Undeclared Analogue Found In A Slimming Product

The Hong Kong Department of Health appealed to members of the public not to buy or use a slimming product named “Kalomees” as it was found to have contained an undeclared drug analogue that may cause serious side effect.

A spokesman for the department said that laboratory tests on the product sample today showed the presence of N,N-didesmethylsibutramine which is an analogue of sibutramine.

The sample was obtained from a beauty parlour in Tuen Mun during market surveillance recently.

DH officers inspected the beauty parlour this afternoon and instructed it to stop selling the product. The wholesaler was also instructed to recall the product from the market. A telephone hotline 3106 8091 has been set up by the wholesaler to answer public enquiries on the recall.

Sibutramine is a western medicine used as appetite suppressant for slimming. Its side effects include increased blood pressure and heart rate, symptoms of psychosis, and possibly convulsion. People with heart problems should not take it.

The spokesman said sibutramine analogues, being chemically similar to sibutramine, are expected to have the same side effects of sibutramine.

He appealed to members of the public who have been using the above product to stop using it immediately. They should consult their medical professionals for advice if they feel unwell.

They should destroy and dispose of the products or submit them to the department’s Pharmaceutical Service at 3/F, Public Health Laboratory Centre, 382 Nam Cheong Street, Kowloon during office hours.

The spokesman stressed that a balanced diet and exercise are crucial factors in keeping fit and healthy. Members of the public who want to reduce weight are advised to consult medical professionals first.

Lancet Questions Rimonabant Weight Loss Pill’s Efficacy

The demand for weight loss pills is growing, but safety and efficacy of anti-obesity drugs should always be in focuse as study questions benefits of weight loss drug Rimonabant, made by Sanofi Aventis.

The following is the summer of Rimonabant weight loss pill study from Lancet.

Since the prevalence of obesity continues to increase, there is a demand for effective and safe anti-obesity agents that can produce and maintain weight loss and improve comorbidity. We did a meta-analysis of all published randomised controlled trials to assess the efficacy and safety of the newly approved anti-obesity agent rimonabant.

We searched The Cochrane database and Controlled Trials Register, Medline via Pubmed, Embase via WebSpirs, Web of Science, Scopus, and reference lists up to July, 2007. We collected data from four double-blind, randomised controlled trials (including 4105 participants) that compared 20 mg per day rimonabant with placebo.

Patients given rimonabant had a 4 7 kg (95% CI 4 1-5 3 kg; p<0 0001) greater weight reduction after 1 year than did those given placebo. Rimonabant caused significantly more adverse events than did placebo (OR=1 4; p=0 0007; number needed to harm=25 individuals [95% CI 17-58]), and 1 4 times more serious adverse events (OR=1 4; p=0 03; number needed to harm=59 [27-830]). Patients given rimonabant were 2 5 times more likely to discontinue the treatment because of depressive mood disorders than were those given placebo (OR=2 5; p=0 01; number needed to harm=49 [19-316]). Furthermore, anxiety caused more patients to discontinue treatment in rimonabant groups than in placebo groups (OR=3 0; p=0 03; number needed to harm=166 [47-3716]).

Our findings suggest that 20 mg per day rimonabant increases the risk of psychiatric adverse events – ie, depressed mood disorders and anxiety – despite depressed mood being an exclusion criterion in these trials. Taken together with the recent US Food and Drug Administration finding of increased risk of suicide during treatment with rimonabant, we recommend increased alertness by physicians to these potentially severe psychiatric adverse reactions.

Earlier this year FDA had similar findings on this weight loss drug, also know as Acomplia, which led FDA advisin against marketing the drug. As reported in ABC.com “In addition to a potential risk of depression and anxiety, the FDA also found an increased chance of irritability, insomnia, panic attacks, aggression and suicide in patients taking the diet pill. Several patients taking rimonabant were prescribed antidepressants or tranquillizers to keep their symptoms under control.”

According to Daily Mail “Disappointing weight-loss results from anti-obesity drugs are reported in the British Medical Journal. Patients on Acomplia, Xenical (also known as orlistat) or Reductil (sibutramine) lost less than 11lb, or less than five per cent of body weight.”

Discovering Drug That Cuts Appetite, Boosts Energy

In a major advance in obesity and diabetes research, Yale School of Medicine scientists have found that reducing levels of a key enzyme in the brain decreased appetites and increased energy levels.

Reductions in the levels of the enzyme prolylcarboxypeptidase (PRCP) led to weight loss and a decreased risk of type 2 diabetes in mice, according to research published in the August issue of The Journal of Clinical Investigation. The team found that PRCP is located in the hypothalamus and regulates levels of a peptide known for inhibiting food intake and stimulating energy expenditure — the alpha-melanocyte stimulating hormone (alpha-MSH). Researchers found that blocking the PRCP enzyme keeps the alpha-MSH peptides from being degraded, resulting in higher levels of alpha-MSH and decreased appetite.

“Our research provides the first evidence that breaking down molecules in the brain that regulate metabolism is an important component of weight control,” said senior author Sabrina Diano, associate professor in the Departments of Obstetrics, Gynecology and Reproductive Sciences, and Neurobiology. “Our findings provide a possible new target for the development of drugs to control metabolic disorders such as obesity and type 2 diabetes.”

Diano and her team conducted the study in congenic mice that were naturally lean and later in mice that had PRCP removed. Animals without the PRCP enzyme were leaner and ate less food. They also had higher levels of alpha-MSH in the hypothalamus compared to control animals. The mice were put on a diet of 45 percent fat—the equivalent of eating fast food everyday—and even with this high fat diet, they did not gain as much weight as control animals on a regular diet.

Breakfast Improves Diet, Help With Weight Management

A groundbreaking new study published in the November 2008 issue of the American Journal of Clinical Nutrition 1 shows that eaters of lower energy dense breakfast have improved diet quality, and may have a better ability to maintain a healthy weight. The study found that those who enjoy a less energy dense morning meal have diets that are richer in important vitamins and minerals and lower in saturated fat and cholesterol compared to those who consume a more energy dense meal.

The study explored whether or not the energy density — the number of calories in relation to the grams of foods and beverages — consumed at breakfast predicted energy density and diet quality for the rest of the day, as well as weight among 12,000 US women and men (as assessed by BMI – body mass index).

“Our new findings carry several important implications concerning breakfast and overall health,” says study co-author, cardiologist Dr. James Rippe of the Rippe Lifestyle Institute. “Our study confirms the findings of many previous studies that eating breakfast helps maintain a healthy weight and provides multiple health benefits. However, what’s unique is that we found lower energy density breakfast foods and beverages high in nutrients, such as whole grain oatmeal and 100 percent orange juice, appear to predict better food choices for the rest of the day and may help with better management of body weight.”

The energy density concept provides new insights into better understanding weight management strategies. Recent studies have reported that individuals with lower energy density diets gain less weight as they age.

Generally, foods with the lowest energy density include fruits, vegetables, soups and whole grains that soak up water, such as oatmeal or rice. Fats and oils, fried foods, desserts, crackers and pretzels are highest in energy density. The more calories per gram of food, equals greater energy density. For example, a breakfast pastry would have more calories per gram (more energy dense) than a bowl of oatmeal and glass of 100% orange juice.

“One simple way to choose breakfast items that are low in energy density is to immediately increase the ratio of high-fiber foods such as fruits, vegetables and whole grains in your morning meal. These foods are less packed with calories, but nutrient-rich, providing a concentrated amount of valuable nutrients to start your day off right,” says Jeff George, vice president of research and development at Quaker Oats.

The study examined the breakfast choices and dietary patterns of a nationally representative sample of 12,000 adults using the most recent National Health and Nutrition Evaluation Survey (NHANES) datasets from 1999-2004 for analyses. Researchers calculated and compared the energy density values for all reported breakfasts and total 24-hour diets among both breakfast eaters and non-eaters.

This research further contributes to the growing body of literature that demonstrates consuming the right foods for breakfast may help with weight management and improve dietary quality. Without breakfast, key nutrients determined by the Dietary Guidelines for Americans are often under-consumed in the daily diet. So it turns out that the recommendation that our mothers gave us is correct – eating breakfast is the most important meal of the day – and choosing more filling and less calorie-dense options at breakfast can make it even more essential for health and well being.

Lancet Questions Rimonabant Weight Loss Pill’s Efficacy

The demand for weight loss pills is growing, but safety and efficacy of anti-obesity drugs should always be in focuse as study questions benefits of weight loss drug Rimonabant, made by Sanofi Aventis.

The following is the summer of Rimonabant weight loss pill study from Lancet.

Since the prevalence of obesity continues to increase, there is a demand for effective and safe anti-obesity agents that can produce and maintain weight loss and improve comorbidity. We did a meta-analysis of all published randomised controlled trials to assess the efficacy and safety of the newly approved anti-obesity agent rimonabant.

We searched The Cochrane database and Controlled Trials Register, Medline via Pubmed, Embase via WebSpirs, Web of Science, Scopus, and reference lists up to July, 2007. We collected data from four double-blind, randomised controlled trials (including 4105 participants) that compared 20 mg per day rimonabant with placebo.

Patients given rimonabant had a 4� 7 kg (95% CI 4� 1-5� 3 kg; p<0� 0001) greater weight reduction after 1 year than did those given placebo. Rimonabant caused significantly more adverse events than did placebo (OR=1� 4; p=0� 0007; number needed to harm=25 individuals [95% CI 17-58]), and 1� 4 times more serious adverse events (OR=1� 4; p=0� 03; number needed to harm=59 [27-830]). Patients given rimonabant were 2� 5 times more likely to discontinue the treatment because of depressive mood disorders than were those given placebo (OR=2� 5; p=0� 01; number needed to harm=49 [19-316]). Furthermore, anxiety caused more patients to discontinue treatment in rimonabant groups than in placebo groups (OR=3� 0; p=0� 03; number needed to harm=166 [47-3716]).

Our findings suggest that 20 mg per day rimonabant increases the risk of psychiatric adverse events – ie, depressed mood disorders and anxiety – despite depressed mood being an exclusion criterion in these trials. Taken together with the recent US Food and Drug Administration finding of increased risk of suicide during treatment with rimonabant, we recommend increased alertness by physicians to these potentially severe psychiatric adverse reactions.

Earlier this year FDA had similar findings on this weight loss drug, also know as Acomplia, which led FDA advisin against marketing the drug. As reported in ABC.com “In addition to a potential risk of depression and anxiety, the FDA also found an increased chance of irritability, insomnia, panic attacks, aggression and suicide in patients taking the diet pill. Several patients taking rimonabant were prescribed antidepressants or tranquillizers to keep their symptoms under control.”

According to Daily Mail “Disappointing weight-loss results from anti-obesity drugs are reported in the British Medical Journal. Patients on Acomplia, Xenical (also known as orlistat) or Reductil (sibutramine) lost less than 11lb, or less than five per cent of body weight.”