Diet Pills, EndoBarrier, Tongue Patch, and AspireAssist Pump promise non-surgical weight...

It seems lately the flood gates have opened on the prescription diet pill market (see my sharepost Prescription Diet Pill Market Set to Expand). After writing that piece, I learned that Novo Nordisk is staffing up for an obesity drug they plan to launch in 2014 - liraglutide – which is already on sale as a treatment for type-2 diabetes under the brand name Victoza.

 

Now with the AMA just this week declaring obesity is a disease, I expect new and novel approaches to weight loss will be trying to hit the market (see my sharepost Is the Tongue Patch the Next Weight Loss Innovation?). One of the more controversial devices on the ASMBS emerging technology list is the AspireAssist pump, which works by sucking the food right out of the stomach so that only about a third of the calories are absorbed by the body. Patients wait 20 minutes after eating, then empty 30 percent of their stomach contents into the toilet through a small, handheld device that connects to a skin-port discretely embedded on the outside of the abdomen. Calories not digested are calories not absorbed, which, in theory should lead to weight loss. Did I just hear someone say Roman vomitorium?

 

And now I learn of the EndoBarrier by way of this article, which at least sounds more promising than the aforementioned devices. My gut feeling on this, however, is that it either will not get US FDA approval - getting drug/device approval outside the US is typically easier so I do not take those approvals as a sign that this will be approved here - or if it does get approved I think the device will not show long-term success. That's just my instinct and I am neither a clinician or a scientist, but the fact remains that outside of bariatric surgery there are virtually no effective long-term weight-loss solutions although many have come to market and failed.

 

Clearly with 70% of Americans being overweight or obese and a high percentage of those having obesity-related illnesses such as diabetes, solutions are needed. Speaking for myself, as someone who initially struggled with the decision to have bariatric surgery, in hindsight these 10-years my life has been wonderful since taking control of my health (read my sharepost My Life after Weight-Loss Surgery is Wonderful). And I don't know why I or anyone else who meets the criteria for weight loss surgery would not want to have this life-saving procedure.

 

I get it - the permanent rerouting of my anatomy scared the heck out of me. But looking back I would do it again in a heartbeat. 

"And I don't know why I or anyone else who meets the criteria for weight loss surgery would not want to have this life-saving procedure."

I was more than qualified for the surgery and carried a bmi over 50 for years. However,I have watched 3 immediate family members have gastric bypass surgery. *ALL* three initially lost alot of weight. Then a few years out gain and again struggle with their weight and maintain "overweight" or "obese" BMIs. I chose to make lifestyle changes that are also required with surgery. I did the head work (which I believe is the key to success) and started to exercise. I put down my drug of choice, food, and worked on my recovery and sobriety.

I currently weigh less than what I have lost. I never lost 60 in a month but had to go at it slow and steady. I have denied myself when I would have liked to indulge. I have maintained 160 lb loss for almost 3 years. *NOT* having surgery but changing the core of how I abused food did. I knew that in order for my children not to live the "fat my whole life" story that I would have to teach them a better way.

Btw, the sucking the stomach contents out sounds gross...and really just encourages the future abuse of food....uh, gross.

Agree with you completely... And yeah, sucking out the food you have eaten is no differ than binging and purging... Nothing good can come of that.i dealt with bulimia for years and it was difficult to overcome.

I did too. As crazy as it is I was sickest at my highest weight which still seems odd...

The problem with Victoza is that it is injectable AND has nasty side effects including pancreatitis.

 The tongue patch seems to be too extreme. 

 A new drug that has just been approved by the fda called Belviq seems to be promising. Drugs.com has many reviews by individuls that have tried it and it seems t work pretty well. It also seems to affect mood in a positive way abd to help with smoking cessation. http://www.drugs.com/comments/lorcaserin/belviq.html

Thank you for your reply. so e of the non surgical weight loss interventions are extreme, indeed!

however, I do not believe Belviq to be a good solution. The gravity of the side effects of lorcaserin are worth noting. You may read more here http://www.healthcentral.com/obesity/c/276918/154206/lorcaserin-loss

Thank you for sharing the link.

 In my opinion, there are some inacurracies in the article that you are referring to.

 The article states: "Lorcaserin has had an effect on the serotonin receptor, the origin of theheart problems associated with phen/fen"

This statement is misleading. There are three receptors for serotonin, the 5HT2C receptor which Belviq targets specifically, and the 5HT2A and 5HT2B (fenfluramine) which Belviq does NOT target. Fenfluramine, which is the part of Phen/Fen that caused heart valve damage, targets the 5HT2B receptor.

Here is the FDA briefing document on Belviq: http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMe etingMaterials/Drugs/EndocrinologicandMetabolicDrugsAdvisory Committee/UCM303198.pdf

"Lorcaserin preferentially activates 5HT2C with 8- to 15-fold greater potency compared to 

5HT2A, and 45- to 90-fold greater potency compared to 5HT2B"   "Arena additionally demonstrated that based on functional activity across four in vitro  assay platforms, lorcaserin grouped with low-potency 5HT2B agonists that are not known  to be associated with clinical valvulopathy. By comparison, compounds known to cause  clinical valvulopathy such as nordexfenfluramine and pergolide showed substantially  higher 5HT2B receptor potency in these assays"    "The 2011 receptor potency data provides supportive evidence that off-target activation of  the 5HT2A or 2B receptors is unlikely at the proposed clinical dose of lorcaserin (10mg bid)"    The article that you have enclosed also states "The medication should not be used by pregnant women". The FDA's opinion is that pregnant women should NOT think about losing weight until after they give birth. The fetus needs nutrients and depends on his mother in order to get the nutrients.   The author should have done a lot more research before posting the article. 

Be careful -  the drug (Belviq) is the subject of a FDA investigation right now as there are serious risk and safety concerns associated with the product.

Can you please provide me with a link that supports what you just wrote? belviq has only been on the market for less that 2 months, so I'm my opinion it is too soon for any FDA investigation. I am not aware of any FDA investigation

Thank you

 

 Here's a recent article that appeared recently on abc about Belviq :

 http://www.abc15.com/dpp/news/local_news/investigations/new- diet-drug-that-targets-appetite-suppression-in-the-brain

 

 Here's a youtube video : http://www.youtube.com/watch?v=ZtZyUjeSQ2g