Americans are fat. One third of us are obese. And another third are overweight. A new study suggests that carrying around even a few extra pounds may shorten our lives.
If you happen to be 5 foot 9 and you weigh between 169 and 202 pounds, you are considered overweight. The study in the New England Journal of Medicine (Aug. 24, 2006) suggests that middle-aged people in that category are 20 to 40 percent more likely to die prematurely. If you are over that range, your risk is substantially higher.
So, what are we to do? Almost everyone knows that losing weight means eating less and exercising more, but that is very hard work. Americans want instant results.
This explains the eternal popularity of diet books. Nonprescription diet pills are also big sellers. Products sold on cable TV and on the Web offer dramatic results for minimal effort.
Whenever you see someone promoting a miracle weight loss pill or dietary program, be suspicious. Hucksters have been taking advantage of desperate dieters for decades.
It astonishes us that people would spend hard-earned money to buy juice from the rare Mongo-Bongo tree found only on the volcanic mountains of Vanuatu. Just because some beautiful babe says Mongo-Bongo helped her shed 150 pounds in three weeks while she slept with no exercise or dietary restraint does not mean it will work for you.
How can we lose weight? Some will opt for stomach surgery. While this can work for some truly obese people, there are risks and it is inappropriate for the merely overweight.
Others are turning to medications that were developed for other purposes. Some doctors are willing to prescribe “off label. Drugs like Adderall or Ritalin for attention deficit disorder tend to suppress appetite and may cause weight loss as a side effect. Adderall contains amphetamines, compounds that were abused in earlier decades. These stimulants are not very different from some prescription diet pills that come with a long list of warnings.
People are willing to risk serious side effects (such as addiction or serious cardiovascular complications) from these off-label medicines because there are only a few approved diet pills. Xenical (orlistat) will soon become available over the counter as Alli, but it may not lose the side effects that have made it famous: fecal incontinence, oily spotting and “flatus with discharge.
That’s why there is such excitement about a new drug awaiting approval by the FDA. Acomplia (rimonabant) has recently gone on sale in Europe. Studies show that people taking rimonabant for a year lost about 15 pounds more than those on placebo.
It also improves insulin efficiency and has a beneficial impact on blood fats, lowering triglycerides and raising good HDL cholesterol. Side effects may include diarrhea, nausea, anxiety, headache, dizziness and depression. None of these would normally be expected to keep the FDA from approving a drug. But the agency has not said if or when it may approve Acomplia.
Even if this new prescription medicine gets a green light, don’t expect a miracle in a bottle. Losing weight will still require exercise and dietary restraint.
