Michael:

Just thought I’d provide a little update on the whole diet experience. For those of you not following my personal soap-opera closely, I have been engaged in a pretty serious diet for the past three-and-a-half months. (Well, it wasn’t that serious during January as a result of home-remodeling and my daughter’s bat mitzvah, but I’ve gotten pretty hard-core recently.) So far, I’ve lost just over 50 pounds, 21 of those in the past four weeks.

My approach in the last month has been what I would call ‘moderate’ strict Atkins: that is, a strict Atkins diet (less than 20 grams of carbohydrate a day, testing my urine with ketostix to make sure I’m in fat-burning mode) combined with moderate exercise (3-5 miles walking daily) and moderate quantities of food (as opposed to just shoveling the old protein in.) I would also stress the value of getting together with a reasonably intimate group to discuss progress and pitfalls weekly. To the extent that overeating is an addictive disorder, it appears that the peer pressure of such a group is the only practical defense against ‘falling off the wagon.’ I’m getting pretty serious about figuring out how to stay in such a group even after I hit my goal weight. Otherwise, any objective observer would conclude that my long-term outlook for maintaining weight is rather dicey, sad though that is to say.

On the lighter side (no pun intended, it just popped out) I’ve noticed the press releases and news stories about a drug that is, at best, a good two years away from commercial release but already looks like it has ‘commercial blockbuster’ written all over it. Sanofi-Synthelabo (great name for a pharmaceutical company, no?) has been touting the early clinical successes of its CB1 blocker drug rimonabant (trade name: Acomplia). This drug seems to simultaneously make it easier for people to quit smoking and to not gain weight while doing so, or to simply help people lose weight. You can read about it here.

My first reaction to this wonder drug was to think: quit smoking and lose weight? Doesn’t it give you whiter whites and brighter brights too? And how about a date on Friday night? (Now that I think about it, of course, it might actually deliver on that one.)

But as I read about how this drug works on the endocannabinoid system, “a natural system that modulates the body's energy balance and nicotine dependence” I began to wonder about exactly what kind of research had led to this discovery. And in a story in the Wall St. Journal I hit pay-dirt: just as the name of that system implies, this drug comes out of ‘scientific’ research into why smoking marijuana gives you the munchies!

Dr. Spicoli. Dedicated Researcher of the Endocannabinoid System

Unbidden visions of the development process came to mind: a group of dedicated Jeff Spicolis sitting around in white lab coats blazing doobies. Naturally, they would be divided between a group taking a CB1 blocker and a control group that just, er, took a placebo and thus followed nature’s course. “Whoa, dude, I just ate like four pizzas!” “I don’t know why, but I could barely choke down two! I'm switching to pepperoni!”

And then, the ultimate thrill of triumph as the results were tallied: “The group on the drug only gained 25 pounds in two weeks, while the control group gained 43!”

Ah, the triumphs of science…

Cheers,

Friedrich

Congratulations on your progress. I for one can't wait for the drug. Remember those Vic Tanney ads when Lynda Carter would say: "A great body can't come out of a bottle." Ha! Just wait a few years!!

But, I still wonder, if they figured out why pot makes you want to eat...have they figured out how the rest of life is like pot, and so people want to overeat? I don't think the only people who are overweight in the country are pot smokers. Jeff Spiccoli was pretty skinny. What's the similar stimulus in regular life, I wonder.

Posted by: annette on March 18, 2004 11:23 AM

Wow, impressive, congrats. How many more pounds are you shooting to shed?

Have you started enjoying audiobooks on your walks, by the way? It's a great way to get some "reading" done.

Now for the big challenge of keeping it all off. How do you foresee dealing with that? Continued Atkins? Continuing with the walking?

Posted by: Michael Blowhard on March 18, 2004 11:36 AM

Michael:

I'm aiming for another 33-34 pounds. That will get my BMI index down to 30 (from 42!), which I think gets me just out of the 'obese' category--I started in the 'morbidly obese' category--and into the mere 'overweight' category. Maybe the medical community could rethink its terminology, huh? From there we'll see.

As to long term maintenance, I think I'm going to have to sign up with Overeaters Anonymous, or something along those lines. Since my own will-power is obviously insufficient, I'm hoping peer-pressure will help me to hang in there.

Annette:

I googled 'endocannabinoid' and came up with a bunch of scientific papers. It looks like the endocannaboid system may be responsible for 'runner's high' and a bunch of other stuff, including the rate of progression of various types of cancer!

My doctor maintains steadfastly that overeating is an addictive behavior, and that fatties (like me) use food to manage our affect. (Fat storage, apparently, creates a positive buzz in the human brain.) Actually, he maintains that everybody uses food to manage their affect, but that overweight people have poor receptors or something, and need more fat storage to get their buzz.

I'm not sure if I'm answering your question, but the science of weight control is quite interesting. I might even read (or try to read) some of these research papers.

Posted by: Friedrich von Blowhard on March 18, 2004 11:54 AM

I saw the headline on this drug and immediately turned away. As much as I'd love a pill that will do everything for me, the Catholic in me sees it as an easy out. I love your Spicoli observation, but I think it might be how to get chemo patients to eat without, egads, making them high.

Posted by: Keiran on March 18, 2004 2:38 PM

Keiran--

Not to question your theological principles, but most of what I've read recently tends to pretty strongly downplay the notion that willpower plays much of a role in weight gain. For example, in a San Francisco Chronicle story we read:

The system evolved during an era when early humans had to struggle to find food while also dealing with the constant threat of predators and a heavy burden of intestinal parasites. An ability to put weight on quickly, and keep it on, was a good evolutionary adaptation. Now, food is plentiful, predators are scarce and parasites are mostly relegated to the developing world. And so, for most of us, the hormonal machinery that once helped ensure our survival now helps keep us fat. We are blessed, it seems, with many redundant defenses against starvation, which turns out to be a curse during these times of plenty... There's no need to look in the mirror or step on a scale for your brain to know your body weight. All sorts of chemical signals take care of that. And so, like it or not, once you're heavy, your brain tends to keep you that way, altering metabolism to "defend" the higher weight. The system includes a brain region known as the nucleus accumbens - the heart of the same "reward circuit" that keeps drug users hooked. "The brain is hard-wired to consume food," said Dr. Michael Schwartz, an endocrinologist and obesity specialist at the University of Washington in Seattle. "The basic drive is to consume with abandon."

So, I say, if we can game the biochemistry of weight gain, why not?

Posted by: Friedrich von Blowhard on March 18, 2004 3:29 PM

But what do you substitute for the pleasure of food?

Posted by: ricpic on March 18, 2004 5:46 PM

I don't think it's necessary to substitute anything. The weird truth is that I get no less pleasure out of eating a minimal diet than I do out of pigging out...when you're eating less, you appreciate it a great deal more, or something.

Posted by: Friedrich von Blowhard on March 18, 2004 9:00 PM

Oh the state of knowledge of the cannabinoid system(s) has progressed a LOT the last few years. They also have found recently that it's various defects in the cannabinoid receptor systems that produce much (or most) Post Traumatic Stress Disorder (the THC's and CBD's are related compounds that do different magic. The new wonder drug you mention here in on the CBD side of the house, as are many of the observed medicinal effects of pot).

Turns out that when we experience trauma THC's are released, which fuzz out our short term memory of it. If the trauma is repeated, our fuzzy recollections of it get re-inforced, so we can formulate survival plans to deal with it. Those with various defects, either in the production, uptake or reception of THC's, don't get the fuzz out, and have vivid, sharp memories of it burned it, which get much more easily triggered by similar phenomena. Apparently when the memories are fuzzy a stimulus match is less likely.

Lord only knows what that plant is doing with such a gene!

Posted by: David Mercer on March 26, 2004 5:42 AM






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