Tuesday, June 29, 2010

Slimming Capsules: attention danger!

One person died and sixteen others hospitalized for taking diet pills based thyroid extracts. How such an accident could happen? What are the dangers of pharmaceutical preparations for weight loss? These products are legal? A point with Professor Bernard Guy-Grand.

Thyroid extracts prepared on site and for slimming, it proposed that the pharmacy Demours located in the 17th borough of Paris, on prescription from Paris. Until a person dies treated and six others were hospitalized. And more than 120 people have received the capsules in question.


Pills régimeMais what is this substance "miracle" slimming supposed to patients who were offered? This thyroid extracts obtained from pig included in compounding (made directly into the pharmacy and not supplied by laboratory). The purpose of these preparations is to administer thyroid hormones to people who suffer from hypothyroidism (the thyroid does not secrete enough). This disease leads to fatigue, depression ... and weight gain. Then administer thyroid extract in healthy individuals, only in a thin object, is it common? "I thought these practices had disappeared. It's like income thirty years back!" said Professor Bernard Guy-Grand, nutritionist attached to the Hotel-Dieu (Paris).

No miracle pill

Indeed, these slimming capsules manufactured in pharmacy were more common a few decades, with a "manual" well known, as pointed out by Professor Guy-Grand "take thyroid extracts, which are added diuretics, potassium and a sedative to counteract the negative effects of hormones. " An explosive cocktail for at least that is far more to keep its promises: "The weight loss is very poor: the thyroid hormones will melt more muscle than fat. And the weight gain will be automatic once the end of treatment "said Professor Guy-Grand.

And of course, these pills are not without risk. Besides the fact that there certainly was an error preparation of the pharmacist in this case, the dangers of thyroid extracts used carelessly are well known: rapid heartbeat, psychological ...

Beware of slimming preparations

In terms of slimming drugs, the legal framework, however, is very strict and can normally prevent abuse. The prescription of thyroid hormone extracts should be done for specific indications, which are not mere loss of weight. In addition, the law forbids Talon 1980 that the compounding mixture psychotropic substances anorectic (appetite suppressant), diuretics and thyroid hormones. The Health Minister also pointed out April 22 that he would take all measures to directly "prohibit this type of compounding-based and prescription thyroid extracts. The only medications such as Xenical, now marketed for the indication of weight loss, are highly controlled and authorizations on the market are lengthy and rigorous.

So if you plan to lose your few extra pounds, beware of all the miracle pills and other methods that promise to lose weight effortlessly. Rebalance your diet and physical activity are essential. Therapies and so-called miracle pills are not the only ones to be wary. Thus schemes completely wacky, with declines of calories too large or risk of deficiency, may also threaten your health. And in all cases, medical follow-up is still a guarantee of seriousness.

Wednesday, June 16, 2010

Acomplia ®: a new weapon against obesity

Rimonabant (Acomplia) is removed from European market since October 23, 2008.

Molecule entirely new mode of action, Acomplia ® arrives in France. Attention is not a miracle pill but a drug. Discover the real effects and limitations of this new compound.

There are in France nearly 10% of obese and over 15% of children are concerned. Momentum, the disease primarily benefits the disruption of food and a sedentary lifestyle.

A mode of action

Rimonabant (Acomplia ®) is the first drug of a new therapeutic class. It acts on the endocannabinoid system recently discovered. This system would regulate the weight, energy balance and glucose. It would be overactive in people with excess fat in the abdomen.

It works by selectively blocking the cannabinoid type 1 (CB1) found in the brain, liver, gastrointestinal tract, muscle and abdominal fat cells. It thus controls the hyperactivity of the endocannabinoid system.

Effective in reducing weight, it is indicated in the management of obese or overweight severe disorder of carbohydrate (especially type 2 diabetes) or associated lipids (high cholesterol).

Recommended for overweight, flunked in weaning

The effects of Acomplia ® has been tested in humans in four studies involving over 6600 obese or overweight. Result: After one year, loss of weight of all treated patients was higher than those on placebo: they lost on average 4.9 kg more, except in the context of the study on patients with diabetes, difference observed was 3.9 kg. The drug also reduced the risk of weight regain.

Tested in the context of smoking cessation on nearly 7000 patients, it could not demonstrate real benefits. The laboratory has decided to withdraw its application for marketing in this indication. It does not make sense in the context of smoking cessation.

The main side effects are nausea, mood alteration with depressive disorders, anxiety and dizziness. This medication can be prescribed to patients with renal or hepatic or uncontrolled serious psychiatric disorders, like major depression.

A drug and not a miracle pill

Warning: this drug is not a miracle pill for people seeking to lose a few pounds. It is a drug for people suffering from obesity and overweight. Please note, obesity is defined by a BMI ≥ 30 kg/m2 and overweight is defined by a BMI> 25 kg/m2. Calculate your online body mass index. The main risk is not aesthetic. Such overweight exposes people to potentially serious medical complications including cardiovascular disease and diabetes.

Finally, remember that the management of obesity and overweight based on any pre-implementation of lifestyle modifications (diet, practice of regular physical activity), treatment of diseases possibly associated, and if necessary, the prescription of a drug indicated in this context.

Wednesday, June 9, 2010

Dietitian or nutritionist?

Overweight, chronic disease ... Sometimes, eating healthy does not just happen. It is thus sometimes necessary to consult a nutritionist or dietitian, to better balance their diet. We are giving an update on these two professions.

Nutritionist or dietitian?

It is not necessarily easy to make a difference. Yet, when one is faced with a problem of nutrition or a disease requiring special monitoring, it is important to find the right person.

Dietitian or nutritionist: what training?

Dietitian or nutritionist? Dietitians have a degree of state: BTS or DUT dietetics. They exercise their profession in a cabinet, a liberal, or in various health facilities and catering. As they share their know-how both in collaboration with physicians in hospitals and within communities such as schools or businesses.

The nutritionist has, meanwhile, trained in basic medical endocrinology, pediatrics, general medicine or gastroenterology. He then completed a specialty in nutrition in a university. As dietician consult either liberal or within a hospital or clinic.

Nutritional problems: when to see?

"Nearly 80% of my patients come to consult me on the advice of their GP" says Dr. Guerin-Sacreste, nutritionist. Unlike a visit to the dietitian in private practice, consulting a nutritionist is reimbursed by social security (if being sent by his general practitioner). Also, be careful and costs of consultations, as some doctors practice overruns fee.

Dr. Guerin-Sacreste said "a majority of my obese patients with or without complications. But I also met women followed for pregnancy as well as people with type 2 diabetes. For Laffond Anais, a dietician at Paris, the profile of patients is different: "I get mostly women 20-40 years, wishing to lose weight, they come to me spontaneously or following advice from their GP.

If doctors, nutritionists and dietitians practicing in the same field, only doctors are allowed to prescribe medication. Thus, for disorders of weight without complications, you can see both the other one. In contrast, for problems with diabetes or obesity such as hypertension, a visit to the doctor will be more suitable. Moreover, "dieticians have generally a more concrete and more practice-oriented food. This is also why they act in a complementary manner with physicians in medical networks," says Anais Laffond.

Nutritionist or dietitian: choose the right partner

"It's mostly a question of trust, as a general practitioner advise a dietician, while another advise a physician specializing in nutrition," says Dr. Guerin-Sacreste.

Whether dietitian or nutritionist, it is important to establish a good relationship from the start with your partner. According to Anais Laffond "good consultation is characterized by an exchange of at least half an hour to an hour in order to know the habits of his patient. This discussion is essential to propose a plan and follow custom.

For extra weight or the management of chronic disease, beware of promises miracles. Choose a professional who can set goals and choose a simple plan for your situation. Finally, do not hesitate to seek advice from your GP.

Friday, June 4, 2010

Obesity: a matter of life or death!

The North Americans are becoming larger. and live less and less old! France is she immune to this decline in average life expectancy in the U.S.? Nuanced response from Dr. Jean-Michel Lecerf, endocrinologist and nutritionist at the hospital of Lille and the Institute Pasteur.

Obesity expectancy lifeAnother recent U.S. study has highlighted the fact that obesity reduces life expectancy of Americans for several months. If the progress of this scourge continues, the expected drop from two to five years in 50 years. But does that mean we can connect the Bulge to the years at least? Because he does not like smoking obesity: if the effects of smoking on health are mathematics, things are different with regard to overweight. Not obese, but obese or overweight, including the vital risk depends on the characteristics of weight gain and the land on which it occurs.

A risk associated with fat distribution

"A very obese with a body mass index (weight ratio of the height squared) greater than 40, definitely shortens life expectancy, statistically 10 years," said Dr. Jean-Michel Lecerf. Less immediately quantifiable, the impact on the prognosis of obesity mean (BMI between 30 and 40), which depends on several criteria. Most importantly, the distribution of fat. Thus, the obesity of the lower body (buttocks, thighs), called "gynecoid" is not dangerous to health. However, the morphotypes android, "the big bellies," which fat is preferentially localized around the organs (which is not the most visible part), present risks that have been specifically identified, cardiovascular disease and cancer particular.

The consequences of overweight

Originally cardiovascular problems, stroke or myocardial infarction, elevated blood fats (cholesterol and / or triglycerides), sugar (diabetes) and / or blood pressure. Three great leaders of cardiovascular disease, including at least the first two are almost directly related to abdominal obesity. For example, high blood pressure could be determined, in part, by hormones secreted by adipose tissue. In the case of massive obesity, the risk of sudden death, due to a weakening of the heart by atheroma or left ventricular hypertrophy, respiratory-induced overweight or arrhythmias, yet the hope of lowering life.

As for cancers, adipose tissue functions as a gland which modifies the rates of estrogen particularly true promoters of cell proliferation. The hormone-dependent cancers (uterine, breast or prostate) are indeed favored by the excess weight (but less harmful, with respect to cancer in general, an alcohol or smoking.). Pulmonary embolisms are also more frequent and the consequences of intervention often more complicated.

And in France?

If the number of obese people continues to rise in France, there is no reason why life expectancy is not affected, and for the same reasons the United States, with a lag time since the phenomenon is more recent. Moreover, for manifest the effects of obesity (such as a smoking), it takes an average of twenty years. However, medical advances that allow us to treat the consequences of overweight, yet offset any drop in life expectancy. But better safe than sorry.