Diet drugs are an interesting phenomenon. While there are literally scores of short-term weight loss solutions, there are only two recognized long-term drugs that have any sort of success in treating the obese. An appetite suppressant called sibutramine, which is a non-addictive cousin of amphetamines, and the fat blocker orlistat, better known to you and I as the OTC product Alli.
The problem is, even these products have issues. Sibutramine has demonstrated a less than ideal side effect of increasing blood pressure. When your target market is already chocked full of hypertension riddled customers, asking them to take a pill that will exacerbate the issue isn’t exactly good medicine. With Alli, the primary side effect can best be summed up in two of the least appealing words ever mentioned on these pages, fecal urgency. That is right, you can see it for yourself right on the box of Alli at your local Walgreens. In fact, they go so far as to suggest wearing dark pants and bringing a change of clothes to work.
The other issue with these two products is that they stop being effective as soon as you stop taking them. Alli can’t block fat and sibutramine won’t suppress your appetite unless you have them in your system. With such a massive (and lucrative) market, which can’t the drug makers come up with something that works?
That might have something to do with how diet drugs currently work on our brain. Diet drugs are typically built around a process of boosting certain desirable chemical signals already present within our normal brain activity. The chemical signals travel from one cell to another communicating everything from mood, energy level, pain and hunger. Most diet pills are trying to manipulate the frequency or volume of these chemicals in an effort to control mood levels and/or appetite. Chemicals can get ‘stranded’ between the nerve cells and then get reabsorbed into the transmitting cell. This has the effect of diminishing the value of the message. A new experimental drug called tesofensine is currently undergoing tests that will block this reabsorption of stranded cells to allow more of the message to get through.
The problem with this is that none of the current crop of diet drugs works particularly well with that great controller of appetite, the hypothalamus. Without controlling, the input and output of the hypothalamus, we are simply masking the issue and not attacking it at the source. The latest research and experimentation is focused primarily in this area and holds a lot of promise. The idea is to manipulate the levels of hormones communicating with the hypothalamus in order to reduce the appetite levels.
Unfortunately for anyone battling against being significantly overweight or obese, we are still years away from effective long-term treatment. The brain is a very mysterious and powerful system. Combine that with our other internal organs and their interaction with the brain and the task of finding the great weight loss pill is daunting.