Despite the growing prevalence of childhood overweight and obesity, anti-obesity drug therapy is not currently indicated for the treatment of children – perhaps due to concerns about side effects associated with older anti-obesity drugs. In the study “Treatment of Obese Adolescents with Sibutramine: A Randomized, Double-Blind, Controlled Study,” researchers aimed to evaluate the safety and efficacy of sibutramine in obese adolescents. Sibutramine is a long-term obesity treatment, currently indicated for obese adults, which acts to suppress one’s appetite. Sibutramine use, though effective for suppressing weight gain, has been associated with possible risk of increased blood pressure and heart rate in some adults. The study investigators enrolled 60 adolescents in this randomized, double-blind, placebo-controlled clinical trial. During the first month of the trial, all participants received placebo and were put on a diet low in calories as well as a moderate exercise regimen. Following this control month, participants were randomized to receive either sibutramine or placebo for the duration of the six-month trial period. The study revealed that treatment of obese adolescents with sibutramine, as well as a diet low in calories and a moderate exercise regimen, effectively caused greater weight loss in trial participants than placebo alone. Contrary to prior thought, this study showed that sibutramine did not increase the adolescents’ blood pressure or heart rate readings, or lead to changes in echocardiographic parameters when compared to the placebo trial group. Although additional research is required, this study suggests that weight-loss medications, such as sibutramine, may be effective treatment options for childhood obesity.

For additional information from The Endocrine Society on the fight to combat childhood obesity, please see Other Happenings/Events

Low Fat or Low Carb to Lose Weight? The Answer Might Actually Lie in How Much You Put on Your Plate

Recently, a research team led by Dr. Bonnie J. Brehm reported that obese women on low-carbohydrate diets lost more than twice as much weight as women on diets low in fat over a six-month trial period. In that study, the differential weight loss between the two study groups could not legitimately be explained by theories of differences in energy intake because the women in both groups self-reported similar food intake, or energy consumption. The researchers therefore hypothesized that diets low in carbohydrates increase energy expenditure more so than diets low in fat, causing additional weight loss. To test this hypothesis in the current study, the researchers studied 40 healthy, but moderately obese, women with body mass index rates of 33.2 +- 0.28 kg/m2. Resting energy expenditure and physical activity levels were assessed in all women and the thermic effect of food was assessed in a subset of women. As in the first study, short-term weight loss was found to be greater in obese women on a low carbohydrate diet than in those on a low fat diet even when the reported food intake is similar. However, the differential weight loss was not explained by differences in resting energy expenditure, thermic effect of food, or physical activity. Researchers reason that the difference may, therefore, be explained by underreporting of food consumption by low fat dieters. Further research into the differences in weight loss attained by a diet low in fat and one low in carbohydrates is needed.

Aerobic Exercise is Essential to Overall Health

In the study “Exercise is Required for Visceral Fat Loss in Postmenopausal Women with Type 2 Diabetes,” researchers examined the effects of aerobic exercise, diet and a combination of exercise and diet on total abdominal and visceral fat in obese postmenopausal women with type 2 diabetes. For fourteen weeks, researchers assigned thirty-three women to either a low calorie high monosaturated fat diet, an exercise regimen only or a combination of diet and exercise together. The study investigators measured the trial participants’ aerobic capacity, body composition, abdominal fat distribution, glucose tolerance and insulin sensitivity pre- and post-intervention. The researchers found that modest weight loss, either through diet alone or a combination of diet and exercise together, resulted in similar improvements in total abdominal fat, adipose tissue and glycemic status, however, they revealed that the addition of exercise to diet is essential for visceral fat loss. Overall, the experts agree that regardless of whether you are losing weight, it is important to add a healthy exercise regimen to your daily routine in order to better your health.

The Pioglitazone Dilemma: Effective PCOS Symptom Relief Associated with Additional Weight Gain

In the study “Responses of Serum Androgen and Insulin Resistance to Metformin and Pioglitazone in Obese, Insulin-Resistant Women with Polycystic Ovary Syndrome,” researchers aimed to evaluate whether pioglitazone, a treatment for type 2 diabetes, treats the symptoms associated with polycystic ovary syndrome (PCOS), including insulin resistance and hyperandrogenism, to the same extent as metformin – currently the most common treatment for PCOS. PCOS is an endocrine-related condition characterized by increased male hormone (androgens) levels, infertility, irregular menstrual cycles, ovarian cysts, excessive hair growth, and increased risk for diabetes and obesity, among other health problems. An examination of fifty-two women with PCOS randomly assigned treatment with either pioglitazone or metformin spanned six months. The study revealed that treatment with pioglitazone was as effective as treatment with metformin in improving the symptoms associated with PCOS, however, treatment with pioglitazone was also associated with an increase in weight, body mass index and waist-to-hip ratio. Because of the connection between PCOS and obesity, further research into determining the benefit to risk ratio of prescribing pioglitazone for the treatment of PCOS – i.e., the effective treatment of symptoms associated with PCOS vs. increased weight gain – is needed.

See these studies and more in the upcoming issue of JCE&M from The Endocrine Society. To interview an author or to obtain a copy of the studies discussed above, contact Tadu Yimam of The Endocrine Society at media@endo-society.org

Other Happening/Events [RETURN TO TOP]

	New Consensus Statement on Childhood Obesity Over the last few years, childhood obesity has become a growing concern among members of the medical community and the public. The U.S. Centers for Disease Control and Prevention reports that a shocking 16 percent of children in the U.S. alone are now considered overweight. Due to this growing prevalence, in March 2004, leading health experts convened in Israel to explore available science, present evidence and propose recommendations aimed toward developing a global platform for approaching the childhood obesity issue. In the upcoming issue of The Journal of Clinical Endocrinology and Metabolism, a group of 65 endocrinologists, physicians and other health professionals representing nine countries on four continents present a Consensus Statement on the widespread public health crisis in childhood obesity. These recommendations will be published in JCE&M for the first time.
	ENDO 2005 ENDO 2005, The Endocrine Society’s annual meeting and the world’s largest gathering of endocrinologists, will be held Saturday through Tuesday, June 4-7, 2005, in San Diego, California. This meeting will feature more than 2,500 abstract presentations of the latest research in all areas of endocrinology, including obesity. During the meeting, the Society also hosts several press conferences to highlight some of the most exciting research of the meeting. This year’s focus is “Pathways to Discovery and Practice” and research in all areas of endocrinology will be presented at the meeting. Information about press conferences and other media events planned for ENDO 2005 will soon be available online at www.endo-society.org.
	ENDO 2004 Webcasts Webcasts of research presented at ENDO 2004 are now available at www.endo-society.org. These Webcasts offer more than 20 hours of materials from all areas of endocrine research, including Global and Childhood Obesity, Controversies in Treating Obesity and Secondary Causes of Obesity, among other topics. The easy to view format includes slide graphics with accompanying audio from presentations given during The Endocrine Society's annual meeting. To request a username and password, which will provide access to the Webcasts, please contact Tadu Yimam at media@endo-society.org