Body attempts to regain after weight loss

By Melissa Healy

Los Angeles Times

As if people needed a reminder that losing weight is hard and maintaining weight loss is even harder, a study has found that for at least a year, subjects who shed weight on a low-calorie diet were hungrier than when they started and had higher levels of hormones that tell the body to eat more, conserve energy and store away fuel as fat.

The report, published Wednesday in the New England Journal of Medicine, helps explain why roughly 80 percent of dieters regain lost pounds within a year or two of losing them and, sometimes, regain more.

After weight loss, "multiple compensatory mechanisms" spring to life, the study shows, and work together to ensure that weight loss is reversed.

The researchers, led by Joseph Proietto of the University of Melbourne's Department of Medicine, write that more than one solution to obesity will likely be necessary: "a combination of medications" that will have to be safe for long-term use.

The study paints a "very comprehensive" and "really discouraging" picture of the breadth of the body's response to weight loss, said Dr. Daniel Bessesen, an endocrinologist and obesity researcher at the University of Colorado Hospital.

The study enrolled 50 obese men and women without major health problems and put them on a strict low- calorie diet for eight weeks.

Within two weeks after that diet, and again a year later, researchers measured subjects' blood levels of nine hormones that affect appetite and metabolism, and asked subjects about feelings of hunger.

Even 52 weeks after subjects had completed their diets and were struggling to maintain their loss, their hormones were sending a single message: Eat more.

Weight-loss gene test in the spotlight

WEIGHT-loss programs based on genetic tests operating out of pharmacies at a $1600 cost to patients have become the latest enterprise to expose the Pharmacy Guild to controversy over its links to commercialized care.

The guild, already under a cloud over its deals with drug companies and the abandoned agreement with complementary medicine giant Blackmores, has an agreement with a genetic testing company to provide dietitian-led weight-loss programs at pharmacy clinics.

Experts have dismissed the genetic test-based weight-loss program as a ''gimmick'' which did not have the support of clinical research.

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Under the Pharmacy Guild's agreement with a Melbourne-based testing company, MyGene, pharmacies provide clinic space for a dietitian to take the test swab which is then analysed for genes linked to how the body metabolises carbohydrates and lipids.

The in-pharmacy dietitian then provides nine sessions of dietary advice based on the test results which are said to guide ''a personally optimised eating plan and weight-loss program'', a joint statement by the guild and MyGene stated when the scheme was launched in March.

The overall price for test and dietitian services is $1600, the managing director of MyGene, Nick Argyrou, said yesterday.

Mr Argyrou said the scheme had proved ''very popular'' and was now offered in 15 pharmacies, mostly in Victoria and about to open in Sydney and had been successful in reducing patients' weight.

A spokesman for the guild said that under due diligence arrangements, MyGene had produced ''a body of supporting evidence''.

Associate Professor Katie Allen, a gastroenterologist and food allergy expert, said the research findings MyGene cited did not back the use of genetic tests to guide weight-loss programs. While the idea of tailoring a diet to fit with a particular patient's profile ''would be wonderful, at the present time there is insufficient evidence to support that as a currently available therapy'', Professor Allen of the Murdoch Children's Research Institute said.

But Toorak pharmacist John Button, whose store offers the MyGene service, says he accepts the scheme might be controversial, but said: ''I don't think it is charlatanism. It is not a poke in the dark.''

The weight-loss program had worked for his customers, including his friends who had been pleased with the results.

Mr Button said he did not receive any ''kickback'' and his only revenue from the service was sales of the meal substitute diet shakes recommended to customers in line with the recommendation of the dietitian on the basis of the genetic test findings.

A spokeswoman for the Therapeutic Goods Administration, said yesterday it appeared that the MyGene test for weight loss was not a therapeutic good and did not need to be registered as a therapeutic good.

Source theage.com by Mark Metherell