Epilepsy drug leads to weight loss, side effects

(Reuters Health) - A drug approved to prevent seizures may also help obese people lose a few pounds when it's added to therapy and nutritional guidance, a new small trial suggests.
But people who took zonisamide also reported more side effects, from nausea and vomiting to anxiety and depression. And two researchers not involved in the study questioned how much the drug would actually help people in the real world.
Although zonisamide is only approved by the U.S. Food and Drug Administration for seizures, doctors can prescribe it "off-label" for non-approved purposes. Prior small trials and anecdotal evidence suggested it might help heavy people shed extra pounds.
"There is a little bit of weight loss with this drug when it is given for treatment of epilepsy," said lead researcher Dr. Kishore Gadde, from Duke University Medical Center in Durham, North Carolina.
That could be because of its effects on serotonin and dopamine, he said. Those two neurotransmitters are known to effect motivation and reward pathways in the brain, including those related to food.
Gadde said his team wanted to see if zonisamide could produce weight loss in people without epilepsy, and with the added help of a behavioral intervention.
According to disclosures published with the study, Gadde has multiple patents for zonisamide as a treatment of obesity and weight gain, and he owns equity in a company developing a combination weight-loss drug containing zonisamide.
For the new study, funded by the National Institute of Diabetes and Digestive and Kidney Diseases, Gadde and his colleagues randomly assigned 225 obese people to take either 200 or 400 milligrams of zonisamide or a drug-free placebo pill every day for one year. On top of that, all participants met regularly with a dietician and were encouraged to be more physically active.At the outset, they had an average body mass index - a measure of weight relative to height - of 37.6. That's the equivalent of a five-foot, six-inch person weighing 233 pounds.
One year later, people assigned to the placebo had lost an average of nine pounds, and those on the lower zonisamide dose had dropped ten pounds. Participants taking the higher daily dose had the greatest average weight loss, at 16 pounds.
Side effects were most common in the high-dose group. Out of 75 people, 10 reported nausea or vomiting, 14 had headaches, 15 developed infections, eight had impaired memory and seven reported anxiety.
Gadde said it's not clear which of those were directly related to the drug, or how much they bothered patients. Between four and six participants in each group, including the placebo cohort, dropped out because of side effects.
According to an FDA-mandated warning on the drug's label, zonisamide can cause serious skin rashes, suicidal thoughts and problems with memory and thinking, among other possible side effects.
In its generic form, the drug can be bought for about $30 per month.
NO SHORTCUTS
Obesity researcher Dr. Raj Padwal, from the University of Alberta in Edmonton, Canada, said the difference between the high-dose zonisamide and placebo groups in this study was "modest" at best.
"Overall it's kind of a ho-hum result," Padwal, who wasn't involved in the new research, told Reuters Health.
"The earlier studies of zonisamide were a little more promising, so I would characterize this as a bit disappointing."
Dr. Yoni Freedhoff, from the University of Ottawa in Canada and the Bariatric Medical Institute, also said he wasn't incredibly impressed with the extra weight loss with zonisamide, especially because the study only lasted one year.
"Although that sounds like an awfully long time, it's not when it comes to weight management. It's keeping the weight off that's a struggle," he said. "To be useful for clinical management of people who struggle, we need to see whether two, three, four, five years down the road, there's actually any benefit."
What's more, Freedhoff added, it seems unlikely based on the data that zonisamide would have any effect on cholesterol levels or diabetes risk.
"At the end of the day, there just aren't any shortcuts," Freedhoff, who also didn't participate in the study, told Reuters Health.
Gadde said much larger studies, with hundreds or thousands of obese people in each treatment group, will be necessary to more clearly see the weight-loss benefits and possible risks of zonisamide. He plans to ask the National Institutes of Health if they will fund him to do that research.
"The more options that we have available, the better it's going to be for clinicians as well as the consumers," Gadde told Reuters Health.
A combination drug including a different anti-seizure medication, topiramate, was approved by the FDA for weight loss in July.
Freedhoff said zonisamide may be useful for people who need anti-seizure treatment but are on other epilepsy drugs that make them gain weight"Have a discussion with your doctor, not about whether there's a magic bullet you could be on for weight loss, but whether or not you're on any medications at this point that could be contributing to weight gain" when there's an effective alternative, he advised.

How One Mother Lost 125 LBS in 36 Months with the SENSA Weight-Loss System

Wendy knew she was overweight. She'd never enjoyed shopping, dating, taking pictures with friends or doing any of the typical teenage girl stuff. Still, she'd met and married a great guy, had two beautiful children, and seemed to have a happy life.But her weight still bothered her."I’d tried pretty much everything to lose weight — diet pills, pre-packaged meals, supplements, calorie counting, liquid diets, prescription meds," she says. "Every once in a while, I’d actually lose a couple pounds, but then I’d end up gaining the weight right back." For Wendy, the situation seemed impossible, so she gave up, reaching an all-time high of 266 pounds.Then came a family trip to California, and Wendy's world was rocked—but not in a good way. At least, not right away.As Wendy and her family boarded the plane, she  realized she could barely fit in the airplane seat.Blood rushed through Wendy's face. She started sweating from embarrassment and shame, but when she saw her children and husband happily preparing for their upcoming vacation, she also felt fearful that she wouldn't be around to see them live their lives."It was then that I knew I had to do something – not just for myself, but for my family."  Wendy recalled seeing an infomercial for SENSA® and decided to give losing weight one last shot. "To my delight, I used SENSA® with a sensible diet and exercise, and I lost 2 pounds in the first week."According to the National Academy of Sports Medicine's The Training Edge magazine, a sensible diet and exercise promotes a healthy lifestyle, and this steady, gradual approach is key to successful, long-term weight loss."As the months went on, I found myself eating less and becoming more active and healthy," Wendy exclaims, her entire face lighting up as she speaks. "I was so motivated by my results that I even started jogging and eventually ran two 10K races. Keep in mind, I used to avoid running the 10K in high school!"When sprinkled on food, SENSA®  works with your sense of smell and taste to help you feel full faster. Wendy found that SENSA encouraged portion control, leading her to a well-balanced lifestyle, which is essential for healthy living. Wendy soon found herself looking and feeling better. This boosted her spirits and got her on track to being motivated to pursue a healthier lifestyle."I’m proud to say that I’ve lost 125 pounds in 36 months with SENSA®," she says^†. "I used SENSA with a sensible diet and exercise and for the first time in my life, I can finally fit into a size 8! That’s a huge victory for me because even as a teen, I had to wear a size 10 or 12. I can finally play with my kids, take the stairs, shop in real stores, eat out and feel comfortable in my skin for the first time in my life. I feel like I can do almost anything now, and that confidence is priceless. SENSA® has completely changed my life!"

"I Walked Off 149 Pounds and Lowered My Blood Pressure!"

A health scare prompted Taneisha Marks to make herself a priority. Now she's half her former size

Taneisha Marks, 40

Southfield, MI 
Height: 5'4"
Heaviest weight: 324
Current weight: 175
Lightbulb moment: Realizing I was going to die young if I didn't change
Biggest benefits: Lowering my blood pressure and boosting my energy
Taneisha's Story
I never worried about my weight in high school, but after I graduated, the weight started piling on. My parents both worked, and to help them out, I babysat my little brother during the day and attended college at night. I had zero time for myself. Pretty soon, food--whether it was pizza, sugary drinks, or cereal--was the highlight of my day. By the time I was 25, I weighed around 230 pounds. To make matters worse, my doctor diagnosed me with high blood pressure. High blood pressure and obesity run in my family, so I was put on medication right away.Learn how to get back in shape.  Walk off pounds and inches and melt belly fat!
I tried Weight Watchers when I was 29 and lost about 30 pounds, but I fell off the wagon when my mom was diagnosed with breast cancer (see 7 other reasons your diet isn’t working). She's OK now, but it was a yearlong, stress-filled nightmare. Around then, the scale hit 305, and my doctor had to increase my medication. That helped for a few years, but as my weight continued to climb, my blood pressure did too. Video: Salt-Free Ways to Flavor Food
Wake-Up Call
By the time I was 36, I weighed 324 pounds and was taking the top dosage of two different blood pressure medications. That same year, my dad had a massive heart attack. He survived, thank God, but a few months later, I found myself in the hospital. I'd gone in for a checkup, and my blood pressure was sky-high. We're talking you-could-have-a-stroke-any-minute high: 150/110. My doctor sent me to the hospital for an echocardiogram. I looked around the cardiac unit, and everyone waiting to be seen was obese--me included. At that point I realized that if I didn't lose weight soon, I'd end up with a heart attack, just like my father--or worse.I'll never forget lying there in the cold hospital room with all these wires attached to my chest. I really thought I was going to die. I'm a spiritual person, so I started praying. Lord, please change my palate so that I stop craving unhealthy foods. Help me change so that I can live a long, healthy life.
The Weight Loss Numbers That Really Matter
Starting from Scratch
The next day, I got rid of all the junk food I had in the house. Cookies, chips, bagels, Hawaiian Punch—everything. (RELATED: Check out our list of 100 Cleanest Packaged Foods to restock your kitchen). Then I thought, Now what? I said a prayer asking for guidance, and then I sat down at the computer and started Googling things like "what to eat for weight loss." I kept reading about fiber. I learned that it's something in plant-based foods that can help me feel fuller longer, so I went to the store and bought high-fiber foods like vegetables, fruit, and beans and started incorporating them into my diet. Over the next few months, I read as much as I could about nutrition. I started looking at food labels, especially calories and servings, and became more aware of what I was purchasing. I also made a pact with myself to stop the fast food. From that point on, I let myself have fast food only on Fridays. By the time my doctor saw me again, I'd dropped 12 pounds, and my pressure had gone down some. My doctor was optimistic and encouraged me to keep going.
Moving Ahead
Around that time, I saw a Leslie Sansone Walk at Home DVD at Target. I thought, I'm walking in the store, so why can't I walk at home too? Every night when I'd get home from work, I'd pop in the DVD and start marching. When I felt like quitting, I'd repeat the scripture "I can do all things through Christ who strengthens me." Some days my body hurt so bad that I'd go into the ladies' room at work and cry.
Within 10 months, I'd dropped about 50 pounds, and my size-26 pants were falling off me. While I continued to take both pills, my blood pressure entered the normal range when I hit the 70-pound mark. By the end of 2010, I was down 100 pounds and fitting into a size 14.
Happy and Healthy--For Life
I worked my butt off to lose each and every pound, but it was worth it. Today I weigh 175, and my pressure is at a normal level with just a low dose of a single blood pressure medication. I hope and pray that one day I can get off it for good, and I'm going to do everything I can to get there. My new goal: fitting into a bikini!

(Will) Power Through Your Weekends!

Yeah, you deserve to have fun when Friday rolls around, but that doesn't mean your diet has to go off the rails. How to treat yourself and still ward off Monday muffin top

Image: Thinkstock There's a new type of Sunday-night dread, and it has nothing to do with returning to work the next day. It happens—cue the Jaws music—when you step on the scale after a weekend of indulgence, only to discover you've gained three pounds in two days. (Search: How many calories are in a pound?) Been there? You're not alone. A study in the Journal of Public Policy & Marketing found that adults scarf down, on average, 419 extra calories each weekend. "We have more social events that include food and drinks, we're less structured about our mealtimes, and we give ourselves leeway to eat more," says Kathy McManus, R.D., director of the department of nutrition at Brigham and Women's Hospital in Boston. That said, who wants to spend their downtime counting every single calorie? Here's the compromise: Use this advice to strategically navigate common diet dilemmas so you can loosen up this weekend without needing to loosen your belt.

Why You Might Feel Lousy When You Lose Weight

We are excited to share one of our fave stories from Shape here on FitSugar. This week Shape turns to Cynthia Sass, a registered dietitian with master's degrees in both nutrition science and public health.I've had a private practice for a long time, so I've coached many people on their weight-loss journeys. Sometimes they feel fantastic as the pounds drop off, as though they're on top of the world and have energy through the roof. But some people struggle with what I call weight-loss backlash, the physiological and psychological side effects of weight loss that are powerful enough to make you feel downright miserable. Here are three you may encounter (do they sound familiar?) and how to get through the rough patch.
Toxin Release
According to research published in the International Journal of Obesity, environmental pollutants trapped in fat cells are released back into the bloodstream when you lose weight. The data collected from 1,099 adults looked at blood concentrations of six pollutants as people lost weight. Compared to those who reported gaining weight over a 10-year period, those who had lost significant pounds had 50-percent higher levels of pollutants in their blood. Scientists say the release of these chemicals as body fat is lost may account for feeling ill as you shrink your shape.
Advice:This study highlights why it's particularly important to eat a "clean" diet that boosts immunity and optimizes health as you lose weight. In my experience, low-calorie diets comprised of processed foods or ultra-low carb diets that omit antioxidant rich fruits and whole grains can add to feelings of sluggishness or symptoms like headaches and irritability. My best advice is to eat on a regular schedule to give your body consistency, which plays a major role in regulating hormones, and focus on the quality of your food by building meals made from nutrient-rich balanced portions of veggies, fruits, whole grains, lean proteins, plant-based fats, and antioxidant-rich seasonings.
See how to cope with the other negative side effects of weight loss after the break!
Surging Hunger Hormones
Studies show that as people lose weight, levels of a hunger hormone called ghrelin rise. It may be a build-in survival mechanism since our bodies don't know the difference between voluntary food restriction and famine, but one thing's for sure —raging hunger hormones make it much harder to stay on track.
Advice:The most effective strategy I've come across for combating hunger involves these three steps:

1. Eating on a regular schedule — Eat breakfast within an hour of waking up, with meals and snacks no sooner than three and no more than five hours apart. Eating on a regular schedule helps train your body to expect food at these times to better regulate appetite.
2. Including lean protein, plant-based fat and fiber-rich foods at every meal — Each has been shown to boost satiety so you feel fuller longer.
3. Getting enough sleep — Adequate sleep should be a key part of your weight-loss program, as getting too little sleep has been shown to increase appetite and boost cravings for fatty and sugary foods.

The Mourning Period
Starting a healthy eating program can put you on an initial emotional high. It's exciting to make a fresh start. But as time goes on it's normal to start missing your 'former food life,' from foods you enjoyed but no longer eat, to comfortable rituals, like curling up on the couch with crackers while watching TV. It's also tough to let go of the freedom that comes with just eating whatever you want, whenever you want, as much as you want. Honestly, it really is a mourning period as you come to terms with letting go of the former relationship you had with food. Sometimes no matter how motivated you are to adopt healthier habits, these feelings can make you want to throw in the towel. Just remember, it's not that you don't have enough willpower – you're just human.
Advice:Change is always difficult, even when it's a healthy change. If you feel like giving up, think about all of the reasons why you're doing this that really matter to you. It may sound cheesy but making a list can really help. Write down of all the 'pros' of staying on track. For example, maybe you're looking for more energy or confidence, or you want to be a healthy role model for your kids or family. When you feel like falling back into your old routines, remind yourself how important the things on that list are to you. And if your old habits were to meet emotional needs, experiment with alternatives to fill the void. For example, if you used to turn to food for comfort or to celebrate, try out other ways to meet those needs that don't involve eating.