Health and Fitness Blog

PARIS (AFP) – Designers of anti-obesity drugs have suffered three major setbacks, but the potential reward from treating the world's fat epidemic is so great that their quest is unlikely to be deterred.

After investing a sum rumoured to be in the hundreds of millions of euros (dollars), Sanofi-Aventis of France announced this month it was abandoning its drug rimonabant, which had stoked huge expectations at its launch in 2006.

Rimonabant -- brand name Acomplia -- ran into a flurry of ever-tougher warnings from European watchdogs about potential psychiatric side effects, including depression.

In October, the European Medicines Agency (EMEA) recommended that rimonabant be pulled from sale in Europe. The drug had never been able to gain approval in the all-important US market.

Also this month, the US giant Pfizer put a stop to tests of a prototype in late-stage development called CP-945,598, citing regulatory hurdles.

"The risk/benefit profile in this class of drugs was lower than expected for obtaining market authorisation," said Catherine Baulac, in charge of new products with Pfizer's French subsidiary.

And on October 2, Merck of the United States pulled the plug on its own experimental obesity fighter, taranabant, because of concerns about anxiety and depression at high doses.

The main causes of obesity -- overconsumption of fatty or sugary food and a sedentary lifestyle -- are well known. But the molecular machinery that drives it is in many ways obscure and, it is now suspected, more complex than thought.

Treating obesity entails a limited basket of options, from lifestyle changes to drugs and gastric-bypass surgery.

But when it comes to that middle choice, the most promising class of new prescription medicines for treating long-term obesity has just been wiped out.

The three scratched drugs belong to a group called cannabinoid receptor antagonists.

They take on the same target in the central nervous system as marijuana. But instead of sharpening appetite -- the "munchies" associated with smoking cannabis -- they work in reverse, dulling the urge to eat.

"There are now just two drugs left, orlistat and sibutramine," said Colin Waine, a doctor who is chairman of a British organisation, the National Obesity Forum.

Anders Sjoedin, a specialist in obesity drugs at the University of Copenhagen, Denmark, said cannabinoid receptor antagonists had now been discredited as an approach.

"Cannabinoid receptors not only regulate the appetite, they also affect mood," he said.

Orlistat, marketed as Xenical or alli, curbs absorption of fat in the intestine by blocking a pancreatic enzyme. Sibutramine, sold as Reductil or Meridia, affects levels of a brain chemical called serotonin, believed to influence feelings of hunger or satiety.

Both are "very useful," said Waine. But they come with a list of side effects, including, in orlistat's case, the risk of sudden, oily faeces.

As proof of the glittering allure of the obesity market, drug engineers are exploring unusual paths.

According to the UN's World Health Organisation (WHO), around 400 million adults were obese in 2005, and the tally is expected to balloon to more than 700 million in 2015.

In the lab, at least, are potential rivals to orlistat in the field of lipase inhibitors; new neurotransmitter inhibitors that reduce appetite; and even a hydrogel pill that expands in the stomach to give a sense of fullness.

But, should these prototypes ever get the green light to go on sale, will they meet the hopes of people desperate to lose dozens of kilos in a year, rather than just a few?

Even more important, are they safe?

Eleven years ago, the search for an obesity drug ran into controversy when fenfluramine, an appetite suppressant, was banned in the United States over fears of its effect on the heart.

This month, a study published in the journal BioMed Central found fenfluramine's damage to cardiac valves was visible seven years later.

Such questions pose a dilemma for scientists much as they do for drug regulators.

Obesity is a huge and growing problem, for which people are clamouring for a quick fix. Yet it is also a complex condition, and no drug is without side effects to some degree.

Sjoedin said that researchers believed that regulators, especially in the United States, were becoming increasingly demanding about proposed obesity drugs.

Watchdogs were wanting to see more data about adverse effects from proposed drugs, as well as further proof of benefits other than weight loss, such as lower blood pressure.

"Obese people will be around, and I'm not sure that surgery is the solution for all them," said Sjoedin.

"In that respect, there is a need for drugs. But no one is going to make a drug unless they can make money out of it in the end."

Source

FRIDAY, Nov. 14 (HealthDay News) -- Eating a high-fat diet during pregnancy causes permanent changes in the fetal brain that can result in overeating and obesity early in life, according to a study with rats.

The researchers from Rockefeller University in New York City said their finding is an important advance in understanding mechanisms of fetal programming. It also sheds light on the production of new brain cells, helping to explain the dramatic rise of childhood obesity in the United States over the past three decades.

"We've shown that short-term exposure to a high-fat diet in utero produces permanent neurons in the fetal brain that later increase the appetite for fat," study senior author Sarah F. Leibowitz, director of the Laboratory of Behavioral Neurobiology at Rockefeller, said in a university news release. "This work provides the first evidence for a fetal program that links high levels of fat circulating in the mother's blood during pregnancy to the overeating and increased weight gain of offspring after weaning."

For the study, pregnant rats were fed either a high-fat or a balanced diet for two weeks. Pups born to mothers that ate the high-fat diet ate more, weighed more throughout life, and began puberty earlier than pups born to mothers that ate a balanced diet. The pups born to the mothers that at the high-fat diet also had higher levels of triglycerides in the blood at birth and as adults, and also had greater production of brain peptides that stimulate eating and weight gain.

The study was published in the Nov. 12 issue of the Journal of Neuroscience.

The creation of neurons that increase the appetite for fat may also occur in human babies born to mothers who eat a high-fat diet during pregnancy, Leibowitz said.

"We're programming our children to be fat," she believes. "I think it's very clear that there's vulnerability in the developing brain, and we've identified the site of this action where new neurons are being born. We now need to understand how the lipids affect these precursor cells that form these fat-sensitive neurons that live with us throughout life."

More information

The Nemours Foundation has more about overweight and obesity in children.

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WASHINGTON (Reuters) – A nationwide system requiring fast-food chains to list calories on their menus could be gaining support in Congress as more states adopt the practice and the restaurant industry concedes change is on the way, a consumer, industry and health panel said on Friday.

Laws requiring that calories and other nutritional information be posted have become increasingly popular as states and cities struggle to combat the country's growing obesity problem while promoting health and nutrition. At the same time, lawmakers in Washington have struggled to get the practice adopted nationwide.

A bill introduced by Rep. Rosa DeLauro and Sen. Tom Harkin has stalled several times since 2003 for various reasons including opposition by Republican leadership and special interests and a lack momentum on the state level, according to DeLauro's office.

The aide said the bill requiring nutrition labeling on chain-restaurant menus across the United States would be reintroduced in the next session of Congress.

Similar legislation has been introduced by Sens. Tom Carper of Delaware, a Democrat, and Lisa Murkowski, an Alaska Republican. Restaurants and grocery stores could post the calories on the menu, a menu board or other approved ways.

"We think our prospects are a little better, not because of the election results, but because of what's been going on on the state level," the DeLauro aide told Reuters.

In late September, California became the first U.S. state to require fast-food restaurant chains to list calories on their menus. Similar calorie information went into effect in New York City earlier this year, and more than a dozen states are considering similar health code provisions.

Jonathan Blum, a senior vice president with Yum Brands, said the fast food company supports a uniform nationwide approach that would apply to supermarkets, convenience stores and restaurants, including Yum's Pizza Hut and Taco Bell brands.

"This is far better for consumers and for our business than seeing a hodgepodge of different standards in different states and communities," said Blum, who added a nationwide system would create a level playing field for all restaurants and better protect them from frivolous lawsuits.

After California passed its bill, and in response to comments from health, consumer and other groups, Yum has pledged to display calorie information on menus at its company-owned stores by 2011.

Margo Wootan, a director of nutrition policy for the Center for Science in the Public Interest, said action by the states has helped spur the restaurant industry to become more interested in a national solution.

"We were not very effective asking for voluntary change," she conceded.

The World Health Organization estimates 1.6 billion adults worldwide are overweight and at least 400 million adults are obese. That includes a third of all U.S. adults.

Obesity increases the risk of many diseases and health conditions including heart disease, Type 2 diabetes and cancer.

(Reporting by Christopher Doering; Editing by David Gregorio)

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BOSTON (Reuters) – A large European study has confirmed that simple measurements of the waist and hips may offer a better way of predicting obesity-related death than a standard, but more complicated, system of relating weight to height.

The standard body mass index, or BMI, method does not work very well for some people, such as the elderly or body builders, and researchers have begun building a case that it is better to look at waist circumference or the ratio of waist size to hip size.

Among people with comparable BMIs, having an extra 2 inches around the waist increased the annual risk of death by 17 percent for men and 13 percent for women, according to the team led by Dr. Tobias Pischon of the German Institute of Human Nutrition Potsdam-Rehbruecke in Nuthetal, Germany.

When they calculated the waist-to-hip ratio by dividing a person's waist size, measured at the navel, by the biggest part of their hips, the Pischon group found that the risk of death increased by 34 percent for men and 24 percent for women every time that ratio increased by 0.1.

Hip circumference alone did not predict death any better than BMI, which is a person's weight in kilograms divided by the square of the height in meters, the researchers found.

They used data from the European Prospective Investigation into Cancer and Nutrition database, involving 359,387 people in nine countries.

Even among people of normal weight, men with the biggest bellies had more than twice the death rate of the slimmest. For women, the rate was 79 percent higher if their weight was in the normal range yet their bellies were big.

The findings, published in the New England Journal of Medicine, "underscore the importance of assessing the distribution of body fat even among persons of normal weight and challenge the use of cutoff points to define abdominal obesity, at least when they are used to predict the risk of death," the researches wrote.

Earlier research had suggested that men should not have a waist-to-hip ratio above 0.95, and in women it should be no higher than 0.8.

(Editing by Maggie Fox and Cynthia Osterman)

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TUESDAY, Nov. 11 (HealthDay News) -- Kids these days are 13 going on 45, at least when it comes to their arteries.

According to research presented Tuesday at the American Heart Association's annual scientific sessions in New Orleans, obese adolescents had arteries more representative of someone three decades older.

"These data further illustrate the potential detrimental effects of obesity and its related risk factors, particularly components of the metabolic syndrome, on cardiovascular disease in children," said Dr. Carl Lavie, medical director of cardiac rehabilitation and prevention director of the Stress Testing Laboratory at Ochsner Heart and Vascular Institute in New Orleans.

And even beyond the results of this study, said Dr. Catherine McNeal, an associate professor of internal medicine and an assistant professor of pediatrics at Texas A&M Health Science Center College of Medicine and a pediatrician at Scott & White Hospital in Temple, "it is clear that obesity is a risk factor for the development of premature cardiovascular disease in youth."

According to one scoring measure, obesity in male adolescents is a greater risk factor for cardiovascular disease than smoking, McNeal noted.

Obesity and related health problems are a pressing issue in most countries.

"Certainly, there is considerable concern that there is an obesity epidemic in the U.S., including in our children who are becoming more sedentary, watching more and more TV, playing video games and on the computer as opposed to physical activity outside," Lavie said. "In fact, there is concern that if the current obesity epidemic continues [and it actually seems to be worsening], we will soon see an abrupt end to the steady improvement in life expectancy in the U.S."

Researchers at the University of Missouri Kansas City School of Medicine and Children's Mercy Hospital used ultrasound to measure the thickness of the inner walls of the carotid arteries, located in the neck, in 70 high-risk children aged 6 to 19.

Carotid artery intima-media thickness (CIMT) is a measure of atherosclerosis, or the fatty build-up within the arteries that can eventually choke the vessels, leading to a heart attack or stroke.

"Generally kids have much smaller CIMT than do adults, and this increases with age," Lavie explained. "In adults, CIMT has correlated with a risk of heart attack and stroke, so generally, it is well-recognized that having a thinner CIMT is preferable."

The average age of participants was 13, most were white, and about half were male. Fifty-seven percent had a body-mass index (BMI) above the 95th percentile for their age.

On average, participants' "vascular age," meaning the age at which this level of thickening would be normal, was three decades older than their chronological age.

Children who were obese and who had high triglyceride levels in the blood (triglycerides are a form of fat) were more likely to have advanced vascular age.

McNeal said it was worth noting that the study was a small one and lacked some statistical data, making her shy away from stating that the findings are conclusive.

In any case, researchers do need to explore whether losing weight and adopting healthier lifestyles could correct these problems. Other research indicates it could.

"The prevention of this starts prenatally, with educating mothers and fathers about the nutritional needs of raising an infant and a child," McNeal said. "Most young parents fail to understand the nutritional requirements of a child and fail to balance the caloric intake with energy expenditure. . . A study two years or so ago suggested that this generation of youth would be the first generation to not outlive their parents."

More information

Visit the Alliance for a Healthier Generation for more on kids and heart disease.

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NEW ORLEANS – Obese children as young as 10 had the arteries of 45-year-olds and other heart abnormalities that greatly raise their risk of heart disease, say doctors who used ultrasound tests to take a peek inside.

"As the old saying goes, you're as old as your arteries are," said Dr. Geetha Raghuveer of Children's Hospital in Kansas City, who led one of the studies. "This is a wake-up call."

The studies were reported Tuesday at an American Heart Association conference.

About a third of American children are overweight and one-fifth are obese. Many parents think that "baby fat" will melt away as kids get older. But research increasingly shows that fat kids become fat adults, with higher risks for many health problems.

"Obesity is not benign in children and adolescents," said Dr. Robert Eckel, a former heart association president and cardiologist at the University of Colorado-Denver. It is why the American Academy of Pediatrics recently recommended cholesterol-lowering drugs for some kids, he noted.

Raghuveer wanted to see if early signs of damage could be documented. She and colleagues used painless ultrasound tests to measure the thickness of the wall of a major neck artery in 70 children, ages 10 to 16. Almost all had abnormal cholesterol and many were obese.

No one knows how thick a 10-year-old's artery should be, since they're not regularly checked for signs of heart disease, so researchers used tables for 45-year-olds, who often do get such exams.

The kids' "vascular age" was about 30 years older than their actual age, she found.

A separate study tied childhood obesity to abnormal enlargement of the left atrium, one of the chambers of the heart. Enlargement is a known risk factor for heart disease, stroke and heart rhythm problems.

Julian Ayer, a researcher at Royal Prince Alfred Hospital Sydney Australia, did ultrasound exams on 991 seemingly healthy children ages 5 to 15. He saw a clear link between rising weight and size of the left atrium.

A third study by Dr. Walter Abhayaratna of Australian National University in Canberra, Australia, also used ultrasound tests and found impairment in the heart's ability to relax between beats in children who were overweight or obese.

The study involved the first 150 children participating in a larger community-based study.

Earlier research he helped conduct found more rigid arteries in such children — a possible sign of plaque deposits starting to form.

"Even at this young age of 10, you can have children who have got arterial stiffness who are comparable to 30- and 40-year-olds," he said.

Dr. Michael Schloss, a New York University heart disease prevention specialist, said the evidence shows obesity is more than a cosmetic issue for children.

"If you've seen what's on the menu for most school lunches, these findings are no surprise," he said. "The time has come to seriously deal with the issue of childhood obesity and physical inactivity on a governmental and parental level."

___

On the Net:

Heart meeting: http://www.americanheart.org

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WASHINGTON (AFP) – The neck arteries of obese children and teenagers experience similar strain as those of middle-aged adults, US researchers said Tuesday.

"There's a saying that 'you're as old as your arteries,' meaning that the state of your arteries is more important than your actual age in the evolution of heart disease and stroke," said Geetha Raghuveer, professor of pediatrics at the University of Missouri School of Medicine and cardiologist at Children's Mercy Hospital, Kansas City, Kansas.

"We found that the state of the arteries in these children is more typical of a 45-year-old than of someone their own age," she said.

Researchers, who presented their work at the American Heart Association's Scientific Sessions 2008 in New Orleans, used ultrasound to measure the thickness of neck arteries -- carotid arteries -- that supply blood from the heart to the brain.

Increased carotid artery intima-media thickness (CIMT) indicates a fatty buildup of plaque, which can clog the arteries and lead to a heart attack or stroke.

Researchers analyzed data from 34 boys and 36 girls who were deemed "at-risk" due to obesity, abnormal cholesterol and/or a family history of early heart disease.

The group's average age was 13 and 89 percent of the participants were white.

It was discovered the children's "vascular age" -- the age at which the level of artery thickening would be normal for their gender and race -- was approximately 30 years older than their actual age, Raghuveer said.

Researchers also found that having a higher Body Mass Index and higher blood pressure had the biggest impact on CIMT.

Further research is needed to determine whether the build-up of artery thickness decreases if children lose weight and exercise, according to the study.

"I'm optimistic that something can be done," Raghuveer said.

"In children, the buildup in the vessels is not hardened and calcified. We can improve the vessel walls and blood flow in adults through treatment, and I'm sure we can help children even more."

Source

WASHINGTON (Reuters) – An obese child's arteries may be just as clogged as the arteries of someone who is middle-aged, researchers said on Tuesday.

This buildup of fatty plaque means the children may risk heart attack or stroke as early as age 30, according to Dr. Geetha Raghuveer of the University of Missouri Kansas City School of Medicine and Children's Mercy Hospital.

"This is an alarming finding," Raghuveer, who led the study presented at an American Heart Association meeting in New Orleans, said in a telephone interview.

Her team used ultrasound to measure the thickness of the inner walls of neck arteries of 70 mostly obese children with an average age of 13, and found that the state of their arteries was more typical of a 45 year old.

Obesity among children is rising in many places worldwide. This is the latest study to show that obesity can begin to lay the groundwork for cardiovascular disease at a very young age.

The children in the study had high levels of low-density lipoprotein (LDL), known as "bad cholesterol," low levels of high-density lipoprotein (HDL), known as the "good cholesterol," or elevated levels of a type of fat found in the blood called triglycerides. Forty of the children were obese.

The study focused on the thickness of the inner lining of the carotid arteries, which are two large blood vessels in the neck that supply the brain with blood.

"We wanted to gauge their vascular age," said Raghuveer, referring to the age at which the level of arterial thickening would be normal.

In these children, their "vascular age" generally was three decades older than their chronological age, she said.

Obesity and high triglyceride levels together were closely associated with an advanced vascular age, Raghuveer added, indicating that this combination should alert doctors that a child may be at high risk of developing heart disease.

The build-up of plaque can narrow arteries and limit the flow of blood, leading to a heart attack or stroke. Plaque is made of fat, calcium and other stuff in the blood, and its build-up in arteries is called atherosclerosis.

Raghuveer said she is hopeful that the artery build-up can be reduced if the children make important lifestyle changes -- losing weight and exercising more -- and in some cases take medications like cholesterol-lowering statins.

The American Academy of Pediatrics in July said some children as young as age 8 should be treated with statins if they have certain cholesterol levels.

(Editing by Maggie Fox and Cynthia Osterman)

Source

NEW YORK (Reuters Health) – Preliminary findings from patients who underwent obesity surgery, also known as bariatric surgery, at Washington University in St. Louis, indicate that this procedure used to induce weight loss may improve the ability of morbidly obese women to conceive after undergoing in vitro fertilization (IVF).

Meanwhile, a second study conducted at Albert Einstein College of Medicine in Bronx, New York, suggests that reproductive hormone levels are reduced in obese women and are only partially restored to normal within 6 months following weight-reduction surgery.

Both studies were presented Tuesday at the 64th annual meeting of the American Society for Reproductive Medicine in San Francisco.

"Some studies have shown that women who are obese and undergoing fertility treatment have less success, require higher doses of medication to help get them to ovulate, as well as higher miscarriage rates," Washington University's Dr. Beth M. Lewkowski said in an interview with Reuters Health. As a result, "a lot of centers will advocate that obese women attempt to lose weight before considering fertility treatment."

Lewkowski's team reviewed the records of five obese women who underwent bariatric surgery followed by IVF. Currently, three of the women have delivered healthy full-term infants, Lewkowski said, and the other two women are still pregnant.

All five women had been infertile for 2 to 10 years before bariatric surgery. Three of the women became pregnant after one IVF cycle; their body mass index at the time of IVF ranged from 22.8 to 29.9. The other two women underwent three IVF cycles before they conceived. The body mass index during the first cycle was higher, at 36 and 39.2.

Body mass index(BMI) is the ratio of weight to height. A normal BMI ranges from 18.5 to 24.9.

Despite these outcomes, Lewkowski commented, adding infertility as a reason for bariatric surgery is something that requires more research before such a recommendation can be made.

In the second presentation, the Einstein team led by Dr. Alex J. Polosky discussed how morbid obesity affects follicle stimulating hormone, inhibin, and Mullerian inhibiting substance (MIS).

"Obesity leads to decreased fertility in women with irregular and regular menstrual periods alike," Polosky told Reuters Health. "However, weight loss only partially reverses reduced fertility; and we don't know why."

They studied seven morbidly obese women (with an average body mass index of 49) who underwent bariatric surgery, leading to an average BMI of 37 at 6 months after surgery, along with 36 normal-weight infertile women who had normal ovarian reserve.

At the start of the study, the obese women had levels of follicular stimulating hormone and inhibin B (an ovarian hormone) that were significantly lower than in normal-weight women.

The 25 percent average weight loss was associated with significant recovery of follicular stimulating hormone levels, but not of inhibin B. MIS, a measure of ovarian reserve, did not differ significantly between normal and obese subjects.

"Our data suggest that morbidly obese women do not produce enough follicular stimulatory hormone from their pituitary gland to make the ovary function properly," Polotsky noted. "Inhibition of follicular stimulatory hormone secretion via inhibin B was lower than expected. Yet, despite this inhibitory hormone being low, follicular stimulatory hormone did not rise."

Polotsky concluded: "This apparent deficit in follicular stimulatory hormone responsiveness in obese women is incongruous with their apparently normal ovarian reserve," as indicated by MIS levels. "These data imply that in a morbidly obese woman either the brain is not sensing the ovarian hormone signal (inhibin), or the ovarian hormone signal is not working properly."

Polotsky's group is now planning studies in which they will block the normal hormonal feedback from the ovary more completely and examine how the pituitary gland responds.

Source

PARIS (AFP) – Designers of anti-obesity drugs have suffered three major setbacks, but the potential reward from treating the world's fat epidemic is so great that their quest is unlikely to be deterred.

After investing a sum rumoured to be in the hundreds of millions of euros (dollars), Sanofi-Aventis of France announced last Wednesday it was abandoning its drug rimonabant, which had stoked huge expectations at its launch in 2006.

Rimonabant -- brand name Acomplia -- ran into a flurry of ever-tougher warnings from European watchdogs about potential psychiatric side effects, including depression.

In October, the European Medicines Agency (EMEA) recommended that rimonabant be pulled from sale in Europe. The drug had never been able to gain approval in the all-important US market.

Also Wednesday, the US giant Pfizer put a stop to tests of a prototype in late-stage development called CP-945,598, citing regulatory hurdles.

"The risk/benefit profile in this class of drugs was lower than expected for obtaining market authorisation," said Catherine Baulac, in charge of new products with Pfizer's French subsidiary.

And on October 2, Merck of the United States pulled the plug on its own experimental obesity fighter, taranabant, because of concerns about anxiety and depression at high doses.

The main causes of obesity -- overconsumption of fatty or sugary food and a sedentary lifestyle -- are well known. But the molecular machinery that drives it is in many ways obscure and, it is now suspected, more complex than thought.

Treating obesity entails a limited basket of options, from lifestyle changes to drugs and gastric-bypass surgery.

But when it comes to that middle choice, the most promising class of new prescription medicines for treating long-term obesity has just been wiped out.

The three scratched drugs belong to a group called cannabinoid receptor antagonists.

They take on the same target in the central nervous system as marijuana. But instead of sharpening appetite -- the "munchies" associated with smoking cannabis -- they work in reverse, dulling the urge to eat.

"There are now just two drugs left, orlistat and sibutramine," Colin Waine, a doctor who is chairman of a British organisation, the National Obesity Forum, said.

Anders Sjoedin, a specialist in obesity drugs at the University of Copenhagen, Denmark, said cannabinoid receptor antagonists had now been discredited as an approach.

"Cannabinoid receptors not only regulate the appetite, they also affect mood," he said.

Orlistat, marketed as Xenical or alli, curbs absorption of fat in the intestine by blocking a pancreatic enzyme. Sibutramine, sold as Reductil or Meridia, affects levels of a brain chemical called serotonin, believed to influence feelings of hunger or satiety.

Both are "very useful," said Waine. They come, though, with a list of side effects -- including, in orlistat's case, the risk of sudden, oily faeces.

As proof of the glittering allure of the obesity market, drug engineers are exploring unusual paths.

According to the UN's World Health Organisation (WHO), around 400 million adults were obese in 2005, and the tally is expected to balloon to more than 700 million in 2015.

In the lab, at least, are potential rivals to orlistat in the field of lipase inhibitors; new neurotransmitter inhibitors that reduce appetite; and even a hydrogel pill that expands in the stomach to give a sense of fullness.

But, should these prototypes ever get the green light to go on sale, will they meet the hopes of people desperate to lose dozens of kilos in a year, rather than just a few?

Even more important, are they safe?

Eleven years ago, the search for an obesity drug ran into controversy when fenfluramine, an appetite suppressant, was banned in the United States over fears of its effect on the heart. Last week, a study published in the journal BioMed Central found fenfluramine's damage to cardiac valves was visible seven years later.

Such questions pose a dilemma for scientists much as they do for drug regulators.

Obesity is a huge and growing disease, for which people are clamouring for a quick fix. Yet it is also a complex disease, and no drug is without side effects to some degree.

Sjoedin said that researchers believed that regulators, especially in the United States, were becoming increasingly demanding about proposed obesity drugs.

Watchdogs were wanting to see more data about adverse effects from proposed drugs, as well as further proof of benefits other than weight loss, such as lower blood pressure.

"Obese people will be around, and I'm not sure that surgery is the solution for all them," said Sjoedin. "In that respect, there is a need for drugs. But no one is going to make a drug unless they can make money out of it in the end."

Source