Ramonabant (Acomplia) for Weight Loss - Sinner or Saint?

If you went to college in the 60's and 70's you may remember the "munchies" or voracious appetite which sometimes accompanied marijuana smoking. Little did the pot heads of that day realize that medications in the future which block the munchies would help them shed the pounds that they would gain over the next 30 or so years.

This new medication, ramonabant (affectionately known at metabolism.com as Ramona), brand name Acomplia, is presently available in Europe and may soon be available in the United States. The company which produces this medication, Sanofi-Aventis, has been in lengthy negotiations with the FDA regarding gaining the critical approval required to bring Acomplia to market in the U.S. There has been much speculation about the reasons for the lengthy delay in gaining approval from the FDA. One possible reason is that although extensive clinical trials suggest that the new drug is safe and effective for weight loss, many experts are concerned about potential side-effects of ramonabant.

Studies show that about 30-40% of obese people taking ramonabant lost more than 5% of their body weight and 10-20% of subjects lost over 10% of their body weight above what they lost on diet alone. Because Ramona acts on the liver as well it had beneficial effects on triglycerides and other fats in the blood. Blood pressure reduction has also been observed with Ramona treatment.

Ramona works by blocking an important chemical pathway in the brain known as the endocannabinoid system. Scientists speculate that our body naturally manufactures substances resembling cannabis (marijuana, pot, reefer erc.), which interact with the endocannabinoid system. The endocannabinoid system not only participates in the control of appetite but is active in many areas of the body including the gastrointestinal tract, mood regulation, bone development, muscle control, blood pressure, adaptation to stress and the reproductive system. Several experts such as University of Colorado at Colorado Springs biology professor Dr. Robert Melamede have warned that the long term use of Ramona for weight loss could result in unwanted side-effects involving these other body systems. In fact, depression is listed as one of the side-effects that may limit Ramona's tolerability occurring in about 3% of obese subjects in a weight loss study. Nausea was another important limiting side-effect.

Industry experts speculate that Acomplia may be available for U.S. consumers by this summer but no one knows for sure. Insurance companies in the U.S. will not pay for medications for weight loss. Only a drug that treats a medical illness or condition will be "covered" by an insurance company. For that reason it is thought that Sanofi-Aventis will approach the FDA for an approval to use Ramona in the treatment of diabetes. This is because many diabetics will see an improvement in their blood sugar as they lose weight and because Ramona may have a direct beneficial effect on glucose and cholesterol regulation, as well. It will then be up to the FDA to finish their analysis of the safety and efficacy of the drug for this purpose. How long this will take is anyone's guess.

In the meantime we wait and wait and wait for Ramona. At metabolism.com we have been thinking that it might help if our members wrote a song about their feelings on the matter.

We took a stab and came up with this little ditty.

(in a Calypso beat)


Lyrics by GPepper, Director Metabolism.com

Oh Ramona, Oh Ramona


Why you left me so blue?


Xenical not nearly so sweet as you.

Oh Ramon, My Ramona


Me want to shed these ugly pound


Me getting to look so soft and round

Oh Ramona, Oh Ramona


Why you left me so blue?


I'm all alone wit'a powerful taste for some yellow cheese fondu.

Oh Ramona, Oh Ramona


I don't know if you sinner or saint


You make my liver happy but the rest of me body complaint.

Please add your comments and your own song to the blog at metabolism.com. It may help you feel better.

Only you and your doctor can decide on what medical treatments are best for you. The articles on metabolism.com such as this one are meant for educational purposes only and should not be used to guide you in your medical care. Speak to your health professional before undertaking to change or initiate medical treatment plans.

Gary Pepper M.D.


Editor-in-Chief


http://metabolism.com

Diet Comparisons

In today's world, diets have become a way of life. Popular diets have become the focus of talk shows, magazines and entertainment news where celebrities and their spokes-persons are continuously endorsing one diet or another. Whether it is to shed a few pounds, put on extra muscle mass or just simply to stay in shape, every individual is looking for a diet that is most suited for his or her body type.

Contrary to popular belief, a 'diet' is not eating only celery sticks, digestive crackers and drinking carrot juice all day long. In fact a healthy meal combining of fruits, vegetables, proteins, grains, cereals and lean meats, all in moderation would be considered an ideal diet as well as a good dietary habit. People lose weight over a few months time only to gain it back in no time at all. It has been established that the true secret of losing weight and to maintain that loss is to make some permanent changes to your eating and lifestyle habits.

The meal you eat is influenced by several factors that include how hungry you are, how long it has been since you have eaten your last meal, smell and taste of food as well as the genetics that shape your appetite. Perhaps, the most important is the feel of satisfaction that one derives after eating. You only feel full when the stomach sends the requisite signals to your brain. Satisfaction however, does not depend only on how much you eat but what kind of foods you choose to eat.

Although most people tend to overlook it, a healthy diet is a matter of common sense. When one is really looking to shed a few pounds, besides sacrificing excessive fried foods and desserts, all one needs to do is eat few calories per ounce of food ingested. Fruits, vegetables, soups, stews or whole grain cereals are some instances of such foods. They are full of fibre and have high water content which not only provide you your share of nutrients but leave you feeling satisfied without having broken the calorie bank.

There are several different kinds of diets to suit individual needs. The most popular are:

Atkins - The Atkins Diet, although extremely popular, is a move away from the conventional. Instead of an emphasis on the inclusion of a combination of different food types that typically make up a healthy, balanced diet, the Atkins approach is towards eating more of protein, fat and cutting down on carbohydrates. Although it represents a drastic lifestyle change, you can eat as much as you want as long as you keep to the restricted food groups. The diet has proven very effective and helped people achieve their weight loss goals, but whether, it is an healthy option in the long run, remains to be determined.

Jenny Craig - The Jenny Craig diet offers much more than just a weight loss program by including exercise, healthy meals and lifestyle change. With a great deal of support it inculcates counselling and prepared meals within your diet regimen. Moreover, along with prepared meals delivered home, it also offers vegetarian options. It may not however, be suitable for people who travel constantly and those who are cost conscious, because buying prepared meals on a daily basis may prove expensive. It however advocates the moving away from the prepared meal option after acquiring the weight loss results initially aimed at.

The Zone is similar to the Atkins Diet in that it emphasizes on increased protein intake and less carbohydrates. However, as compared to Atkins, you can eat greater amounts of carbohydrates with smaller portions. It is a more balanced approach and even allows the intake of vegetables. However, for people who like larger portions, variety and flexibility in their diets, the Zone can be restricting.

NutriSystems- The NutriSystems is an easy to follow plan which concentrates on low Glycemic index, good carbohydrates and optimal amounts of protein to keep your sugar levels stable as well as aims to keep you satisfied. The plan offers a NutriSystem meal, pre packaged and delivered on order which you supplement with different food items like fresh fruits, salads, dairy etc.

Weight Watchers- The Weight Watchers Diet believes that dieting is one part of long-term weight management. It does not tell people what they can or can't eat. The goal is to help people make healthy eating decisions and encourage them to enjoy more physical activity, thereby losing weight safely and sensibly -- and keeping it off. It gives information on food choices, recipes and meals as well as exercise plans. It has an online support network and weight loss tracker and progress chart to keep you motivated.

South Beach- The South Beach Diet is more like the Atkins Diet and restricts carbohydrates except for some good carbs which are allowed. What is an absolute no-no are food types like potatoes, fruit, bread, cereal, rice, pasta, beets, carrots and corn. Again it discourages fats but promotes the healthy ones. It is a diet for life. Eat normal foods in portions.

How To Measure Your Servings?

Do you know much you eat? Maybe you do, and maybe you don't. It's amazing how many people struggle with weight loss for years, convinced that don't eat a lot. Yet the weight stays on or actually increases over time.

When, people nosh their way through the day in a distracted state and don't pay attention to the fact that they're eating. More often, they know what they eat, and they know how many servings they have of what they eat. The problem is their notion of what counts as a serving.

When doctors and other expert spell out guidelines for weight loss, they usually create a plan they recommends a certain number of servings of any food or food group. To know what they mean by the word "serving", you have to read through the particular guidelines that you're following. The side panel on a cereal box routinely reports nutrition information according to one serving. But one kind of cereal considers one serving to be one cup of the cereal, while another, higher fat, sugary cereal may specify one quarter cup. In the case of the cereal manufactures, they understand that the buying public expects one serving of any cereal regardless of its makeup to contain approximately the same number calories as the rest. So the people who make and tell cereal simple adjust the volume of the cereal that they call one serving.

On the diet programs, one serving is actually one unit of the food. One serving of strawberries might be one quarter of a cup, and you'd be allowed two servings of the berries in a single sitting. One serving of beef might be designated as one ounce, which means that at a single sitting, you would be allowed four serving. A more understanding of "serving" would be the standard total of that particular food for one meal. Thus, one serving of strawberries would be a half cup, while one serving of beef would be four ounces.

Having said all that, and even knowing all that, some people still don't know how much they eat. They don't actually measure a cup. They eyeball it. Or they measured once, and now they're gauging by what remember about how it looked in a certain dish.

They only accurate way to know how much you're eating is to measure it. If you think you're consuming one designated serving and routinely, it turns out to be twice that, you can see how you might quickly find the weight staying on or moving upward. It only takes a moment to measure food, which is far less that it takes to lose a pound of extra weight. Measuring cups and a simple food scale are all it will take to get in touch with the amounts of your food consumption.

Weight Training for Women - Fitness for Weight Loss

As obesity levels rise higher and higher around the world, there is one aspect to this problem that hasn't changed...

You have to expend some energy and put in some effort if you want to achieve weight loss and fitness with diet and slimming exercises and weight training.

While there are many ways to go about this one of the most efficient weight loss methods continually meets resistance... (Hmm. Maybe that's why it's called resistance training ...) namely, weight training.

Women generally have the hardest time accepting weight (resistance) training into their fast fighting repertoire. After all, few women want to bulk up and look muscular and less feminine...
and that's what'll happen if you pump iron, right?

Wrong!

The only time you see a female body builder is when they're posing on stage and a common reaction is 'Yuk. I don't want to look like that! I just want fitness and a nice slim figure.'

Yet if you saw those same women in normal clothes in normal situations you'd most likely want to have the trim, shapely body that they have.

The common misconception is that if you do weight training you are going to suddenly bloom out with muscles all over you. If only that were true; keeping the weight down would be easy.

The fact is, very few women could ever make themselves look like a Ms Olympia body builder. They are professional athletes who work incredibly hard in their training and on their diet in order to maximize their muscle mass and muscular appearance.

Believe me, getting too muscular is the least of your problems. So don't reject this major weapon in your arsenal against body fat on a mistaken assumption.

Instead, consider what weight bearing exercise will do for you in the war on fat:

1. Build a firm foundation to your muscle structure.

You have muscles all over you. We all do. Without them we wouldn't be able to move. Moderate resistance training is all that's required to firm and tone your muscles. Remember, it takes a lot of work to actually look muscular.

2. Burn more calories right away.

You know aerobic exercise burns calories while you've doing them but a real boost comes from weight training. Your metabolism (rate of calorie burning) stays quite elevated for 20-40 minutes after an aerobic workout. With resistance training your metabolism stays elevated for at least an hour after your workout. Overall your metabolism will stay somewhat elevated and boosts calorie burning for anything from 4 to 24 hours depending on the intensity. It is important that your resistance training be progressively increased in intensity.

3. Burn even more calories in the long run.

With resistance training you are actually building muscle tissue, which is very active metabolically in comparison to fat, which is nearly inert. A kilo of muscle requires 50-100 calories a day just to maintain itself. So the more muscle tissue you have the more energy (fat) you'll burn off just by living, even when you're resting!

4. Strengthen bones and supporting muscle structure.

This is so you don't become prematurely old, stooped and weak and susceptible to injury. This is a major reason why even women who don't need to lose fat should still be concerned about maintaining muscle tissue.

5. Improve self-esteem.

When you look good you tend to feel good. With more toned muscle you not only look better but feel good because you actually have more energy. You feel more confident and positive about life, and better able to cope with stress.

So c'mon ladies, regardless of your age, let's assist your diet and slimming program and boost your general fitness. It's time to get into moving some weights around so you can move that excess weight off your body and raise the quality of body and life. Don't wait. Start your weight training today.

Why Many Diets Are Doomed to Fail- How to Choose the Right Diet for You

You have probably seen it before. You or someone you know starts a new diet full of enthusiasm about the amazing weight loss to come. They stick with the diet for about a week, and then return to their old habits and lose all of the ground they had made. This is the saga that goes on in many people's lives indefinitely. Always signing up for the next diet that is going to melt the pounds off in a big hurry only to quit in less than two weeks with no permanent results. This is not the recipe for lasting weight loss.

So what causes people to start out strong a new diet and quickly fade into old habits? This article is going to reveal where most diets go wrong and show you how to avoid this weight loss trap.

A lot of people hold the belief that they need a strict, harsh diet to be able to achieve great weight loss. While these kinds of diets may work, how likely is a person to really stick with something so extreme for the long haul? The diet was doomed to fail because it is too hard to stick with.

If you are accustomed to eating anything you want all day and then suddenly start eating carrots, apples and rice, how do you think you would react? You might be able to stick it out for a couple of weeks, but sooner or later you would likely quit. This is because the diet is not satisfying. If you don't feel ok with what you're eating you will crave all of the things that the diet doesn't allow. These cravings only become stronger with time.

This is why it is critical to choose a diet that is healthy and satisfying. This will give the best of both worlds. You will like the food you eat, and you will experience lasting weight loss. What starts as a healthy diet becomes a lifestyle. This is where all lasting results are found… in a lifestyle change. I hope you take this article to heart and begin a reasonable diet that will provide the change you desire.

An Insight into the Countless Benefits of Green Tea Dieting

Green tea has been used as a medicine in China for at least 4,000 years and the Chinese have been using it to treat everything from headaches to depression. Unlike black tea which is processed in a different manner, green tea retains its original color and the nutrients which are beneficial for your body. The benefits of green tea dieting are endless, and I will describe just a few of the benefits of green tea dieting in this short article.

The benefits of green tea dieting come from drinking 3 to 5 cups a day of green tea along with a balanced healthy diet and regular exercise. The easiest approach to attain the benefits of green tea dieting is by simply drinking a cup with each meal and snack you eat.

Since green tea is not as processed as black tea, one good chemical that remains is called catechin polyphenois which works with chemicals in your body to burn more fat. As a result, one of the many benefits of green tea dieting is a faster metabolism. In fact, a study published in 2005 indicated that drinking green tea can lead to a reduction in body fat and cholesterol levels which is one of the major benefits of green tea dieting.

Another one of the many benefits of green tea dieting is that it helps depress leptin which decrease the appetite. This means you will feel full with less food, and as a result of the calorie reduction, you will lose fat, assuming of course that you eat healthy food.

One of the benefits of green tea dieting not often mentioned is its role as a glucose regulator which basically means that it slows down the digestion of carbohydrates which can cause rises in blood sugar levels and insulin spikes that cause fat gain. To get these benefits of green tea dieting, you need to drink green tea on a regular basis.

Aside from weight loss, there are other benefits of green tea dieting such as its many health benefits. Green tea contains a powerful antioxidant which helps boost your immune system and researchers suggest that the active ingredient may be up to 200 times more powerful than vitamin E.

Another one of the benefits of green tea dieting is that instead of drinking green tea, you can take green tea pills. These are often 500 mg capsules which are to be taken two to three times daily. Studies show that green tea helps people to lose weight, regardless of whether in pill or liquid form.

What's more, while some green tea pills contain caffeine, it is often half of that in coffee. This lower amount of caffeine means you can lose weight naturally and safely, and avoid the ephedra or prescription weight loss drugs which can raise heart rates.

You may be wondering if aside from all the benefits of green tea dieting, are there any negative points, such as side effects? While green tea may have some side effects it will be mostly from the caffeine, since a 6 oz. cup of green tea contains around 30 mg of caffeine. If you have over 6 cups a day this can cause sleeplessness, irregular heart beat, diarrhea, vomiting, dizziness, headaches, and a loss of appetite. However, you can get caffeine-free green tea pills to avoid these side effects.

The benefits of green tea dieting are very clear. Even if your intention is not necessary to lose weight, these benefits of green tea dieting should not be underestimated.

What Vitamins Does A Breastfeeding Mother Need?

No single source of food gives you all the vitamins you need except for breastmilk. Because a breastfeed baby gets all the nutrients it requires from its mother breastmilk it's vital that a nursing mother is getting all the vitamins she needs.

Breastfeeding is the best way to give your baby all the nutrients it needs to grow and thrive. And, as a breastfed baby gets all its vitamins for her mother's milk, it's important that a breastfeeding mother is getting her daily quota of vitamins; you get out what you put in.

Amongst other nutrients, such as minerals and protein, vitamins play an important role in your baby's development. A nursing mother should be aware of what vitamins are important and what part of her diet provides these vitamins.

Vitamin A and C, and the B group

Vitamin C is needed every day for a baby to develop well. Vitamin C helps our bodies to fight off infection and disease as well as helping to heal wounds. Vitamin C also plays a role in preventing anaemia (lack of iron in the blood). Vitamin C can't be stored in the body, so we must eat food that gives us the vitamin C we require. Eating fruit and vegetables is the best way to get vitamin C. Citrus fruits especially are a great source as is papaya, broccoli, strawberries, cauliflower and kale. Some breastfeeding mothers may need more vitamin C than others, especially when overcoming a cold, surgery or some form of injury. In these circumstances, it is a good idea to increase your intake of foods rich in vitamin C.

Vitamin A (also known as retinol) helps in the formation and maintenance of healthy skin, hair, and mucous membranes. It is also necessary for proper bone growth and tooth development. Unlike vitamin C, which is water-soluble, vitamin A is a fat-soluble vitamin. Good sources of vitamin A include cheese, eggs, oily fish (such as mackerel), milk, fortified margarine and yogurt. Liver is also a rich source of vitamin A but is to be avoided during pregnancy. However, after birth a breastfeeding mother can eat liver but, because it's such a rich source, if you already eat it every week, you might want to choose not to have it more often.

There are many B group vitamins. Vitamin B12 (also known as cobalamin) is needed for the production of new cells. It also contributes to a healthy nervous system and is involved in the making of fatty acids. Vitamin B12 is only naturally found in foods that come from animals such as meat, fish, eggs and milk. It is very rare for a woman who eats animal foods to be deficient in B12. If you are a vegan breastfeeding mother then you may need to eat foods that have been fortified with vitamin B12. You might also consider a B12 supplement.

Vitamin D

Vitamin D is important as it helps our bodies to absorb calcium, which is important for bone development and strong teeth. Babies who don't get enough vitamin D are at risk of developing rickets - a softening of the bone that causes curvature. Vitamin D can be manufactured by the body when our skin is exposed to natural sunlight. However, many mothers - especially during winter - don't get enough sunlight for their bodies to make enough vitamin D. Foods like salmon, tuna, liver and kidney are good sources of vitamin D. Also, many foods are now fortified with vitamin D such as breakfast cereals and margarine.

If in doubt about your recommended daily amount of vitamins needed while breastfeeding, you should first consult your doctor. But, if you have a well-balanced diet, and eating the 5 portions of fruit and vegetables each day as recommended, the chances are that your baby is getting all the vitamins it needs.