Public release date: 21-Feb-2012
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Contact: Kevin Ziegler
zieglek2@ccf.org
216-636-5876
Cleveland Clinic

Tuesday, February 21, 2012, Cleveland: With 1 in 5 overweight Americans suffering from chronic kidney disease, Cleveland Clinic researchers analyzed the nutritional and lifestyle habits of overweight adults, finding that their methods included diets and diet pills that may cause further kidney damage.

The study findings, published online this month in the International Journal of Obesity, came from an analysis of food choices and lifestyle habits of 10,971 overweight adults taken from the National Health and Nutrition Examination Survey (NHANES), a federally-administered assessment of the overall health and nutritional status of Americans.

Of the overweight and obese patients with kidney disease included in the survey, 50 percent reported that they had attempted to lose weight in the past year. The survey showed that, on average, obese Americans with kidney disease consume protein in amounts that are above the recommended levels prescribed by the National Kidney Foundation for chronic kidney disease patients.

The typical American diet each day includes approximately 1.2g of protein per kilogram of body weight. Patients with CKD are advised to consume 0.6g to 0.75g protein per kilogram of body weight each day and popular high-protein diets may call for up to 1.9g per kilogram of body weight.

"People who are overweight or obese are at higher risk for chronic kidney disease and there is a great need to define what the appropriate lifestyle changes and weight loss modalities are for protecting kidney function," said Sankar Navaneethan, M.D., a nephrologist in the Glickman Urological and Kidney Institute at Cleveland Clinic and lead author of the study. "Rather than using fad diets or diet pills, overweight and obese people with kidney disease may adopt a weight loss plan that incorporates a low-protein, low-calorie diet, regular physical activity and close follow-up by their physicians."

The survey asked patients whether they participated in regimens that included diet or exercise or both, but the specific program, such as a high-protein diet or low-protein diet, was not named. The survey also found that eight percent of weight loss seekers with CKD used medications as part of their weight loss regimen. Certain weight loss methods, especially high-protein diets and weight loss medications are not recommended in people with kidney disease as they may lead to further kidney damage.

The authors recommend further studies designed to identify safe treatment strategies for weight loss with regards to protecting kidney function.

According to the Centers for Disease Control and Prevention, more than 10 percent of adults aged 20 or older in the U.S., or more than 20 million people, have chronic kidney disease (CKD), a condition that describes the progressive worsening of kidney function. It is often found in patients who have diabetes or hypertension, and can exist without symptoms until it progresses to severe levels. When CKD progresses to end-stage renal disease, patients typically require treatment through dialysis or transplantation. The prevalence of the disease is rapidly growing as is the cost burden. Medicare costs in the U.S. for the care of patients with end-stage renal disease has risen from $12.2 billion in 2000 to $20.8 billion in 2007.

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About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S.News & World Report consistently names Cleveland Clinic as one of the nation's best hospitals in its annual "America's Best Hospitals" survey. About 2,800 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. Cleveland Clinic Health System includes a main campus near downtown Cleveland, eight community hospitals and 18 Family Health Centers in Northeast Ohio, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and opening in 2013, Cleveland Clinic Abu Dhabi. In 2010, there were 4 million visits throughout the Cleveland Clinic health system and 167,000 hospital admissions. Patients came for treatment from every state and from more than 100 countries. Visit us at http://www.clevelandclinic.org. Follow us at http://www.twitter.com/ClevelandClinic.

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Excerpt from:
Study says overweight Americans may risk kidney damage when attempting weight loss

Will there soon be a new weight loss pill for people who struggle to lose weight on the path to better health? Qnexa is in the hands of an FDA panel once again because the drug's maker, Vivus Inc., provided new safety information about the drug.

The weight loss pill combines two currently approved drugs: phentermine and topiramate. Phentermine is the safer part of the wildly popular "phen-phen," which is still sometimes used for weight loss. However, topiramate is used for seizures and migraines, which does list troubling side effects.

The problem is, people want a pill to aid in weight loss to be a quick fix, and it seems clear that there is no magic weight loss pill out there. They seem to have way too many side effects, or they are not effective. The last time the FDA panel voted on this drug, it was 10 to six against approval. Perhaps things will change, but even then this isn't going to be a magic pill. Ultimately, there will be risks to be weighed against the health benefits.

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Originally posted here:
Weight Loss Pill Qnexa in FDA's Hands: Will it be Approved?

A group of weight-loss clinics in Southern California is under fire for an aggressive advertising campaign and the death of five patients.

The 1-800-GET-THIN marketing campaign and its affiliated surgical centers are being investigated by local, state and federal agencies, including Congress.

If you travel Los Angeles freeways you've undoubtedly seen the billboards advertising the weight loss Lap-Band device. The group also has a catching ad jingle, which is even available as a phone ringtone.

The ubiquitous ad campaign and the surgeons affiliated with it are under intense scrutiny. At least three wrongful death lawsuits have been filed, and the Los Angeles County Coroner is investigating one of the deaths. And according to a spokesman at the California Department of Insurance, the agency has initiated an investigation into allegations of insurance fraud.

Mona Misra is a bariatric surgeon at L.A.'s Cedars Sinai Hospital. She says she's glad regulators are looking into the practices, but she says many of her patients are getting the wrong message.

"For a lot of patients, the band might be the perfect operation for them and we don't want them to be afraid of it because they think that it is such a dangerous operation," Misra says.

The Lap-Band is a small, surgically-implanted silicone ring that, when inflated, restricts part of the stomach so only a small amount of food can get in.

Democratic Congressman Henry Waxman, whose district covers much of Los Angeles, says he wants more regulatory oversight of the Lap-Band.

"Here you have an outfit that is putting up billboards urging people to get this Lap-Band product, and they're not giving people all the information that they are entitled to have about the risk, cautions and possible side effects," Waxman says.

The Food and Drug Administration recently sent a warning letter to the 1-800-GET-THIN marketers ordering them to include more prominent safety warnings. The group's website now has disclaimers, but an FDA spokeswoman said the agency could not comment whether the marketers had fully complied with the warning. She would only say that firms are expected to correct violations, and failure to do so may result in enforcement action.

Those new disclaimers are too little and too late for Alexander Robertson, a lawyer who has brought five different lawsuits, including two wrongful death claims, against the 1-800-GET-THIN marketers and its affiliated surgeons.

"They really preyed on a very susceptible group of the population that obviously would like to look like those skinny beautiful people on the billboards and were told it this is a safe one hour procedure," Robertson says. "You come in and get it done and you are going to be thin right away."

A lawyer for the surgical centers and others affiliated with 1-800-GET-THIN declined to be interviewed. But he did send a written statement denying all allegations against his clients and touted "the success we have achieved in improving the quality of life of thousands of patients."

Meanwhile for years Allergan, the manufacturer of the Lap-Band, continued selling the device to surgeons affiliated with the 1-800-GET-THIN campaign. Earlier this month the company reversed that stance and announced that they would no longer sell to Top Surgeons, Inc, which is affiliated with the controversial ad campaign. A spokeswoman for the company would not elaborate why the decision to halt sales was made.

Scott Cunneen the head of Bariatric Surgery at Cedars Sinai, applauds the move. He and 29 other doctors recently sent a letter to members of congress denouncing the approach to anti-obesity treatment used by the 1-800-GET-THIN surgical centers. Cuneen says he fears Congress will crack down on the use of the Lap-Band instead of monitoring surgeons who he says, improperly use it.

"We hope that Congress regulates the practices and the facilities in such a way that the safety is maintained and doesn't condemn the whole category of therapy," says Cunneen, who insists that surgery, when performed properly and marketed truthfully, is the best and most effective way to combat obesity.

Link:
The Big Squeeze: Calif. Weight Loss Clinics Under Investigation

Weight loss is not as simple as eating less and exercising more, and for those who struggle to shed the pounds, a new equation may offer some help.

Scientists are now using mathematics to better understand the physiology of weight loss, and more accurately predict just how much weight someone will lose on a specific diet and exercise regime, researchers said here today at the American Association for the Advancement of Science's annual meeting.

In the past, physicians assumed that eating 500 fewer calories per day would lead to about a pound of weight loss per week, said Kevin Hall, a researcher at the National Institutes of Health in Bethesda, Md.

But it turns out, this rule of thumb is wrong, Hall said, because it doesn't take into account that metabolism slows down during dieting. Thus, predictions that used this rule were overly optimistic, Hall said.  

Hall and colleagues have developed a model that takes into account an individual's age, height, weight and physical activity level to better predict how much weight they might lose on a diet and exercise plan. Currently, the model is intended only for use by physicians and researchers scientists, Hall said.

Hall's research has also come up with a more realistic rule of thumb for weight loss. The new rule says you need to cut 10 calories per day from your diet for every pound you want to lose over a three-year period. So cutting 100 calories per day will lead to a 10-pound weight loss over three years, Hall said. Half of this weight loss would occur over the first year. To lose more weight after the three-year period, you'd have to cut more calories, Hall said.

The model may help policy makers understand the impact of public health measures on the obesity epidemic. For instance, one estimate of the effect of a 20 percent tax on sugar-sweetened beverages predicted that such a tax would lead to a 50 percent reduction in the number of overweight people in the United States in a five-year period. Hall 's new equation predicts about a 5 percent reduction in the percentage of overweight people in five years, Hall said.

The rest is here:
Weight loss not so simple as previously thought?

VANCOUVER — Weight loss is not as simple as eating less and exercising more, and for those who struggle to shed the pounds, a new equation may offer some help.

Scientists are now using mathematics to better understand the physiology of weight loss, and more accurately predict just how much weight someone will lose on a specific diet and exercise regime, researchers said here today at the American Association for the Advancement of Science's annual meeting.

In the past, physicians assumed that eating 500 fewer calories per day would lead to about a pound of weight loss per week, said Kevin Hall, a researcher at the National Institutes of Health in Bethesda, Md.

But it turns out, this rule of thumb is wrong, Hall said, because it doesn't take into account that metabolism slows down during dieting. Thus, predictions that used this rule were overly optimistic, Hall said.  

Hall and colleagues have developed a model that takes into account an individual's age, height, weight and physical activity level to better predict how much weight they might lose on a diet and exercise plan. Currently, the model is intended only for use by physicians and researchers scientists, Hall said.

Hall's research has also come up with a more realistic rule of thumb for weight loss. The new rule says you need to cut 10 calories per day from your diet for every pound you want to lose over a three-year period. So cutting 100 calories per day will lead to a 10-pound weight loss over three years, Hall said. Half of this weight loss would occur over the first year. To lose more weight after the three-year period, you'd have to cut more calories, Hall said.

The model may help policy makers understand the impact of public health measures on the obesity epidemic. For instance, one estimate of the effect of a 20 percent tax on sugar-sweetened beverages predicted that such a tax would lead to a 50 percent reduction in the number of overweight people in the United States in a five-year period. Hall 's new equation predicts about a 5 percent reduction in the percentage of overweight people in five years, Hall said.

Pass it on: New math models may be able to more accurately predict how much weight people will lose if they follow a specific diet and exercise regimen. 

This story was provided by MyHealthNewsDaily, a sister site to LiveScience. Follow MyHealthNewsDaily staff writer Rachael Rettner on Twitter @RachaelRettner.  Find us on Facebook.

Read the original here:
New Weight-Loss Equation: Researchers Determine Key Calorie Cutoff

TUESDAY, Feb. 21 (HealthDay News) -- The U.S. Food and Drug Administration plans to take a second look at the weight loss pill Qnexa on Wednesday, after initially rejecting it because of concerns about heart problems and possible birth defects.

While effective at reducing weight, the drug, manufactured by Vivus Inc., was denied approval in 2010 because of its potential side effects. An FDA advisory panel will now review two years of data; when advisers last voted on Qnexa, only one year's worth of follow-up data was available.

The drug combines the appetite suppressant phentermine and the anti-seizure/migraine drug topiramate. Phentermine was once widely prescribed as the "phen" part of the fen-phen weight loss drug. This combo was withdrawn from the market after its use was linked to high blood pressure in the lungs and heart valve disease. The problems were related to the "fen" or fenfluramine part of the combination, not the phentermine.

No new weight-loss drug has been approved in the United States in the past 13 years, according to published reports. As it stands, Xenical is the only FDA-approved drug specifically for long-term use -- up to a year -- for weight loss. Xenical is sold over-the-counter as Alli. However, other drugs may be used off label to promote weight loss.

Last April, a study funded by Vivus found that obese patients taking Qnexa lost an average 22 pounds over a year, while also lowering their blood pressure and cholesterol levels.

Dr. Louis Aronne, founder and director of the Comprehensive Weight Control Program at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City, is cautiously optimistic that Vivus did a good job responding to FDA safety concerns, and that the FDA will give the drug its nod of approval, with some caveats. Aronne was not involved in the trials but has been an adviser to Vivus and other companies developing weight loss medications.

"I am not as pessimistic as most people," he said.

Vivus has reported that Qnexa may increase the risk of cleft lip in babies of women who use the drug while pregnant. Aronne said the birth defect concern could be addressed through education on who should and should not use the new drug.

"We have learned our lessons with weight loss drugs," he said. "They need to be used in the right people under the right circumstances." The heart risks need to be weighed against reductions in heart disease risk factors that come with weight loss, he said.

Qnexa is not any riskier than bariatric surgery, according to Aronne. "The problem is that it can be distributed more widely," he said. He hopes for a compromise that allows the new compound to be prescribed, but not misused. "Once new medications are approved, local medical boards will need to enforce rules and make sure these medications are prescribed appropriately to the right candidates," he said. "We don't want to open up pill mills."

One thing is clear, he said: More options to treat obesity are needed. "For hypertension, there are 120 medications in nine categories," Aronne said. "We need new options and we need to get physicians thinking about obesity and obesity treatments."

Dr. Scott Kahan, an obesity expert at Johns Hopkins University in Baltimore and director of the National Center for Weight and Wellness in Washington, D.C., agreed. He is optimistic about the FDA's upcoming decision on Qnexa. "The weight loss effects are striking and approaching the amount of weight loss over two years that we get with bariatric surgery," he said. "This is really impressive."

More information

Learn more about weight loss medications at the U.S. National Institutes of Health.

Excerpt from:
FDA Weighs Fate of Qnexa for Weight Loss, Again

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Continued here:
Safe Quick Weight Loss Using the e84 Health Challenge Program - Video

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How To Lose Weight In 10 days Only ! - Video