Wellcome letter


Hi to all of our followers! First of all I have to thank all of you for letting me take care of your health and lifestyle. Hopefully you have found some answers to your problems and are well on your way to a healthier you or hopefully you are already on a maintenance plan facing your relationship with food and the scale in a new amicable way. As I probably commented before, I am starting a new way of anonymous communication with all of you. There is a lot of information to be shared as well as a lot of experience and tips that can benefit most of us. As all of you know, I insist and always recommend to be part of a support group, one of the keys to success and one of the main pillars of Lifestyle Intervention for Weight Loss. You also know that I can not share individual information. This blog will be a way of having that. I invite you all to participate and post your experience without sharing any of your personal information. My second intention is to share as much medical/nutritional information as I can. The more educated you become the easier it will be to understand what you are going through.



Link: http://www.lifestylemedicinespecialists.com/







Thursday, September 18, 2014

More good news

More good news in Obesity Medicine, please take a look. This is a piece of an article from the Obesity Society newsletter directed to the medical community.
Enjoy!


September brings two major milestones for obesity treatment 
Letter from the Executive Director

Dear Colleagues,


Last week was an exciting week for obesity treatment. The FDA acted twice in favor of
 expanding needed obesity treatment options — action that will bring new tools for 
clinicians treating the disease, and for millions of people affected.

1) On Wednesday (9/10), FDA approved the new drug treatment, Contrave™, for
 the long-term medical treatment of obesity in adults. Contrave (combination of 
naltrexone sustained release [SR] and bupropion [SR]) is a drug developed by 
Orexigen Therapeutics, Inc. and will be marketed by Takeda Pharmaceutical 
Company Limited. It is expected to be available on pharmacy shelves this fall, and —
 like all obesity medications — is considered an adjunct to diet and exercise.
2) The very next day (Thursday, 9/11) an expert advisory committee appointed
 by the FDA voted by an overwhelming margin of 14-1 to recommend approval
 of a Novo Nordisk drug, liraglutide 3mg (proposed brand name Saxenda®), for
 obesity treatment. The Committee agreed liraglutide 3mg has a favorable benefit/risk 
profile for the treatment of obesity. The next step for this medication will be a final ruling
 by the FDA, which is due in October. Currently, liraglutide is approved and marketed under
 the brand name Victoza® at doses of 0.6, 1.2, and 1.8mg for the treatment of type 2 diabetes.

Monday, January 13, 2014

News from a Lifestyle friend

Hi everyone! Sorry I have not posted anything in such a long time.
This time I have no miracle news to share with you but just a link to one of our dear friend's new blog. Please visit it, it will give you a new look on disease and their circumstances. The interest in sharing this link is not only to advertise our friend's blog but for you to see that weight is not just an aesthetic problem, actually, that is the last and least of our concern about it. It is linked to disease that does not even cross our minds ( well, it does cross mine, that is why I'm your physician) or the mind of the one carrying the weight. The blog talks about a patient's perspective on a recent serious diagnosis and his own experience going through it. It is worth the time, I promise.  I have to tell you also that I am including this link and related information with the permission of the author.  You will also find the link on the list of links at the bottom of the blog page.

bthumor.wordpress.com

Dr P

Tuesday, August 14, 2012

Food additives

This posting is not meant to scare you or put you on the look out for every possible hidden additive in food, but just for you to pay attention to the list of foods that contain them, then link them to certain side effects. The list of foods this additives are on are mostly breads, ice cream, diet sodas, potato chips and some obscure side dish foods that come in a box. This explains in part, why, when you exclude this type of food items of your nutrition plan, you start feeling a lot better.
Please check the link:
http://eatthis.womenshealthmag.com/slideshow/15-scariest-food-additives#sharetagsfocus

Tuesday, July 24, 2012

New drugs not yet available

Lorcaserin
Lorcaserin/BelviQ
In June 2012, the US Food and Drug Administration approved our internally discovered and developed drug, BELVIQ® (lorcaserin HCI).
We are also seeking regulatory approval for lorcaserin in the European Union, and intend to seek regulatory approval for lorcaserin in additional territories. Regulatory agencies outside the US will independently review lorcaserin.
Our wholly owned subsidiary, Arena Pharmaceuticals GmbH has granted Eisai Inc. exclusive rights to commercialize lorcaserin in most of North and South America, including the United States, Canada, Mexico and Brazil, subject to applicable regulatory approval.
We have patents or patent applications that cover lorcaserin in the United States, Europe, Canada, Mexico, Brazil and many other jurisdictions that, if issued, in most cases would be capable of continuing into 2023 without taking into account any patent term extensions or other exclusivity we might obtain.
BELVIQ will not be available for sale in the United States until after the Drug Enforcement Administration of the US Department of Justice determines BELVIQ’s final scheduling designation.

Monday, July 23, 2012

Qnexa/Qsymia

FDA Approves Qnexa

July 18th, 2012 by MorganDowney Leave a reply »

Vivus Inc. announced today that the Food and Drug Administration (FDA) has approved its anti-obesity drug, Qnexa, which has been renamed Qsymiatm .  Qsymiatm is a combination drug, composed of phentermine and topiramate, both of which have been approved by the FDA for years. As we have previously reported, Osymiatm has the most impressive weight loss of any obesity drug. The FDA has recommended patients discontinue the drug if they lose less than 3% of body weight on the mid-dose formulation or less than 5% on the high dose after 12 weeks. They also recommended monitoring of heart rate for people on the drug and that women of child-bearing age have a negative pregnancy test every month while using the drug. A Risk Evaluation and Mitigation System (REMS) plan includes distribution through certified pharmacies, a medication guide and a timetable for assessments.

The Risk Evaluation and Management Strategy information, Medication Guide, Safety Information and Health Provider Training Program can be accessed at: http://www.qsymiarems.com/

New drugs for obesity treatment

Finally, after rejecting many times new options to treat obesity from the pharmaceutical industry, the FDA has given its blessing to two new drugs, Lorcaserin and Qnexa. Both drugs aide in appetite control. They both have been able to produce at least a loss of 5% of total weight compared to placebo and no more than that.  So, the message to patients is still the same. No matter how many drugs we can use, if you can not control the calories, there will be no miracle. these drugs as the ones currently in use will not operate the change, you will. But still it is a great thing to be able to count on more options to help you with the process. Lorcaserin is a new drug, Qnexa is a combination of two drugs, Topiramate and Phentermine, that we already use of label, is just that now we have the blessing of the FDA and hopefully your insurance will cover it if indicated.
Please read below the information on Lorcaserine, I will also add something on Qnexa.

FDA Approves Lorcaserin

June 27th, 2012 by MorganDowney Leave a reply »

The Food and Drug Administration announced today that it has approvedlorcaserin (to be marketed as Belviq)for the treatment of adult obesity. The drug was developed by Arena Parmaceuticals and went through two advisory committee panels. The final panel voted to recommend approval by a vote of 18-4. This is the first drug for treating obesity approved by obesity since sibutramine was approved in 1997.

Lorcaserin is a novel drug that targets a specific serotonin receptor. It was a different serotonin receptor which was implicated in heart valve problems associated with use of the dexfenfluramine component of Fen-Phen. The FDA briefing document for the Advisory Committee meeting on May 10, 2012 states  that it “is unlikely at the proposed clinical dose” will activate the receptor implicated in the heart valve problem.

The receptor lorcaserin does impact is concentrated in the central nervous system (CNS) and regulates feeding behavior.

In the latest published study of the drug, the BLOOM-DM study led by Patrick O’Neil, 604 patients who were obese or overweight with type 2 diabetes were randomized into a treatment group and a placebo group. Both groups received lifestyle counseling. The group on drug lost 4.5-5% of their initial body weight while the placebo group lost 1.5%. PubMed: Clinical Trial of Lorcaserin in Type 2 diabetes Weight loss in patients with type 2 diabetes is notoriously difficult to achieve.  A 5% weight loss is considered to provide clinically meaningful changes. Weight reduction was evident at 2 weeks which means that patients who don’t see weight loss are likely to discontinue use early on in treatment. Glycemic control improved more in the lorcaserin group. There were not significant changes between the group on drug and on placebo in regard to cholesterol, triglycerides and blood pressure. The lack of statistical significance may be due to the use by a majority of patients being on blood pressure or lipid medications at the start of the trial.

Arena Pharmaceuticals, developer of lorcaserin, has agreed to conduct a number of post-approval trials, including one to assess cardiovascular effects.


Friday, February 24, 2012

New drug Qnexa

The fact that the FDA advisory committee had voted in favor of this drug does not necessarily mean it will be approved by the FDA but at least it is a good first step. Qnexa is a combination of two drugs that have been in the market for many years and are commonly used, Phentermine and Topamax. I am including a copy of the public communication from OCC.


Obesity Care Continuum (OCC) Applauds FDA Advisory Committee Resounding Approval of QNEXA

For Immediate release
February 23, 2012               
                                                                                                              
For More Information:
James Zervios
Director of Communications
Obesity Action Coalition                                   
(800) 717-3117 
http://us.mc1610.mail.yahoo.com/mc/compose?to=jzervios@obesityaction.org
or
Francesca Dea
The Obesity Society
Executive Director                                 
(202) 210-8942
http://us.mc1610.mail.yahoo.com/mc/compose?to=fdea@obesity.org

Washington, DC – Members of the Obesity Care Continuum (OCC) are pleased with the FDA’s Advisory Committee near unanimous vote to approve QNEXA, a new drug to treat those affected by obesity and obesity-related co-morbidities, such as Type 2 diabetes, hypertension and more.

“The robust discussion by the panel surrounding both the risks and benefits of new obesity drugs is both refreshing and powerful,” said Obesity Action Coalition (OAC) President and CEO Joe Nadglowski. “Clearly, our message about treating obesity seriously is beginning to resonate with the FDA,” added Ted Kyle, RPh, MBA, Chair of The Obesity Society’s Advocacy Committee.

The 20 to 2 vote was surprising given the risk-oriented composition of the FDA chosen advisory committee, which included a number of experts in cardiovascular disease and neonatology – FDA suggested risk areas associated with QNEXA. Despite the strong endorsement of the advisory committee that the FDA approve QNEXA, member groups of the OCC remain cautiously optimistic until the agency renders its final decision this April. In 2011, the FDA failed to approve Contrave despite the obesity drug being approved by an advisory committee the previous year.

“Currently there is a vast gap in treatment options.  We have diet and exercise, and we have surgery, with nothing in between. Until we have more treatment options, such as obesity drugs, millions of Americans in this gap will continue to suffer from the devastating effects of untreated obesity,” said Dr. Patrick O’Neil, President of The Obesity Society.” “This a hopeful day for those affected by obesity. We hope that FDA shares this view as well,” added O’Neil.

About the Obesity Care Continuum (OCC):
With a combined membership of more than 125,000 healthcare professionals and patient advocates, the Obesity Care Continuum (OCC) is dedicated to promoting access to, and coverage of, the continuum of care surrounding the treatment of overweight and obesity. The OCC also challenges weight bias and stigma oriented policies – whenever and wherever they occur. The OCC is a coalition of the Obesity Action Coalition (OAC), the Obesity Society (TOS), the Academy of Nutrition and Dietetics (AND) and the American Society for Metabolic and Bariatric Surgery (ASMBS).



Monday, January 23, 2012

Trade fat for muscle workout summary

Hi again, I found this workout table that looks simple enough and it is short enough to follow at home. It does not need a lot of gear either.
Please give it a try, you'll like it :)
http://www.menshealth.com/workout-center/workout-program/27592/summary
Dr P
PS: you will not need a stress test before starting

Friday, January 20, 2012

How I Lost 115 Pounds | Yahoo! Health

Please, to everybody who does not believe they can do this with the help of a trained physician, support and medication, look what this woman did with just the main behavioral interventions that I soooo much repeat in every consult.
Please read:)
How I Lost 115 Pounds Yahoo! Health
Dearly,
Dr P

Wednesday, November 30, 2011

Ohio decision to remove child

Please, if you have a minute read the following press release from the Obesity Society regarding the recent decision to remove a child from his parents care due to his obesity problem.


Bariatric Physicians Do Not Support Ohio's Intervention for Childhood Obesity

The American Society of Bariatric Physicians (ASBP) was discouraged to learn of the state of Ohio's decision to remove an 8-year-old child from his home due to excessive weight issues. Media reports state that the boy was on the honor roll, actively participating in school activities, and not in any immediate danger.  The ASBP believes that this type of state intervention sets a dangerous precedent, is extreme and highly unjustified. 

With approximately one out of three children in America considered overweight or obese, childhood obesity has reached epidemic proportions. ASBP does not attribute this dramatic increase solely to poor parenting. Race and ethnicity, genetic predisposition, environment in utero and birth weight all affect obesity rates long before any active parenting occurs. After birth poverty, infant feeding practices, parent education level, and the cost disparity between healthy and less healthful foods play a role. Children cannot expend energy as in the past due to the fear of abduction as well as unsafe sidewalks, trails, and parks.  In schools vending machines, poor quality school lunches, and the regrettable removal of physical education and health classes factor in.  If that child turns on a computer and browses the internet, she is barraged by cereal and candy advertisements. Increased caloric densities of foods and portion sizes have also paralleled our obesity epidemic.

This is not to say that parents are completely defenseless to our obesity causing environment.  As physicians who treat childhood obesity, the ASBP recognizes that parental involvement is paramount to a child's long-term success.  Simple changes such as sitting down to dinner as a family, decreasing fast food consumption, controlling electronics and modeling healthy eating behaviors can have a significant impact on the weight of the entire family.  Parents can remove junk foods from the home, decrease processed foods and increase produce (if they can afford to do so and have access to fresh fruits and vegetables).  However, these behaviors alone do not guarantee success.  Consider a family who has made these changes and the child remains severely obese.  ASBP does not agree that the best or only option is to remove the child from his home.

Considering approximately two million children are severely obese, it seems risky to conclude that parental neglect is the common cause. Further the sheer numbers are clearly more than an already overburdened foster care system can handle. Obese children are discriminated against by peers and teachers, are bullied relentlessly, and have a quality of life equivalent to that of a cancer patient.  The additional insult of removing a child from his or her home will in most cases do more harm than good. In addition, given the fact that 2/3 of our society is overweight and 1/3 obese, the chances that a child will be placed in a home of family who itself struggles with a weight problem is more likely than not.

In the case of the 8 year old Ohio boy, there appeared to be an engaged mother who expressed love for her child, but struggled to get him to lose weight. Since there were no reported signs of neglect or abuse in conjunction with this boy's obesity, the ASBP considers state intervention unnecessary, unrealistic and likely damaging to the child long term.

Thursday, September 8, 2011

Wednesday, August 24, 2011

Best and worst restaurants....

Hi! here's a  new list, with details, of what our beloved chain restaurants are really made off. There's the very Best and Worst of them. Read carefully and pay attention, it is still possible to eat out...if you know how to chose:) just click on the link below and you will be reading the article. Enjoy!

Wednesday, June 22, 2011

About the protein in your diet

Hi!! long time no posting!!! Here's a litle piece form an article that explains why I keep telling you the importance about the protien in your diet. For the full article I'm including the reference at the end. Enjoy!
Although any
dietary or lifestyle change must be personalized, controlled energy
intake in association with a moderately elevated protein intake may
represent an effective and practical weight-loss strategy. Potential
beneficial outcomes associated with protein ingestion include the
following:
to a greater extent than carbohydrate or fat andmayfacilitate a reduction
in energy consumption under ad libitum dietary conditions;
thermogenesis—higher-protein diets are associated with increased
thermogenesis, which also influences satiety and augments energy expenditure
(in the longer term, increased thermogenesis contributes to the
relatively low-energy efficiency of protein); and
accretion of fat-free mass—in some individuals, a moderately higher
protein diet may provide a stimulatory effect on muscle protein anabolism,
favoring the retention of lean muscle mass while improving
metabolic profile. Nevertheless, any potential benefits associated with a
moderately elevated protein intake must be evaluated in the light of
customary dietary practices and individual variability.
Nutr
1) increased satiety—protein generally increases satiety2) increased3) maintenance orAm J Clin2008;87(suppl):1558S–61S.Dr. P

Thursday, March 3, 2011

Apps you can use

In the era of the App University, there's some you can actually use to improve your eating behavior... if you use them. So if you have a smart phone and are used to play with these little sources of info, here's a coupple of them one of you showed me, that I think can really make a difference in how you choose what you eat. Many of you are most of the time out there trying to eat decently but find yourself navigating a fast food menu... difficult task if there's one. And then, the ultimate challenge, pick what you will eat in the 10 secs the drive through allows you for this task. So here it is, just know what you will get before you get there, how? use one of these apps. You will be more likely to choose something you can eat out there:)
Some of them are:
Fast Food Calories
Jacques Pepin's Fast Food My Way
Fast Food Restaurant Nutrition Quick Reference
Calorie Calc-Fast & Simple Calorie Counter
Why you are fat
Amazing Pizza Calc 
etc
One more thing, there's also some good apps for self reporting (keep track of what you eat) and count calories. Try My net diary.
Let me know what you think
Dr. P

Thursday, February 3, 2011

Bad news.....

This a and extract from the Downy Obesity Report. As I probably mentioned in one of our recent office visits, the FDA had recently given a positive vote to one of the latest drugs in the pipeline for Obesity, Contrave.Well, the FDA decided not to approve it. Frustrating....
Orexigen Therapeutics Inc. indicated today that the Food and Drug Administration (FDA) has, in effect, decided not to approve the company’s obesity drug, Contrave ® in spite of a federal advisory panel vote of 13-7 in favor of approval in December of 2010. The FDA is requiring the company to complete a lengthy and expensive pre-approval of cardiovascular risks. Previously, the FDA had rejected two other new compounds: one developed by Vivus Inc. (Qnexa®) and the other, lorcaserin, by Arena Pharmaceutical Inc. (Lorquess ®) The FDA also pressured Abbott Laboratories to take orlistat (Meridia®) off the market.
According to Morgan Downey, editor and publisher of the Downey Obesity Report, “The FDA has decided that the most significant threat to public health will not be treated by any drug. In the current environment, tap water could not be approved. This is the first time in the FDA’s history that it has decided to abandon a major public health challenge. No doubt the FDA will continue to regularly approve drugs which cause weight gain and to half-heartedly police dangerous and unproven dietary supplements claiming to achieve weight loss. These actions have driven both large pharmaceutical companies and small biotech companies out of obesity research and development. At this time, only Vivus Inc.’s Qnexa has a hope of meeting FDA’s approval.” The FDA has asked Vivus Inc. to explore databases to rule out birth malformations due to one of its elements.
Any thoughts???..

Saturday, January 1, 2011

Happy New Year!!!!

Happy New Year to all! Hope this 2011 brings you closer to your personal goals or be the year is which you finally achieve them. Hope I can help you get there.
Health, Peace and Prosperity are our most sincere wishes,
see you soon,
Dr. P and Vanessa.

Friday, December 10, 2010

It's a start!

Hi everybody! This IS really just a start. I wanted to let you know that the blog is still under construction. It does not look completely  like I want it to look, but at least I can send the invitations out so you can start participating. There's a lot of new information that I would like to share. Finally the FDA is showing some positive signs towards the overweight and obesity community....
As you WILL notice, I am very much experimenting with this blog and I'm hoping it will get better as I find out exactly how it works, so wish me luck.
I would like you to start participating by sharing your experience and we'll take it from there. Remember no need for names or personal info.
Thanks!!!!!
Dr. P