Shortly after recommending approval of Qnexa (Phentermine / Topiramate), the FDA advisory panel this week also voted to approve Arena Pharmaceuticals weight loss drug, Lorgess (Lorcacerin). This medication has been in clinical trials over the past several years and works through the 5HT2c sub-type Seratonin receptor in the brain.
Why is this important? What is 5HT2c? Well, Lorgess is a seratonin agonist – that means it triggers the release of seratonin. Sound familiar? The big hit weight loss drug of the 90′s, Fenfluramine worked as a seratonin agonist as well. That was when it was discovered that we had seratonin receptors in lots of places, not just our brains. In fact, we have a seratonin receptor in heart valves. That’s why Fenfluramine caused heart valve damage.
Fast forward to 2012. We now have the technology to target specific seratonin receptors. By targeting the 5HT2c receptor, Arena Pharmaceuticals has been able to develop a medication that targets only the brain, with little to no activity in the heart. They have done careful safety studies, and have proven that their new obesity drug is both safe and effective.
The FDA panel is scheduled to vote on Qnexa on July 17th, and on Lorgess on June 27th, but they are under no obligations to follow their advisory panel’s advice.
So, will 2012 be the first year in 13 years that we get a new obesity treatment? Stay tuned…
Weight loss and weight gain have many obstacles. Our bodies produce a hormone called leptin and it is a key element in the body weight regulation system. Leptin and other chemicals trigger the area in the brain to let you know you are full. If your system is malfunctioning, you don’t feel full even if you have consumed an adequate amount of food.
Dopamine is a neurotransmitter that motivates us to eat and is involved in other rewarding behaviors. It also is involved in “wanting” more than “liking” which could be why we feel addicted to foods. So different levels of dopamine could be one problem causing obesity.
Weight issues are often rooted in biology, not just “will-power”. Here are some strategies to help with weight loss and to help with maintenance:
1) EAT BREAKFAST-make sure you have lean protein like 3/4 cup to 1 cup of egg whites with low-fat cheese plus Fat-Free yogurt and fresh fruit.
2)Eat ‘Filling Foods ‘such as: skinless poultry, fresh fruit, vegetables, lentils and beans
3)Exercise! Cardio and Weights….aim for 150 minutes weekly
4)Self-weighing or how clothes feel should be evaluated weekly or daily-whichever is most motivating individually.
5)Journal food, exercise and water. Stay mindful of your eating and concentrate on slow eating. Try either writing down food consumed or use apps such as Myfitnesspal and endomondo
6)Water-drink plenty and increase water intake with exercise; Every 15min. of exercise add another 8 oz. cup
7)Positive Self Talk-don’t get mad at yourself but think of being overweight as a health problem and needing treatment. Healthy eating habits and lifestyle behaviors are essential to success….don”t give up! Our clinic is here to keep you HEALTHY!!!
-By Mary Ellen Doukakis, RD
