Diet Pills: The Future
Diet Pills: The Future’
The quest for the perfect weight loss drug continues as the prevalence of obesity in the United States and other industrialized
countries rises.Why has it been so difficult for drug manufacturers to develop the “perfect” diet pill? One reason is that the causes of obesity are not fully understood, so it is difficult for researchers to select a specific target in the body to focus on when studying
potential drugs. Safety is another challenge; most drugs that cause weight loss have negative effects on metabolism and other body processes. Another important reason many diet drugs have failed is that they have been intended for short-term treatment only. Most people gain the weight back as soon as they stop taking the drug. A weight loss agent that provides long-term weight maintenance would have a better chance of being successful. In summary, the perfect diet pill would cause rapid weight loss and long-term weight maintenance with little or no serious side effects.

Diet Pills: The Future Diet Pills: The Future
DIET DRUG RIMONABANT ((brand name: Acomplia / Zmulti )
Rimonabant ((brand name: Acomplia / Zmulti ) is currently under development. This drug has shown early evidence that it may be able to counteract obesity and help people quit smoking. Acomplia is part of a new class of drugs called endocannabinoids, which work by blocking the same pathways in the brain that give people who smoke marijuana the “munchies.” Scientists have found a way to block the cannabinoid receptors in the brain in the hopes of stopping food cravings. In trials of the drug, patients were treated with Acomplia / Zmulti or placebo (sugar pill) for one year. Almost half of the patients receiving rimonabant lost 10% of their body weight by the end of the trial (for example, a 220-lb [100-kg] person lost at least 22 lbs [10 kg]). People receiving Acomplia / Zmulti or lost significantly more weight than people in the placebo group. People on Acomplia / Zmulti or also appeared to have improved cholesterol levels, and people with diabetes appeared to have better blood sugar control, although this requires further study.
Specific adverse effects of rimonabant have not yet been released to the public, although the company that makes the drug reports that their incidence is low. Pending the completion of more safety and efficacy studies, rimonabant is expected to be available in the United States in the next couple of years. This drug may prove to be especially ideal for obese individuals who smoke, since it should help with both problems.
DRUG TESTING
Diet drugs that are in development take years to be approved and marketed in the United States. First, these compounds are studied in the laboratory. Then, they are tested in animals. The next step is to be tested in people. There are three rounds of study—called Phases I, II, and III trials—to establish safety and effectiveness of the drug in humans. Drugs that are in Phase III trials are closest to approval and are usually available in the United States within a couple of years if they prove to be safe and effective. Drugs in Phase II trials are a little further behind in the approval process.
DIET DRUG AXOKINE®
Axokine® is another new drug under development. Axokine is a synthetic (man-made) chemical that mimics a hormone produced in the brain that is responsible for protecting the body from injury. Axokine was initially developed as a treatment for Lou Gehrig’s disease, but researchers noticed that patients who were taking this drug lost weight. Researchers then
turned their attention to studying this drug for weight loss.
Axokine affects the leptin pathway in the brain.As discussed in Chapter 2, leptin is a chemical messenger that tells the brain when the body has had enough to eat. People who are obese may not respond appropriately to this messenger, thus they may not realize they are full. Axokine apparently helps these individuals respond appropriately to leptin.
The main side effects associated with Axokine are nausea and cough. Unlike the other drugs discussed in this book, Axokine is an injection, not a pill. Axokine must be given with a needle, which may cause some pain at the site where it is injected. Axokine is currently being studied in a Phase III trial for weight loss. If Axokine proves to be safe and effective, it should be available in the United States within a few years.
DIET DRUG P57
Scientists found that the Hoodia cactus contained a previously unknown molecule, P57, that may produce weight loss. P57 is the active ingredient that scientists have isolated from the Hoodia gordonii cactus. As mentioned in Chapter 6, Hoodia is a cactus that grows in extremely hot climates, specifically in the African Kalahari Desert (Pic). The stems and roots of the Hoodia cactus were supposedly consumed by the San Kalahari bushmen for thousands of years to stave off hunger during long hunting trips. Hoodia gives a sense of satiety (fullness). The San Bushmen report no side effects from the use of the cactus; however, this requires further study.
A large drug manufacturer has decided to study this molecule and formulate it into a drug if it proves to be safe and effective. As an aside, the San Bushmen of the Kalahari desert are currently impoverished and oppressed. If P57 becomes a money-making drug in developed countries, it may mean a better life for people of this tribe, since they will receive royalties (money) when the drug is sold. This drug is very early in the research process and it will be several years before it could be available in the United States.

RIMONABANT ((brand name: Acomplia / Zmulti )
The Hoodia gordonii plant is a flowering cactus that is native to the African Kalahari Desert. The San Kalahari Bushmen supposedly consumed the stems and roots of this plant for centuries to stave off hunger while on long hunting trips. Scientists believe they have isolated the active ingredient (ingredient that exerts the effects of appetite suppression) from the Hoodia plant. Scientists have named the active ingredient P57 and are currently working on making this ingredient into a drug that can be used for weight loss.
CHOLESCYSTOKIN BOOSTERS AND NEUROPEPTIDE Y INHIBITORS
As discussed in Chapter 3, there are many hormones present in different concentrations in the body. Either increasing or decreasing these hormones can assist with weight loss. Two hormones in particular, cholecystokinin (CCK) and cholecyctokinin boosters, are currently under investigation as possible weight loss agents. CCK is a naturally occurring appetite suppressant.
A neuropeptide Y (NYP) inhibitor is also being investigated as a possible weight loss drug. NYP inhibitors block a potent chemical, neuropeptide Y, which is an appetite stimulant.
THE FUTURE OF WEIGHT LOSS DRUGS
These days, there is a lot of pressure to “look good.”As a result, many young people who are overweight think they should not laugh, smile, or do anything that might draw attention to them. Often, overweight and obese individuals are depressed and feel there is no hope that they can ever lose weight. These people resort to diet pills as their only way to lose excess weight. They feel that if they take more diet pills, they do not have to “watch what they eat” or exercise. The health and legal ramifications of diet pill abuse are never considered. What these individuals do not realize is that weight loss and maintenance need to become a way of life. Abuse of diet pills is not the way to lose weight; the resulting weight loss is temporary and abuse of these agents can lead to death.
The quest for the perfect diet pill is far from over. Readers should use reputable Internet sites and other sources to keep abreast of new developments. In most cases, diet pills will only be recommended for obese individuals who fall into certain risk-based categories. All drugs have side effects; the benefits must always outweigh the risks when you decide to take these pills.
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