{"id":4040,"date":"2016-06-08T09:08:49","date_gmt":"2016-06-08T08:08:49","guid":{"rendered":"https:\/\/www.zoeharcombe.com\/?p=4040"},"modified":"2018-01-13T15:32:07","modified_gmt":"2018-01-13T15:32:07","slug":"obesity-injection-horizon-prog","status":"publish","type":"post","link":"https:\/\/www.zoeharcombe.com\/2016\/06\/obesity-injection-horizon-prog\/","title":{"rendered":"Obesity Injection (Horizon prog)"},"content":{"rendered":"

The story<\/strong><\/p>\n

On June 7th<\/sup> 2016 overweight and obese people were given a hope \u2013 a false hope \u2013 that their weight will simply be injected away.<\/p>\n

\u201cFast forward ten years, obesity won\u2019t be a problem.\u00a0They\u2019ll have the injections, they will be painless, no side-effects and actually really inexpensive and freely available<\/em>.\u201d Sir Steve Bloom, Professor of Medicine at Imperial College, London.<\/p>\n

A miracle injection to end the obesity epidemic. How marvellous!<\/p>\n

Something else you should know about Sir Bloom is that a company called Thiakis was founded in 2004<\/a> \u201cto develop novel medicines for the treatment of obesity and co-morbidities based on original research of Professor Steve Bloom and his colleagues at Imperial College London<\/em>.\u201d The main product range being developed was \u201csynthetic versions of the natural gastrointestinal peptide oxyntomodulin<\/em>\u201d. Look at the bottom line of text: \u201cWyeth Pharmaceuticals acquires Thiakis in a transaction worth up to \u00a3100m<\/em>.\u201d<\/p>\n

That\u2019s a sum worth raving about a product for. It wasn\u2019t mentioned\u00a0on the Horizon programme<\/a>, which covered the story on June 7th<\/sup> 2016.<\/p>\n

The product<\/strong><\/p>\n

The injection involves three hormones being administered in a jab before each meal<\/em>: OXM (oxyntomodulin), PYY and GLP1. All three are understood to suppress appetite \u2013 here <\/a>are a couple of articles<\/a> on this \u2013 ooh look who wrote them!<\/p>\n

The jab is supposed to work by making people feel full, as with bariatric surgery. Writing in the Daily Mail<\/a>, Dr Giles Yeo, the presenter of the Horizon programme, said of the injection: \u201cit appears it can indeed mimic gastric bypass and make the brain think you are full, so patients ate less<\/em>.\u201d<\/p>\n

Two other points made by Dr Yeo in this article are important to address:<\/p>\n

1)\u00a0\u00a0\u00a0\u00a0 \u201cPut simply, we eat too much and move too little. It is physics<\/em>.\u201d<\/p>\n

2)\u00a0\u00a0\u00a0\u00a0 \u201cGene research shows, however, that some people eat more than others because they feel a little more hungry all of the time<\/em>.\u201d<\/p>\n

Why this injection is NOT going to end the obesity epidemic<\/strong><\/p>\n

1)\u00a0\u00a0\u00a0\u00a0 Overeating isn\u2019t about appetite.<\/p>\n

The Jab is supposed to work by making people feel full \u2013 like gastric surgery \u2013 but gastric surgery doesn\u2019t work for many people. Men in white coats seem to have no understanding of why<\/em> people overeat. They don\u2019t seem to understand addiction \u2013 both physical addiction & psychological\/ emotional addiction. Food is a drug of choice for many people \u2013 the most accessible drug of choice. Food is a \u2018prop\u2019 \u2013 researchers need to understand what happens when that prop is taken away.<\/p>\n

The issues that people have with food, and the issues for which food is used, don\u2019t get taken away with an operation or an injection. People with an eating disorder eat WAY beyond feeling full. Feeling full has nothing to do with most weight problems. Feeling less full is going to make no difference to someone who eats for every reason other than genuine hunger.<\/p>\n

The \u2018benefit\u2019 that gastric surgery has over hormones trying to \u2018mimic\u2019 gastric surgery is that people physically can\u2019t<\/em> eat as much after effectively having their oesophagus attached to their anus! People report being physically sick and\/or \u2018dumping\u2019 (a collection of very unpleasant symptoms, from nausea to sweating), when more is eaten than can be digested post surgery. There are mechanisms to prevent people from eating as much post bariatric surgery. These are by no means fool proof. People work out how to liquidise chocolate; they find jelly and ice cream easier to digest than meat and vegetables and they \u2018graze\u2019, so that the restricted amount they can eat at any one time becomes less relevant.<\/p>\n

People find ways around bariatric surgery \u2013 finding ways around this injection will be even easier. Plus \u2013 an injection before every meal?! (it’s actually four hours<\/em> before every meal to be precise!) \u201c…painless, no side-effects and actually really inexpensive and freely available<\/em>…\u201d Seriously?!<\/p>\n

2)\u00a0\u00a0\u00a0\u00a0 The obesity epidemic can\u2019t be explained by genetics.<\/p>\n

Yeo\u2019s Mail article covered \u201cgene research<\/em>\u201d. In the Horizon programme Yeo says: \u201cI believe that genetics play an important part in why some people eat more than others<\/em>.\u201d<\/p>\n

This makes no sense.<\/p>\n

UK obesity has increased from 2.7% (men and women) in 1972 to 22.6% for men and 25.8% for women by 1999 (Michael Wadsworth et al., 2006<\/a>). The UK obesity epidemic has emerged in a generation therefore. Genetics surely can\u2019t explain something that has happened within one generation.<\/p>\n

3)\u00a0\u00a0\u00a0\u00a0 The obesity epidemic can\u2019t be solved by eating less.<\/p>\n

We have known since the Benedict study almost 100 years ago (Francis G. Benedict, 1919<\/a>); through the Minnesota Starvation experiment (Keys et al., 1950<\/a>) and the Stunkard and McLaren Hume research (Stunkard A, 1959<\/a>) to the comprehensive Marion Franz review of 2007 (Franz et al., 2007<\/a>) that eating less does not produce sustained weight loss. A 2015 study of 176,000 people, showed that the chance of someone with a BMI of 30-34.9 achieving normal body weight (in any year of the 9 year study) was 1 in 210 for men and 1 in 124 for women!(Fildes et al., 2015<\/a>) The 2016 review of the Biggest Loser contestants scientifically confirmed the metabolic changes that defeated dieters long term (Fothergill et al., 2016<\/a>).<\/p>\n

The Horizon programme showed two men (yes two), fed one meal (yes one), and eating 203-240 calories fewer respectively with the TV cameras there. Sorry \u2013 after the injection. Dr Yeo is obviously a calorie theory man. He got really excited \u201cOver even a few months, the amount of weight you\u2019d lose would be incredible<\/em>.\u201d Even IF this injection could achieve less intake (and no evidence was presented that the body wouldn\u2019t just adapt to the injection, as it tries to adapts to all change), and even IF this did lead to weight loss, we have a hundred years of evidence showing that weight lost with a calorie deficit is so rarely sustained.<\/p>\n

What might work?<\/strong><\/p>\n

*\u00a0\u00a0\u00a0\u00a0\u00a0 As I\u2019ve said so many times before, we need to eat better, not less. This video<\/a>\u00a0explains why calories are not equal and why we need to eat fewer of some and likely more of others.<\/p>\n

*\u00a0\u00a0\u00a0\u00a0\u00a0 If the Holy Grail of dieting is appetite suppression, then we have the solution already. The trouble is, it\u2019s freely available. There\u2019s no \u00a3100m company to sell. We eat the most satiating macro nutrients naturally provided \u2013 fat and protein \u2013 and shun the one \u2013 carbohydrate \u2013 that is the least satiating and least nutritious<\/a>. The most common statement made by people on a low carbohydrate diet is \u201cI don\u2019t feel hungry<\/em>\u201d.<\/p>\n

*\u00a0\u00a0\u00a0\u00a0\u00a0 The psychological side still needs to be addressed<\/a> and people need support to find a healthy prop, or to get through life without an addictive-like prop, but the eating strategy is there.<\/p>\n

Or, to use Bloom\u2019s own words, but just to change the subject: \u201cFast forward ten years, obesity won\u2019t be a problem.\u00a0They\u2019ll have the low carb diets, they will be painless, no side-effects and actually really inexpensive and freely available<\/em>.\u201d<\/p>\n

Now that really would be a miracle!
\n<\/p>\n

<\/a><\/p>\n

<\/p>\n

References<\/strong><\/h5>\n

Fildes, A., Charlton, J., Rudisill, C., Littlejohns, P., Prevost, A. T., and Gulliford, M. C. (2015) Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. Am J Public Health. Vol.105(9), pp.e54-9.<\/p>\n

Fothergill, E., Guo, J., Howard, L., Kerns, J. C., Knuth, N. D., Brychta, R., Chen, K. Y., Skarulis, M. C., Walter, M., Walter, P. J., and Hall, K. D. (2016) Persistent metabolic adaptation 6 years after \u201cThe Biggest Loser\u201d competition. Obesity. pp.n\/a-n\/a.<\/p>\n

Francis G. Benedict. (1919) Human Vitality and efficiency under prolonged restricted diet. Carnegie Institution of Washington.<\/p>\n

Franz, M. J., VanWormer, J. J., Crain, A. L., Boucher, J. L., Histon, T., Caplan, W., Bowman, J. D., and Pronk, N. P. (2007) Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. Vol.107(10), pp.1755-67.<\/p>\n

Keys, A., Bro\u017eek, J., Henschel, A., Mickelsen, O., and Taylor, H. L. (1950) The biology of human starvation. University of Minnesota Press.<\/p>\n

Michael Wadsworth, Diana Kuh, Marcus Richards, and Hardy., R. (2006) Cohort Profile: The 1946 National Birth Cohort (MRC National Survey of Health and Development). Int J Epidemiol. Vol.35 pp.49-54.<\/p>\n

Stunkard A, M.-H. M. (1959) The results of treatment for obesity: A review of the literature and report of a series. A.M.A. Archives of Internal Medicine. Vol.103(1), pp.79-85.<\/p>\n

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