Would You Take the New Diet Drug?

By Denise Foley for Completely You


A few weeks ago, a U.S. Food and Drug Administration advisory panel gave the nod to what may be the first new weight loss drug in 13 years. This is despite the fact that Qnexa, manufactured by Vivus Inc., had been rejected by health experts in 2010 because of its potential side effects, including heart attacks and serious heart rhythm abnormalities. The FDA will be deciding on Qnexa’s fate sometime this month.

Like many new drugs, this one isn’t really new. It combines two existing drugs -- the appetite suppressant phentermine and the anti-seizure/migraine medication topiramate (Topamax).

If phentermine sounds ominously familiar, it’s because it was one-half of the drug called fen-phen, which was yanked off the market after it was linked to pulmonary hypertension -- high blood pressure in the lungs -- and heart valve disease. It may have led to as many as 49 deaths and more than 100 adverse reactions, many of them grave, though they were traced to the “fen” (i.e., fenfluramine) part of the combo.

A year ago, studies funded by Vivus found that obese people who took Qnexa lost an average of 22 pounds in a year, which was accompanied by lower blood pressure and cholesterol levels. Data suggests that the drug is best at helping people lose about 10 percent of their weight. That may not help you get into a size 6. But many experts say that 10 percent is the threshold where the health benefits of losing weight, particularly a lower risk of heart disease, start to kick in.

But do we really need a new anti-obesity drug? Don’t we have, well, diet and exercise? That’s a question posed, and answered, by Dr. Mark Hyman -- physician and author of The Blood Sugar Solution -- in a recent blog. “There is a solution to our obesity epidemic. But it’s not at the bottom of a pill bottle. It’s at the end of our forks,” he wrote. “Diet is simply more effective than any medication and works better, faster and cheaper not just as prevention, but also as treatment for what ails us in the 21st century.”

So What’s the Answer?
While Hyman makes it sound easy, he needs to talk to the millions of people who lose weight every year and gain it back, along with some bonus pounds. A 2007 UCLA review of studies on dieters found that one-third to two-thirds regain more weight than they lost. Essentially, the researchers said, the biggest risk factor for weight gain is going on a diet. Read more about the UCLA findings.

Dieting should be the answer, but it may not be the entire solution, says Dr. Melina Jampolis, a physician nutrition specialist in San Francisco and author of several books on weight loss, including The Calendar Diet: A Month By Month Guide to Losing Weight While Living Your Life , which she designed for her patients.

Jampolis’ stock-in-trade is nutrition and dieting, yet she says she welcomes a new weight loss drug. “There are simply too many obesity-promoting factors in our environment for many people to overcome. I believe a medication that could help them reduce 10 percent of their body weight when combined with diet and exercise would be very beneficial.”

So beneficial, says Jampolis, that the pros outweigh the cons for many people. “I’m much more concerned about the side effects of obesity, including heart disease, diabetes, arthritis, cancer and fatty liver. The only concern is carefully screening women who are or may become pregnant -- the drug may cause birth defects -- and certainly monitoring those with heart disease closely.”

What do you think? Would you take a new weight loss drug that could cause serious side effects to eliminate the serious side effects of your weight? (And I’m not just talking muffin top and thunder thighs.)

Denise Foley   is Completely You’s “News You Can Use” blogger. She is a veteran health writer, the former deputy editor and editor at large of Prevention, and co-author of four books on women’s health and parenting.

Lifesaving Skills Everyone Should Learn

By Denise Foley for Completely You

Your odds of surviving if your heart suddenly stops beating are doubled if:

1. There’s a defibrillator nearby.
2. There’s someone who knows how to use it to shock your heart back into rhythm and do cardiopulmonary resuscitation (CPR) to keep a trickle of oxygenated blood flowing to your brain.
3. When they turn on that defibrillator, the battery isn’t dead and the paddles aren’t out of date.

But that last one, it turns out, is a big “if.” A recent report in Spectrum, the journal of the Institute of Electrical and Electronics Engineers, found that failures of public-use defibrillators -- the ones in your local shopping mall, gym and workplace -- increased by 85 percent over a five-year period. There was one malfunction for every 50 devices in the country, and more than 750 of the 28,000 failures involved a death. (Read more about the study here.)

Why Defibrillators Don’t Always Work
Many of those AEDs -- automated external defibrillators -- are victims of neglect. When no one is in charge of checking batteries and keeping parts up-to-date, they’re left to gather dust. And when they’re needed, they’re DOA (dead on arrival).

“I’ve been places where I’ve been told proudly, ‘We have an AED,’ and I say, ‘Yes, but your AED is dead and the pads expired months -- if not years -- ago,’” says paramedic Jonathan Epstein, executive director of NorthEast Emergency Services Inc./Massachusetts Region III EMS Council and member of the American Red Cross Scientific Advisory Council.

As part of his job, Epstein advises clients on emergency response procedures, which includes AED upkeep, training, and oversight. “In a public place like a workplace, at least 10 percent of the staff should be trained in AED use and CPR. More than one person in a household should be trained in CPR

But there’s good news. Every year, 5 million people sign up with the American Red Cross to learn CPR and how to operate an AED. And AEDs do work -- as long as someone is taking care of them.
Epstein has seen what can happen when those stars are aligned. “In one workplace about a month ago, a worker collapsed. His co-workers started CPR and had a defibrillator on his chest in less than a minute. He was clinically dead. But with good CPR and good AED on top of it, he was back to work a week and a half later.”

Life-saving Skills You Need to Know
Don’t think that cardiac arrest is rare. It happens to as many as 450,000 people, including children, every year in the US. That’s one every 1.5 minutes. Sudden cardiac arrests cause more deaths than stroke, breast cancer and lung cancer combined.

“You have about a six-minute window to get someone’s heart started again,” says Dr. Mickey Eisenberg, professor of medicine at the University of Washington and medical director of the King County Emergency Medical Services in Washington State. “That becomes 10-12 minutes if CPR is started right away. CPR will not convert a heart to a normal rhythm, but it buys time.”

When I learned CPR about 30 years ago, it was not for the squeamish. Then, you had to do mouth-to-mouth as well as the hard-and-fast chest compressions. My instructor felt it necessary to warn us that sometimes a resuscitated victim can vomit and you don’t always have time to get out of the way. I prayed -- for many reasons -- that I’d never have to use it.

Why CPR Is Easier Than Ever
But today, says Eisenberg, mouth-to-mouth is no longer part of the training. “Only firefighters and paramedics have to learn the full deal,” he says. Hands-only CPR is so easy to do, says Epstein, the Red Cross teaches it in its babysitter classes to kids as young as 12. “My own daughter could do it when she was 9,” he says.

While the experts encourage everyone to get certified, which means taking a four-hour class (find one here), the truth is that anyone can do CPR with a little coaching. “If you call 911, the dispatcher can tell you what to do,” says Eisenberg.

AEDs are equally dummy-proof. “The key thing is to turn it on,” says Epstein. “It tells you where to put the pad and what steps to take.”

You can also bone up on the procedure on Eisenberg’s website where he offers illustrated guides to CPR techniques for adults, children, infants and even cats and dogs. Also on his site: a link to two free iPhone and Android apps with videos you can watch and follow when an emergency strikes.
If all else fails, just remember two words: hard and fast.

“If someone’s heart has stopped, you need to press the chest 100 times per minute and go 2 inches down,” says Eisenberg. “Now, it sounds gruesome, but you may hear cracking sounds. That’s cartilage breaking in the chest. It can be scary. You may think you’re harming the person. But consider the alternative. That person is clinically dead at that moment. You cannot do them harm. Clinical death will become biological death within eight minutes, so you have to jump in fast.”

Photo: @iStockphoto.com/paulprescott72


Denise Foley   is Completely You’s “News You Can Use” blogger. She is a veteran health writer, the former deputy editor and editor at large of Prevention, and co-author of four books on women’s health and parenting.

The Good News About Dark Meat

By Denise Foley for Completely You

Just in time for barbecue season, a new study has found that having high cholesterol may not mean you have to pass up those luscious drumsticks that come off the grill all sizzling and juicy and irresistible (not to mention higher in artery-clogging saturated fat than white meat).

Researchers from the NYU Langone Medical Center discovered that women whose cholesterol numbers were bad but who had high levels of taurine -- an amino acid that’s abundant in dark-meat poultry, shellfish and mollusks -- were actually less likely to develop, or die from, heart disease than women who had less taurine in their blood and their diets.

Oddly enough, women who had normal or low cholesterol along with high taurine levels didn’t get the same protection, say the researchers, who looked at both the blood levels and diet of the more than 14,000 women in the NYU Women’s Health Study.

They linked the taurine in the women’s diets to poultry rather than shrimp and scallops because so few of the women reported eating seafood regularly. On the other hand, they ate, on average, about 5.6 ounces of poultry a week -- about the size of a chicken drumstick. Read a synopsis of the study here.

What’s so heart-healthy about taurine? For one thing, the amino acid has anti-inflammatory and antioxidant properties, says Dr. Yu Chen, associate professor of epidemiology at NYU Langone Medical Center and lead author of the study. “It may be that women with high cholesterol levels are more susceptible to risk of coronary heart disease due to oxidative stress and inflammation,” she says. But taurine helps counteract these factors.

In animal studies, taurine supplementation helps protect LDL, or “bad” cholesterol, from becoming oxidized, which makes it more likely to damage the arteries. It also directly suppresses the formation of arterial plaques -- lumps of fat and debris that cling to arteries, blocking them and, in some cases, forming clots that can travel to the heart or brain.

But that doesn’t mean taurine supplements are the way to go. “We don’t know whether taurine from supplements would have the same effect” as diet does, says Chen.

She did, however, suggest that there might come a day when doctors start recommending that people with high cholesterol eat more poultry -- especially dark meat.

That puts a whole new positive spin on the phrase, “going over to the dark side.”

Like this post? Comment below or connect with us @Completely_You
Denise Foley   is Completely You’s “News You Can Use” blogger. She is a veteran health writer, the former deputy editor and editor at large of Prevention, and co-author of four books on women’s health and parenting.

Why You Should Trust Your Instincts

When the phone rings, you often know who it is. You can predict the weather without once flicking on The Weather Channel. You rarely bother to tune in to the election results because you knew who was going to win all along.


You probably suspect you have psychic powers. You might even tack on the words “The Amazing” in front of your last name and buy a deck of Tarot cards.

Hold on. Don’t invest in that crystal ball just yet. A new study suggests that what you have aren’t psychic abilities, but a perceptive gut … er, brain.

Researchers at Columbia University and the University of Pittsburgh conducted eight studies in which participants were asked to predict various outcomes, from the 2008 Democratic presidential nominee to the weather. What they found was that people who regularly trusted in their feelings -- or who were encouraged to go with their instincts -- were more accurate in their predictions than people who rely more on logic. (Read the study here.)

In fact, the “feelies” were as accurate as the scientific method called “crowdsourcing,” which uses the power of the many to do everything from predicting election outcomes to solving problems. The researchers hadn’t predicted that one.

“We were surprised by it,” admitted Andrew Stephen, assistant professor of business administration at the Joseph M. Katz Graduate School of Business at the University of Pittsburgh. “Crowdsourcing is very scientific. People take it very seriously and put up money for it. We were impressed to see something so relatively straightforward achieve the same outcome.”

And at first, the researchers thought that individuals who rely on their own feelings were, in a sense, crowdsourcing. That is, intuiting how others would act in certain situations. “Putting yourself in another’s shoes -- instead of relying on logic and reason -- works where crowd behavior matters, like who’s going to win an election or ‘American Idol,’” says Stephen. But that kind of thing doesn’t work with something like the weather.” But they decided to try it anyway. “We did it as a little bit of a joke -- kind of tongue in cheek -- saying to ourselves, ‘Now wouldn’t it be funny if it worked?’”

It did.

Yes, people who went with their guts could predict the weather not only at home, but in other places too. They were best at predicting weather in climates they were familiar with and those that were similar. So someone in Fargo, N.D., could “feel” the weather in, say Minnesota, and someone in Miami could have a good sense of what the weather might be like in New Orleans.

ESP? Nah. Instead, says Stephen, the subjects in his study were actually just tapping into the vast -- and often hidden -- stores of knowledge in their own brains. The researchers believe that tuning into your gut instincts help you more broadly access what you already know, whereas basing your predictions based on logic and reason reduces your potential choices to a few pieces of knowledge.

“If you just think about your past experience and exposure, you’re going to be narrowly focused,” says Stephen. “There may be 10 pieces of information that are important, and if you narrowly focus you may hone in on two of them. That’s OK if they’re the most important factors, but chances are they’re not.” On the other hand, your feelings are often the sum total of all those experiences and knowledge you have, parsed unconsciously to predict the future.

This ability makes evolutionary sense, acknowledges Stephen, who says if we were “rational, logical decision-making machines in daily life, we wouldn’t get anything done.” It would take too much time to make even simple decisions.

So, does this mean we should just abandon rational thinking and go with our gut alone? Don’t be too hasty. “The point is not to abandon reason, but to not discount your feelings either,” says Stephen. The truth is that both are great sources of information.

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Denise Foley   is Completely You’s “News You Can Use” blogger. She is a veteran health writer, the former deputy editor and editor at large of Prevention, and co-author of four books on women’s health and parenting.