheimer’s Disease Neuroimaging Initiative, which is examining the factors that help aging brains resist disease.

Because so many people carry the obesity version of the FTO gene, Thompson said the findings may drive research into new drug compounds to alter the effects on the brain.

Short of that, he said the findings should lead carriers to eat less and exercise more.

There is no cure for Alzheimer’s disease, the most common form of dementia affecting 26 million people globally.

Current treatments help with some symptoms, but cannot reverse the course of the disease, leading many scientific teams to look for ways to prevent it.

Obesity gene can shrink the brain

The obesity gene, which is carried by over half of all people in the US with European ancestry, is also associated with a loss of brain tissue, say researchers.

The discovery by senior study author Paul Thompson, a UCLA professor of neurology, and his team puts more than a third of the U.S. population at risk for a variety of diseases, such as Alzheimer’s.

Three years ago, geneticists reported that nearly half of all people in the U.S. with European ancestry carry a variant of the fat mass and obesity associated (FTO) gene, which causes them to gain weight - from three to seven pounds, on average - but worse, puts them at risk for obesity.

Using magnetic resonance imaging, the researchers generated three-dimensional “maps” of brain volume differences in 206 healthy elderly subjects drawn from 58 sites in the U.S. as part of the Alzheimer’s Disease Neuroimaging Initiative- a large, five-year study aimed at better understanding factors that help the brain resist disease as it ages.

They found that there was consistently less tissue in the brains of those who carry the FTO allele, compared with non-carriers.
Read the rest of this entry »

Obese pregnant women are at increased risk of having a baby with a congenital heart defect, a new study finds.

On average, obesity is associated with a 15 percent increased risk of having a baby with a heart defect. But the risk rises with the level of obesity. Compared to normal-weight women, the risk is 11 percent higher in moderately obese women and 33 percent higher in morbidly obese women.

In general, women who were overweight but not obese had no increased risk, said the researchers at the U.S. National Institute of Child Health and Human Development (NICHD) and the New York State Department of Health.

“The trend is unmistakable: the more obese a woman is, the more likely she is to have had a child with a heart defect,” study first author Dr. James L. Mills, of the NICHD’s Division of Epidemiology, Statistics and Prevention Research, said in a news release.

The study was published online April 7 in the American Journal of Clinical Nutrition.

“The current findings strongly suggest that by losing weight before they become pregnant, obese women may reduce the chances that their infants will be born with heart defects,” Dr. Alan E. Guttmacher, acting director of the NICHD, said in the news release.

For this study, researchers compared the records of mothers of 7,392 children born with major heart defects and more than 56,000 mothers of infants born without birth defects. Because the study looked at the records of infants after they were born, it doesn’t conclusively prove that obese women who lose weight before becoming pregnant will reduce their risk of having a baby with a heart defect, the researchers noted.

However, “if a woman is obese, it makes sense for her to try to lose weight before becoming pregnant,” Mills said. “Not only will weight loss improve her own health and that of her infant, it is likely to have the added benefit of reducing the infant’s risk for heart defects.”

Warning over obesity in pregnancy

Medical experts call for all mothers-to-be to be weighed regularly throughout their pregnancies due to health fears

All mothers-to-be should be weighed regularly during pregnancy to help combat the many dangers to women’s and babies’ health from maternal obesity, a group of medical experts is urging.

The National Obesity Forum (NOF) – an influential group of doctors and nurses specialising in weight problems – wants ministers to introduce the change because excessive weight gain among expectant mothers is becoming such a serious problem.

“A pregnant woman should have her weight monitored regularly during pregnancy at all antenatal appointments with midwives, GPs and obstetricians, because every risk of pregnancy, both to the mother and to the baby, is increased with maternal obesity,” Dr David Haslam, the NOF’s chairman, told the Observer.

“Obesity in pregnant women can lead to all sorts of problems, including the death of the mother, or the death of the baby through stillbirth or the baby having foetal abnormalities, or the woman suffering pre-eclampsia or gestational diabetes, or needing a Caesarean section because either she or the baby is too big,” he added.
Read the rest of this entry »

A too-fast heartbeat in early adulthood is a warning sign for increased risk of cardiovascular problems decades later on, a Japanese study suggests.

The study of 614 residents of a rural farming community in southwestern Japan found that a heart rate greater than 80 beats a minute during a first examination in 1979 predicted the development of obesity and diabetes, which contribute to heart problems.

The findings, from Kurume University School of Medicine, were published online Dec. 11 in the American Journal of Hypertension.

A fast heart rate is a signal from the sympathetic nervous system, a part of the autonomic nervous system, which is the body’s automatic pilot that governs instinctive responses, explained Mercedes Carnethon, assistant professor of preventive medicine at Northwestern University’s Feinberg School of Medicine. She found the same rapid heartbeat association in a group of Americans she studied.

“If someone has a consistently fast heart rate, it is because of increased input from the sympathetic part of the nervous system because the body is preparing to respond to stress,” Carnethon said. “There is an increase in levels of blood glucose — essentially because the body is storing energy to prepare for fight or flight, so that predisposes to diabetes.”

Carnethon’s study followed Chicago residents even longer than the Japanese researchers. “Over a 33-year follow-up, we showed that people with a higher heart rate were more likely to have Medicare claims for diabetes-related conditions,” she said.

There’s a possible clinical use for the findings, Carnethon said, since doctors routinely listen to the heart rate.

“It is a very simple measure, regularly taken in clinical practice, that could be potentially useful because it suggests where there might be a higher incidence of heart risk and mortality,” she said. “It is a first stage to alert the clinician that there might be something worth investigating.”

The similar findings in the two studies half a world apart are noteworthy, Carnethon said. “We are always happy to see findings replicated by different investigators in different settings,” she said.

Meanwhile, researchers are reporting a different built-in mechanism that protects a lucky few individuals from heart disease — a genetic mutation that seems to reduce blood levels of the fats called triglycerides.

The mutation was found in members of the Old Order Amish community in Pennsylvania, said the lead investigator, Toni I. Pollin, an assistant professor of medicine at the University of Maryland School of Medicine.

Pollin and her colleagues looked through the complete genetic complement of more than 800 members of the Amish community. “We looked at genes involved in the response to dietary fat,” she said. “One region came up strong on chromosome 11. This genetic marker was not too far from a cluster of genes involved in lipid metabolism.”

The researchers closed in on one gene, designated APOC-3, according to a report in the Dec. 12 issue of the journal Science. That gene makes a protein that inhibits the breakdown of triglycerides. About 5 percent of the Amish in the study had a mutated form of the gene that limited production of the protein, and so they had low blood lipid levels.

“It is an apparent cardioprotective mechanism,” Pollin said. “It raises the hope that by decreasing production of APOC-3 it could potentially be therapeutic.”

It’s possible that a drug designed to target the gene could be used to reduce levels of blood fats and thus reduce coronary risk, Pollin said.

The mutation has not been found outside the Amish community, Pollin said. “We have looked at 200 healthy individuals and have not found it, she said.

High heart rates linked to obesity, diabetes

High resting heart rates may be linked to the development of obesity and diabetes, a Japanese study shows.
Read the rest of this entry »

Researchers have identified at least six new gene mutations linked to obesity and said on Sunday they point to ways the brain and nervous system control eating and metabolism.

Joel Hirschhorn at Children’s Hospital and Harvard Medical School in Boston led a team called Genetic Investigation of Anthropometric Traits or GIANT to screen 15 different studies of the entire human genetic map and pinpoint the six new genetic variations.

“Today’s findings are a major step forward in understanding how the human body regulates weight,” Dr. Alan Guttmacher, Acting director of the National Human Genome Research Institute, said in a statement.

“This study essentially doubles in one fell swoop the number of known and replicated genetic factors contributing to obesity as a public health problem,” added Dr. Kari Stefansson, Chief Executive Officer of DeCODE Genetics of Iceland, who led a team that made similar findings in a separate study.

The GIANT team found variations in six genes — TMEM18, KCTD15, GNPDA2, SH2B1, MTCH2 and NEGR1 — were strongly associated with a height-to-weight ratio known as body mass index or BMI.

“One of the most notable aspects of these discoveries is that most of these new risk factors are near genes that regulate processes in the brain,” added Stefansson, whose company hopes to sell genetic tests based on such discoveries.

“This suggests that as we work to develop better means of combating obesity, including using these discoveries as the first step in developing new drugs, we need to focus on the regulation of appetite at least as much as on the metabolic factors of how the body uses and stores energy,” Stefansson said.

“These new variants may point to valuable new drug targets,” he added.

Nearly a third of U.S. adults are considered obese with a BMI of 30 or more. Obesity is associated with more than 100,000 deaths each year in the U.S. population and trends are similar in many other countries.
Read the rest of this entry »

Breast cancer patients who are overweight have more aggressive disease and are likely to die sooner, U.S. researchers reported on Friday.

A dangerous type of breast cancer, known as inflammatory breast cancer, was seen in 45 percent of obese patients, compared with 30 percent of overweight patients and 15 percent of patients of healthy weight.

“The more obese a patient is, the more aggressive the disease,” said Dr. Massimo Cristofanilli of the University of Texas M.D. Anderson Cancer Center, who led the study.

“We are learning that the fat tissue may increase inflammation that leads to more aggressive disease.”

Writing in the journal Clinical Cancer Research, Cristofanilli and colleagues said they studied 606 women with breast cancer that had spread within the breast.

They classified them according to body mass index or BMI, a globally accepted measure of obesity. People with BMIs of below 25 are considered normal, while 25-29 marks overweight and 30 or above is clinically obese.

After five years, 56.8 percent of obese women and 56.3 percent of overweight women were still alive. But 67.4 percent of the normal weight women had survived.

More than 56 percent of women of normal weight survived 10 years, compared to 42.7 percent of obese women and 41.8 percent of overweight women.

“Obesity goes far beyond just how a person looks or any physical strain from carrying around extra weight. Particular attention should be paid to our overweight patients,” Cristofanilli said.

Many studies have shown that the obese have a greater risk of several types of cancer. Last month British researchers reported in the Lancet medical journal that obesity can double the risk of leukemia, multiple myeloma, thyroid cancer, colon and kidney cancers.

Fat cells produce a range of hormones that could fuel cancer, researchers say.

Locally advanced breast cancer more deadly in obese

Women with locally advanced breast cancer who are overweight have a worst prognosis than their slimmer counterparts, US researchers reported.

An aggressive type of breast cancer, known as inflammatory breast cancer, was also seen in significantly more obese and overweight patients than in normal-weight patients, according to the study, published in the journal Clinical Cancer Research.

“The more obese a patient is, the more aggressive the disease,” said principal investigator Dr. Massimo Cristofanilli of the University of Texas M.D. Anderson Cancer Center in Houston. “We are learning that the fat tissue may increase inflammation that leads to more aggressive disease.”

Cristofanilli and colleagues studied 602 women with locally advanced breast cancer. They classified the patients by body mass index (BMI), the ratio of height to weight, frequently used to measure obesity. (People with BMIs of less than 18.5 are underweight; between 18.5 and 24.9 is considered normal; 25.0 to 29.9 is overweight; and 30 or higher is obese.)

After fiveyears, the researchers report that 58.6 per cent of the obese women, 58.3 per cent of the overweight women and 69.3 per cent of the normal-weight women were still alive.

After ten years, 57.3 per cent of normal- or underweight had survived compared with 42.4 per cent of obese women and 44.1 per cent of overweight women.

“Obesity goes far beyond just how a person looks or any physical strain from carrying around extra weight. Particular attention should be paid to our overweight patients,” Cristofanilli said.

Many studies have shown that the obese have a greater risk of several types of cancer. Last month British researchers reported in The Lancet medical journal that obesity can double the risk of leukemia, multiple myeloma, thyroid cancer, colon and kidney cancers.

Breast cancer, blood sugar and body fat

“Big C risk is worse if you’re fat” reads the headline in The Sun today. The news story it refers to goes on to say that fat women are “less likely to get low-risk breast cancer – but more prone to life-threatening versions”. The researchers have “discovered a link between the fiercest types [of breast cancer] and high blood sugar”, the newspaper adds.

The newspaper report is based on a Swedish study investigating metabolic factors and breast cancer risk. There were few results of statistical significance this study so it is impossible to reach firm conclusions. Although this study adds evidence to previous research which suggests a complex link between metabolism and breast cancer, more studies are needed to identify what this risk is. This study is not conclusive and The Sun and other news sources have overstated its significance.

Read the rest of this entry »

The mix of bacteria in a baby’s gut may predict whether that infant will become overweight or obese later in life, a new study suggests.

Babies with high numbers of bifidobacteria and low numbers of Staphylococcus aureus may be protected from excess weight gain, according to a team of researchers from the University of Turku in Finland.

Their study was published in the March issue of The American Journal of Clinical Nutrition.

The researchers suggested their findings may help explain why breast-fed babies are at lower risk for later obesity, since bifidobacteria are prevalent in the guts of breast-fed babies.

Other studies repeatedly have found that being breast-fed is associated with a reduced risk of excess weight or obesity in childhood, with the risk lowered from 13 percent to 22 percent.

In the new study, researchers evaluated children who had been part of a long-term study to evaluate the effect of probiotics on allergic disease. Probiotics are potentially beneficial bacteria found in foods such as yogurt and in dietary supplements.

The children had been evaluated at birth, five more times before age 2, and then again at ages 4 and 7. The researchers in the original study had also tested for intestinal microbes in fecal samples collected at 6 months and 12 months.

For this latest study, the Finnish researchers selected 49 participants from the larger study — 25 of them were overweight or obese at age 7 years, and 24 were normal weight at the same age.

When they looked at the fecal samples, the average bacterial counts of bifidobacteria when taken at 6 months and 12 months were twice as high in those who were a healthy weight as in those who got heavy.

Those who stayed at a healthy weight also had lower fecal S. aureus levels at 6 months and 12 months than did those who got heavy.

The S. aureus may trigger low-grade inflammation, the authors speculated, and that may also contribute to developing obesity.

In other research, gut bacteria in adults have been found to be altered in obese adults who lost weight. Someday, the Finnish researchers speculated, tinkering with gut flora may help prevent or treat obesity.

The latest study doesn’t pinpoint exactly why intestinal bacteria are linked with the development of obesity, said Connie Diekman, director of university nutrition at Washington University in St. Louis and president of the American Dietetic Association.

“The exact role that bacteria in the intestine play in development of obesity is still the subject of much research,” she said, “but the benefits of breast-feeding are clear. Breast-feeding provides not only the proper nutrition for your infant, but it provides benefits that may impact long-term health and weight issues as well.”

However, she added that, “while breast-feeding may play a role in the weight of children, so many other factors influence weight that parents shouldn’t ignore good role modeling of healthy food choices, proper portions and regular physical activity. Healthy weight is a combination of factors, and no single issue will be the cause of weight gain or the magic answer to weight loss.”

Another expert who has studied how obesity changes microbes in the gut calls the new study unique, because it collected information over several years and could look for differences in gut microflora. “The finding, that the lean children harbored higher levels of bifidobacteria at younger ages, is very intriguing,” says Ruth Ley, a research assistant professor at Washington University School of Medicine in St. Louis.

Still, she says, research on the role of gut bacteria in regulating body weight is in the very early stages.

Research Links Obesity to Mix of Bacteria in Digestive Tract

Obese people have a distinctive mix of bacteria in their digestive systems that seems to make them prone to gaining weight, a startling discovery that could lead to new ways to fight the obesity epidemic, researchers reported yesterday.

Obese people have more digestive microbes that are especially efficient at extracting calories from food, the researchers said, and the proportion of these super-digesting organisms ebbs as the people lose weight. Moreover, when the scientists transplanted these bacteria from obese mice into lean mice, the thin animals start getting fat. This provides more support for the provocative theory that the bacteria that populate the intestine play an important role in regulating weight.

“There appears to be a link between obesity and the type of bugs in your gut,” said Jeffrey I. Gordon of Washington University School of Medicine in St. Louis, who led the series of experiments being published in today’s issue of the journal Nature. “The difference in the structure of microbial ecology of our gut may set us up for susceptibility to obesity.”

Gordon and his colleagues stressed that more work is needed to explore the findings. And they cautioned against trying to manipulate “gut flora” with antibiotics or microbial “probiotic” pills sold in health-food stores. But if the findings are confirmed and better understood, they could lead to profound new insights into one of the nation’s biggest health problems, the researchers said.

“In the future, we could potentially manipulate the structure and function of these microbial societies as a new approach toward preventing and treating obesity,” Gordon said.

The findings produced enthusiasm and caution from other researchers. Some praised the work for possibly offering a long-sought alternative explanation for the obesity epidemic. Perhaps some change, such as a food additive or antibiotic use, has caused a fundamental shift in gut flora, making it easier for many people to gain weight.

“This is very exciting,” said Barbara Corkey, an obesity researcher at Boston University. “We don’t know why the obesity epidemic is happening. People say it’s because of gluttony and sloth. I think there must be something else. It’s exciting to see some work being done on alternative explanations.”

Others suspect that if gut microbes do play a role, it is a minor one.

“This is extremely interesting,” said Hans-Rudolf Berthoud of the Pennington Biomedical Research Center in Baton Rouge. “But lifestyle and the environment are still the major factors in the obesity epidemic.”

On a broader level, the findings highlight the symbiotic relationship humans maintain with the trillions of microorganisms that populate our bodies, Gordon and others said.

“This strengthens the notion that the indigenous organisms in the human body are probably intimately involved in our health,” said David A. Relman of Stanford University. “The ways they are involved remain unclear, but this underscores the idea that it behooves us to figure it out.”

Scientists have long known that the human body is teeming with germs, primarily bacteria, which cover the skin and inhabit every orifice. By some estimates only one out of every 10 cells in the human body is human. These organisms perform a host of functions, especially in the digestive tract, where they help digest food.

“There’s growing interest in the idea that humans are more than just human cells,” said Martin Jack Blaser of New York University. “These cells are not just passengers. They are part of the human metabolism.”

To explore the role of the organisms in weight regulation, Gordon’s team first compared the gut flora of 12 obese people to lean subjects’. The obese tended to have a significantly greater proportion of one of the two main types of bacteria found in the gut, known as Firmicutes, than the other, known as Bacteroidetes.

Next, the researchers spent a year meticulously measuring the gut flora of the obese volunteers as they tried to lose weight by eating low-calorie diets that restricted either their fat or carbohydrate intake. As volunteers lost weight, the proportion of Firmicutes in their digestive tracts fell and the proportion of Bacteroidetes rose, the researchers found.

When the researchers conducted detailed molecular analyses of the two types of bacteria in the laboratory, they discovered the Firmicutes were much better at extracting calories from food.

Moreover, when the researchers examined the gut flora of obese laboratory mice, they found a similar pattern in their ratios of Firmicutes to Bacteroidetes. And when researchers transferred gut flora from obese mice to mice devoid of gut flora, the recipient animals tended to gain weight, confirming that the pattern was associated with weight gain.

“This attribute of being able to harvest and store more energy appeared to be transmissible,” Gordon said. “For the first time, we see that there is a correlation between the microbial gut ecology and the obese state.”

Among other things, the findings could help explain why it becomes harder and harder to lose weight as people get fat, Gordon said.

“That’s part of the pathology of obesity. When you shift the amount of fat tissue, the amount of energy you can harvest becomes somewhat greater, and that’s going to fuel the obese state,” he said.

The researchers acknowledged that the difference in the number of calories extracted by the microbes is relatively small. But over time even a small differential could be significant, they said.

Many questions remain, however. It is unclear what determines the make-up of a person’s gut flora. It might be the microbes they pick up from their mothers; it might be their exposure to antibiotics. It is also unclear how fat tissue and gut flora might affect one another, and whether the change in gut bacteria causes or is a result of the weight loss.

Despite those and other questions, scientists said the findings are sure to inspire more investigation.

“They open up a completely new hypothesis,” said Randy Seeley, an obesity researcher at the University of Cincinnati who wrote a commentary accompanying the research. “There are a lot of hurdles here that we have to deal with in terms of our basic understanding. But it’s fascinating.”