What now for weight loss?

The country is down to onededicated, prescription obesity medication -- the not-too-pleasantXenical -- since Friday’s announcement that Meridiawill be removed from the market due to an increased risk ofheart problems among people with cardiovascular disease. But, notto fear, the major gathering of experts on obesity are gatheringSaturday through Tuesday in San Diego for the Obesity 2010 meeting. Theschedule looks packed with promising ideas aimed at reducing thegirth of Americans although, I must say, I don’t see any easyfixes. We’ll bring you the meeting highlights daily here at BoosterShots. In Saturday’snews:

• For very obese people, those with a body mass index of 35 or higher, most scientific research focuses on bariatric surgery as a remedy. However, a study presented Saturday and published online early in the Journal of the American Medical Assn., found that doctors and patients shouldn’t be so pessimistic about the effects of diet and exercise.

Researchers assigned very obeseadults to either a diet and exercise program for 12 months or thediet component of the program for six months followed by diet andexercise for the remaining six months. The diet program consistedof liquid or pre-packaged meal replacements for all but one mealper day in the first three months of the program followed by onemeal replacement a day in months four through six. The physicalactivity component consisted of walking up to 60 minutes a day,five days a week. Participants were encouraged to wear a pedometerand to walk at least 10,000 steps a day.

The results found both groups lost weight andhad improved health, although the group that exercised in theentire 12 months showed more improvements early in the study. Atthe end of the study, that group lost 27 pounds compared to 22pounds for the group that began exercise in the last six months ofthe study. Both groups had smaller waist sizes, less abdominal fat,healthier livers, lower blood pressure and improved bloodsugar.

This suggestsbariatric surgery isn’t the only way to fight the health problemscaused by obesity. Health insurance programs, however, rarely payto support diet-and-exercise programs but do pay for bariatricsurgery for the very obese, said the authors of an accompanyingeditorial in JAMA. “Physicians should not be discouraged fromimplementing nonsurgical approach in this population, but payersneed to rethink their policies,” they wrote.

• Commercial weight-loss programs can be successful and should be paid for by health insurers, say researchers of a new study and the authors of an accompanying editorial. The study, presented at the meeting and published simultaneously in the Journal of the American Medical Assn., found that women who attended Jenny Craig Inc., programs were more successful at weight loss compared to a group of women who received the standard advice to increase their physical activity.

The study was funded by Jenny CraigInc., and the lead author receives funding from the company.However, the research adds to other evidence that, for overweightwomen, receiving personalized counseling and prepackaged meals iseffective. Such programs, however, may not work as well among obeseor very obese people, said the authors of the editorial.

• Two other studies of note: One found that people who had bariatric surgery had improved cognitive function, as measured by a battery of tests, 12 weeks after surgery compared to before surgery. Another study found people consuming weight-stable diets with high-fructose corn syrup did not gain more weight or accrue more fat than people consuming a weight-stable diet containing sugar.

-- Shari Roan / Los AngelesTimes Return to Booster Shotsblog.