Obesity: Are drugs the answer?

BY MAX MASON

Used appropriately, drugs can play a role in battling the obesity epidemic, Australian experts say.

Professor Margaret Morris, a pharmacologist from the University of NSW, says Australia has now overtaken the US in percentage of population who are overweight or obese.

"Drugs have been used to treat obesity for 30 years," she says.

"They're not right for everybody, they can help some people, they need to be applied very judiciously and be carefully followed up, but for some people if can help make a difference."

Professor Ian Caterson of the Human Nutrition Unit and Institute of Obesity, Nutrition and Exercise (IONE) at the University of Sydney also believes drugs can play a role in tackling weight problems.

He says drugs should only be used as a last resort by people who are extremely obese or people who were previously obese and want to maintain their loss.

"We can either use (drugs) to help people get a bit of a head-start or some other people, if they have lost weight, we can use drugs to help them maintain that weight loss."

Morris agrees that drugs shouldn't be the first line of defence against obesity.

"I don't think its the first thing anyone should try, I think prevention is critical, educating children, educating parents, letting everyone know about exercise and eating healthy," she says.

"Those campaigns are out there and they seem to be having an impact, but we need to monitor these campaigns, if they're not working, find out why they're not working and maybe consider drugs."

According to information from drug manufacturers and Australia's Therapeutic Goods Administration (TGA), weight loss drugs can have adverse effects including raised blood pressure, insomnia, anxiety, headaches, nausea, diarrhoea and impotence.

Caterson believes the key to maintaining a healthy weight is lifestyle, but diets and exercise programs needs to be personal.

He says fad or quick-fix diets rarely work.

"Some people can cope with extreme diet, go ahead and do it for a little while, but if I come back to you within a year, you will have come back towards a normal diet," he says.

"From my point of view, rather than saying, go on these low carbohydrate, Israeli army fad diets, is to say, what are you eating now? Can we can trim that fat.

"You don't need to eat three hamburgers in a sitting, you're drinking four litres of sweetened soft drink, why don't you drink unsweetened, and why you eat a little bit less?"

Obesity also seems to run in families.

Professor Morris has been researching the onset of childhood obesity by modelling experiments with mice and says there are indications that children of fat mothers are predisposed towards obesity.

"We have models where we can render animals obese, then get them pregnant, we have shown that offspring of obese mothers are fatter, they're glucose intolerant, they have increased lipids from a very young age," she says.

"We are now more likely to have mothers that are obese when they get pregnant and then they may be at risk, and their children will have increased risk of developing obesity as a young child.

"Its very hard to translate from the mice to humans, but a child's BMI tends to correlate with its mother."

Morris says environment, rather than genes, is probably to blame for our expanding waistlines.

"Its probably largely environmental, because our genes haven't really changed that much in the last 40 years, but our lifestyle has.

"Fifty years ago people were a lot more physical, in order to do their jobs, and look after their house, do their washing etc.

"There has also been a shift in all the sorts of food we're eating, we seem to have a lot more prepared and packaged foods, energy dense food which is readily available."

A 2008 report by Access Economics found obesity costs Australia $A58 billion ($NZ74.8 billion) a year.

Sixty-seven per cent of Australian adult males and 55 per cent of women are overweight or obese.

- AAP