NEW YORK (Reuters Health) - A drug approved to prevent seizures may also help obese people lose a few pounds when it's added to therapy and nutritional guidance, a new small trial suggests.

But people who took zonisamide also reported more side effects, from nausea and vomiting to anxiety and depression. And two researchers not involved in the study questioned how much the drug would actually help people in the real world.

Although zonisamide is only approved by the U.S. Food and Drug Administration for seizures, doctors can prescribe it "off-label" for non-approved purposes. Prior small trials and anecdotal evidence suggested it might help heavy people shed extra pounds.

"There is a little bit of weight loss with this drug when it is given for treatment of epilepsy," said lead researcher Dr. Kishore Gadde, from Duke University Medical Center in Durham, North Carolina.

That could be because of its effects on serotonin and dopamine, he said. Those two neurotransmitters are known to effect motivation and reward pathways in the brain, including those related to food.

Gadde said his team wanted to see if zonisamide could produce weight loss in people without epilepsy, and with the added help of a behavioral intervention.

According to disclosures published with the study, Gadde has multiple patents for zonisamide as a treatment of obesity and weight gain, and he owns equity in a company developing a combination weight-loss drug containing zonisamide.

For the new study, funded by the National Institute of Diabetes and Digestive and Kidney Diseases, Gadde and his colleagues randomly assigned 225 obese people to take either 200 or 400 milligrams of zonisamide or a drug-free placebo pill every day for one year. On top of that, all participants met regularly with a dietician and were encouraged to be more physically active.

At the outset, they had an average body mass index - a measure of weight relative to height - of 37.6. That's the equivalent of a five-foot, six-inch person weighing 233 pounds.

One year later, people assigned to the placebo had lost an average of nine pounds, and those on the lower zonisamide dose had dropped ten pounds. Participants taking the higher daily dose had the greatest average weight loss, at 16 pounds.

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Epilepsy drug leads to weight loss, side effects

Weight-loss surgical procedures such as stomach stapling and gastric banding reduce the warning signs of heart disease more dramatically than drug treatments and can be life-saving, according to a survey of 73 previous studies.

For more than half of the almost 20,000 patients included in the research, risk factors for stroke, heart attack and heart failure -- such as high blood pressure, diabetes and high cholesterol -- significantly improved or were resolved, said researchers led by Amanda Vest of the Cleveland Clinic in Ohio. The survey was published yesterday in the U.K. journal Heart, which commissioned the research.

At least 2.8 million adults die each year as a result of being overweight or obese, according to the Geneva-based World Health Organization. Candidates for bariatric surgery, designed to limit food intake, include those who are more than 100 pounds (45 kilograms) over their ideal body weight.

The magnitude of effect on risk factors is impressive, and to date no pharmacological therapy for weight management or diabetes has shown a comparable effect over these short time periods, the study authors said in the published paper. In appropriately selected patients, especially those with a high cardiovascular risk, surgical weight loss could be life- saving.

Weight-loss surgery itself carries risks and can even cause death, the authors said. Complications include wound infection, bleeding, gallstones and nutritional deficiencies, according to the Cleveland Clinic.

Almost half of patients undergoing gastric banding for obesity needed to have the device removed, often because of erosion, according to a study published by the Archives of Surgery earlier this year.

Severely obese people benefit from weight-loss surgery, the American Heart Association said in a policy statement March 14. The group, for the first time, said the risks of the procedure arent as great as the help provided by the reduction in the risk of diabetes, high cholesterol and heart ailments associated with obesity.

To contact the reporter on this story: Makiko Kitamura in London at mkitamura1@bloomberg.net

To contact the editor responsible for this story: Phil Serafino at pserafino@bloomberg.net

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Weight-Loss Surgery Cuts Heart Risk More Than Drugs

Readmore: Local, Health, News, University of Chicago, Good Night's Sleep, Exercise, Controlling Weight, Weight Loss, Weight Gain, Sleep, Health Diet, Healthy Lifestyle, Matthew Brady, Insulin, Burn Fat, Body Fat

CHICAGO -- Heres a new kind of weight loss diet for you; a sleep diet.

Researchers at the University of Chicago are uncovering why a good night's sleep can be just as important as food or exercise in controlling our weight.

Researcher Matthew Brady and his team are the first to discover how sleep affects fat cells.

Normally, many of us would like to get rid of fat cells but Brady says our fat cells, along with insulin, actually perform the important job of storing and burning body fat.

Brady says it's that job that becomes compromised in volunteers who got just four and a half hours of sleep at night for several days.

"We were surprised at how quickly we got such a robust effect. I mean four nights at four and a half hours in bed we kind of think is real world, I mean, you're cramming for finals, you have a big deadline, newborn in the house..." says Brady.

Brady says what happened to his sleep challenged college volunteers is like looking at how the body is going to work 20 years later.

Organs will work less well. People gain weight and higher sugar levels can lead to diabetic complications.

"So it can affect your vision, it can affect your kidney function, it can affect your liver function and over time it is the secondary complications that can lead to amputation, blindness and a whole host of problems," says Brady.

See the article here:
How does sleep impact weight loss and body fat?

A new study links weight loss surgery with an increased risk for substance abuse. The study found patients who underwent gastric bypass surgery were at increased risk for alcohol use after the procedure.

Use of both drugs and alcohol increased at the time of surgery, with additional increases in the following two years, HealthDay reports. The study of 132 women and 23 men who underwent one of two commonly performed types of weight loss surgery found the strongest link between gastric bypass and alcohol use. Some patients in the study underwent a procedure called gastric banding. Gastric bypass makes the stomach smaller, and lets food bypass part of the small intestine. Gastric banding involves placing a silicone band around the upper stomach, in order to limit intake of food.

Some experts think people who undergo weight loss surgery may be at increased risk of substance abuse because they are swapping an addiction to food for an addiction to drugs or alcohol, the article notes. Others think after surgery, a person may become intoxicated more quickly with less alcohol. Gastric bypass may also change the reward pathways in the brain, the article notes.

The study is published in the Archives of Surgery.

A study published earlier this year in the Journal of the American Medical Association found patients who underwent gastric bypass surgery may increase the risk of alcohol abuse. The study of almost 2,000 weight loss surgery patients found alcohol abuse rose from 7.6 percent before the surgery, to 9.6 percent afterwards. Patients who had gastric bypass surgery were more than twice as likely to abuse alcohol, compared with those who had the gastric band procedure.

Originally posted here:
Study Links Weight Loss Surgery With Increased Risk of Substance Abuse

By Alan Mozes HealthDay Reporter Latest Diet & Weight Management News

MONDAY, Oct. 15 (HealthDay News) -- A prescription medication originally developed to treat epilepsy may help obese adults shed weight when combined with routine nutritional counseling, researchers say.

Patients who took 400 milligrams of the anti-seizure drug zonisamide daily for a year lost nearly 7.5 pounds more on average than those assigned to dietaryand lifestyle changes alone, the new study found. But they also suffered more side effects than patients not taking the medication.

"The question was to see if more weight loss could be achieved if we provided decent quality lifestyle intervention, mostly dietary counseling, along with this medication," said study lead author Dr. Kishore Gadde, director of the Obesity Clinical Trials Program at Duke University Medical Center in Durham, N.C.

"And the answer was yes," Gadde said.

The research, funded by the U.S. National Institutes of Health, appears online Oct. 15 in the journal Archives of Internal Medicine.

For obese men and women who can't control their weight through diet and lifestyle changes, nonsurgical options are limited, the study authors noted. Just a few prescription medications are approved in the United States for long-term treatment of obesity, including orlistat (brand name Xenical) and lorcaserin hydrochloride (Belviq).

Gadde and colleagues set out to follow up on a 16-week investigation they conducted in 2003 that had indicated that zonisamide (Zonegran) at a dosage of 400 milligrams a day might offer an alternative.

Between 2006 and 2011 the study team randomly assigned more than 200 obese men and women to one of three groups. One group took 200 milligrams of zonisamide daily, another got 400 mg of zonisamide daily and one received a dummy pill. The participants' average age was 43, and their average body-mass index (BMI) was nearly 38. BMI is a calculation of body fat based on height and weight, and a BMI of more than 30 is considered obese. None had diabetes.

All study participants followed their treatment plan for one year. During this time, they all also received monthly individualized nutritional counseling, which Gadde described as "not intensive," to help them reduce their overall caloric intake.

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Epilepsy Drug Shows Promise as Weight-Loss Aid, Study Says

October 16, 2012

Lee Rannals for redOrbit.com Your Universe Online

According to a new study published by Archives of Surgery, patients who undergo weight loss surgery are at an increased risk for substance use.

The researchers found that patients who underwent surgery such as laparoscopic Roux-en-Y gastric bypass surgery were at an increased risk for alcohol use, drug use and cigarette smoking.

Studies have shown that drugs, alcohol, and food trigger similar responses in the brain and that bariatric surgery candidates whose condition has been diagnosed as binge-eating disorder (BED) display addictive personalities similar to individuals addicted to substances, the authors wrote in the journal. Therefore, alcohol and drugs (including nicotine) are likely to substitute for overeating following WLS (weight loss surgery).

The team assessed questionnaire responses from 155 patients who underwent weight loss surgery, and were recruited from an information session at a bariatric surgery center.

Patients underwent either laparoscopic Roux-en-Y gastric bypass surgery (n=100) or laparoscopic adjustable gastric band surgery (n=55).

Each of the patients completed questionnaires to assess eating behaviors and substance use prior to the operation and at one, three, six, 12, and 24 months after surgery.

The authors found that patients reported an immediate decrease in frequency of substance use following weight loss surgery.

They also saw that these improvements were not maintained by the 3-month follow-up, and that there was a significant increase in the frequency of substance use from the time of surgery to the 24-month follow-up.

Link:
Weight Loss Surgery Patients At Higher Risk Of Substance Abuse

Latest Mental Health News

By Katrina Woznicki WebMD Health News

Reviewed by Louise Chang, MD

Oct. 15, 2012 -- People who undergo weight loss surgery may be at risk of addictive behaviors such as drug or alcohol abuse and cigarette smoking.

The study, by Alexis Conason, PsyD, of the New York Obesity Research Center, and colleagues also found a link between a specific operation, laparoscopic Roux-en-Y gastric bypass surgery, and an increase in alcohol use after the procedure. The findings appear in the Oct. 15 online issue of Archives of Surgery.

"We're only talking about a minority of patients here," Conason says. "But what we're seeing is some patients who seek out bariatric surgery have a history of using food to deal with emotions."

When such patients no longer can overeat as a way to cope with their feelings, they may turn to "other external coping mechanisms like drugs or alcohol," Conason says.

The study looked at 132 women and 23 men who underwent either Roux-en-Y -- one of the most common weight loss surgeries -- or laparoscopic adjustable gastric band surgery to treat their obesity. Participants answered questionnaires about their behaviors and history of drinking or drugs before their surgery and then again one, three, six, 12, and 24 months after their operations.

"When we looked at each substance (drugs, alcohol, and cigarette smoking) individually, we didn't see a huge difference, but when you looked at the whole group, we saw a significant increased risk for drug and alcohol use at the two-year point after the surgery," says Conason. "Our findings are important because it raises some concerns about who is at risk."

Nearly 36% of the adult U.S. population is obese. Some 200,000 adults have bariatric surgery each year, according to the American Society for Metabolic and Bariatric Surgery.

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Addiction a Risk After Weight Loss Surgery

Oct 16, 2012 2:55pm

Reported by Lauren Hughes, MD

Weight-loss surgery can help people who are obese ditch their unhealthy relationships with food. But a new study suggests these patients sometimes enter a rebound relationship with something else alcohol, drugs or cigarettes.

The survey-based study of 155 bariatric surgery patients found a 50 percent rise in the frequency of substance abuse two years after the procedure.

Many people who undergo bariatric surgery struggle with eating in response to different emotional cues, said Alexis Conason of the New York Obesity Nutrition Research Center, lead author of the study published Monday in the Archives of Surgery. I [wondered] what happened afterward. If they are no longer able to cope with their emotions through eating do they turn to something like drugs or alcohol to serve the purpose that food did originally.

Conason tested the theory of symptom substitution the swapping of one habit for another. Patients who drank and smoked before surgery reported more drinking and smoking two years after. And while one in 25 patients reported using recreational drugs before the procedure, one in eight said they used them two years later. But Conason stressed that much more research is needed.

The emerging body of literature [on this] is in its infancy, she said, stressing that her study focused on frequency of substance use but not on the quantity of substances consumed or whether doing so caused problems for either the patients or their family members.We have a small sample size, so its going to be important to see how this is replicated with larger samples. We need to [better understand] the problematic nature of the substance use the reasons why.

Some experts think the uptick in substance use might be related to social behaviors.

What this study may be showing is that morbidly obese people are socially isolated, said Dr. Christine Ren-Fielding, chief of bariatric surgery division in the department of surgery at New York University Langone Medical Center. After surgery, they not only become physically healthy but mentally healthy and now become more social. They go out on dates and go to parties which may involve a social alcoholic drink.

The frequency of alcohol use among bariatric patients prior to surgery was very low, Ren-Fielding added.

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Weight Surgery Tied to Substance Abuse

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(PRWEB) October 17, 2012

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hCG Diet / Diet Doc Weight Loss Plans Announces Sugar Free Weight Loss Shakes to Feed a Sweet Tooth While ...