Category Archives: Articles Published on The Huffington Post

Can a Drug or Surgery Solve Your Weight Problem?

Successful Weight Loss
(Published first in The Huffington Post)

In a word, no. Can they help? Perhaps.

Last month I wrote an article that spoke somewhat favorably of the new weight loss drug, Saxenda. I said it was perhaps the most important weight loss medication ever developed.

Wow! Did I get lambasted! I got all sorts of email blasting me for going over to the dark side and becoming a drug pusher and lackey of Big Pharma. I even got an email from my favorite professor of counseling at the University of Massachusetts, now friend, Allen Ivey, Ph.D. Besides being a friend, he is a big shot in the counseling field, the father of Microcounseling and developer of “active listening”. He said he was “sad” to see that I seemed to be pushing drugs. He is the last person on earth that I would want to be mistaken about my views on the solution to obesity. We’ve since gotten that misunderstanding corrected, but I want to make sure it is clear with everyone who reads my blogs.

I am still the world’s staunchest advocate of the behavioral therapy I teach to reverse the condition of obesity. It works -like a miracle, some say. But not 100% of the time. For some, it is not enough.

After 30 years successfully helping people to lose weight permanently, I am convinced that a percentage of the population is dealing with a physiological condition that creates more persistent and intense degrees of craving and compulsion than the rest of us have to deal with. My approach teaches people how to overcome the habits and feelings that make them overweight but sometimes those cravings and compulsions are so strong that nothing on God’s natural earth will quiet them.

If you’ve ever had a blister on your foot or a pebble in your shoe, you’ll remember that your brain is getting the message loud and clear that you need to relieve that pressure and you need to relieve it right now. You will feel the drive to relieve it until you do. It won’t go away until you do whatever it takes. There is no “will-powering” it away. Something is going on in the body, physiologically and chemically, that is triggering a response in your brain that will bother you until you satisfy it. It isn’t exactly the same with the food cravings that some have, but it gives you an idea of what some people are dealing with. Hold your breath for as long as you can and see how powerful the urge to breathe becomes. This is the kind of relentless drive that a small percentage of the population is fighting in their attempts to stop eating too much.

For them, some sort of intervention or tool that would make it easier for them to eat less would be a Godsend. Then, perhaps what they learn in a good behavioral approach would be enough. Self-programming and cognitive techniques like I teach work like magic for many people, but they would be so much more productive for these folks with eating hyperdrive if we could reduce that drive, which the pharmaceuticals can do. Or in the case of surgery, an additional tool to use behaviorally.

Make no mistake about it, drugs or surgery will not by themselves solve your weight problem. To solve your weight problem, you need to make a permanent change in your behavior, made possible with behavioral therapy, taught in my book and by my therapists. Success comes with learning how to eat what you like in ways that keep you at your desired weight and it becoming habitual and a new “normal” for you. Now, with these new medical interventions, success may be possible even for those who have suffered from an abnormally intensive eating drive. Weight loss drugs or surgery may now enable them to overcome the obstacles that prevented them from being able to make those behavioral changes.

What is Saxenda, The New “Blockbuster” Weight Loss Medication?

(Originally published in The Huffington Post)


Successful diet

There is a new “blockbuster” weight loss drug on the market, Saxenda, and it is available in many U.S. pharmacies this month. It is perhaps the most important weight loss medication ever developed. Novo Nordisk Inc., a very big and very old Danish pharmaceutical company, has launched the new drug after months of anticipation by consumers, clinicians and market watchers.

Saxenda is very different from all other weight loss drugs. For one thing, it is a once-a-day injection, like some diabetes medications, instead of a pill. For another, it works in an entirely different way, mimicking a naturally-occurring hormone that your intestine secretes when you eat food.

In research conducted only in the last few decades, scientists have discovered that the gut releases a hormone when you eat food that helps regulate the levels of sugar in your blood and slows down the emptying of your stomach. This results in feelings of satiety and a reduction in sensations of hunger and desire to eat.

The hormone-mimicking drug in Saxenda, Liraglutide, was originally marketed as Victoza, prescribed to treat diabetes. It was discovered that a “side effect” of Victoza was weight loss. Saxenda is essentially a double dose of Victoza, and after much testing, the FDA approved it for weight loss in December of 2014.

One-year studies show that over 60 percent of people using Saxenda had a 5 percent reduction in weight while trying to lose weight, as opposed to 34 percent taking a placebo. Thirty-one percent taking Saxenda lost more than 10 percent of their weight.

One of the most important attributes is that it can be used effectively long term, for chronic management of obesity. It is not like the appetite suppressant weight loss drugs that only work for a while. Like other medications used for diabetes, it introduces a hormone that compensates for a deficiency.

Like The Anderson Method, which is a behavioral weight loss program for people with chronic obesity, Saxenda is not for lightweights, people without a serious weight control problem or who only need to lose a few pounds. Saxenda is appropriate for people who are clinically obese with a Body Mass Index (BMI) of 30 or a BMI of 27 with another medical condition, like high blood pressure or diabetes. For example, someone who is 5’4″ would have to be at least 157 pounds with a medical condition, or 174 pounds without an additional medical condition.

Like many medications, Saxenda has warnings that are frightening. Though rare, some of the possible adverse effects are serious. This is not something to be treated casually. You need to work closely with your doctor if you want to use Saxenda. The adverse effects are not experienced by everyone, but should they occur, this is not for you. The most common are nausea and diarrhea. The serious ones are thyroid tumors and pancreatitis. If you have one of several conditions, like a history of thyroid cancer, this is not for you.

The term “Blockbuster” has been used to describe it because of its “box office” potential. It is expected to be a huge moneymaker. We are talking about “billions and billions” as Carl Sagan would say. The cost will run about $1,000 per month and it remains to be seen if medical insurance will play any part in paying for it. No doubt those who have the means will be getting it right away and others will be waiting for the patent to run out.

Saxenda is not a magic cure, just like bariatric surgery does not fix everything for an obese person. We have to change our behavior. Behavioral therapy is the answer to that. But solving the problem would be so much easier for my clients if they did not have the extraordinary biological drives that I am certain are due to some hormonal disorder that results in extraordinary hunger, cravings and compulsion. Behavior therapy alone has worked for me and many of my clients, but it is not enough in some cases.

I have believed that there is a biological imbalance that is part of the disease of obesity and I have prayed for something that would help resolve it. Saxenda may be the first medical intervention to answer those prayers and I am sure there will be more and better advances in the future.