諾美婷(西部曲明)下市的震撼
從皺紋看健康
小林醫師對減重經驗談(一)
正常吃喝還能減重的新減重藥
減重新藥ZGN-433簡譯文摘要一
小林醫師對減重經驗談(二)
 
 
標題:諾美婷(西部曲明)下市的震撼
 

本文引用~〔記者王昶閔/台北報導〕

在減肥藥市場市佔率高達七、八成的諾美婷將從台灣市場上消失。

醫師指出,雖然「少吃、多動、有恆心」還是減重根本,但現代人飲食西化又懶於運動,不少民眾求速成,依賴減

肥藥積習已深,如今合法減肥藥只剩下一種,恐助長非法減重偏方更為猖獗。

肥胖醫學會~秘書長林文元表示,過去市面上只有諾美婷與羅氏鮮兩種合法減肥藥。

諾美婷:

透過作用於中樞神經抑制食慾,市佔率約七、八成,其餘為羅氏鮮與同成分小劑量的康纖姅,機轉則是排油脂,

會解油便,兩者機轉不同,難以相互替代。

林文元表示,民眾選擇變少,非法的減肥藥、減肥偏方會越來越猖狂。

民眾需求不會減少,只會變多,如何解決此問題,政府機關要思考。

此外,坊間有些診所使用的雞尾酒減重療法 ~

雖然醫師使用的多是合法藥物,但因屬於適應症外使用,一旦吃出問題,民眾只能自求多福,無法受到藥害救濟法的保障。

例如曾有診所拿抗憂鬱劑、心臟病藥物、氣喘藥等藥物,透過加速心跳與代謝幫病患減肥,仍有其風險。

諾美婷主成分sibutramine藥物,恐怕還是不會從世界上消失。

台灣、香港的衛生單位查獲的非法減重藥品,經常被驗出sibutramine,因為具有抑制食慾效果,因此被黑心業者拿來魚目混珠。

肥胖醫學會~常務理事蕭敦仁醫師表示:

有些減重療程尚未結束、諾美婷吃到一半的病患,可能還得想其他替代方案。

例如: 代餐、羅氏鮮,但可預期的是,減重效果將都不如諾美婷。

蕭敦仁也說,諾美婷上市十一年來,全球肥胖人口持續上升,

換言之,現代人變胖,並無法靠一顆藥解決,少了這顆藥也不必太難過。

接下來,所有減重者,必須回到少吃、多動、有恆心的主軸,花功夫在生活形態的改變,正本清源。
 
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標題:從皺紋看健康
 
1)抬頭紋:心情鬱悶、心緒不寧
2)鼻樑前額紋:偏頭痛
3)眼下皺紋:腎臟及膀胱排毒能力差
4)眼周笑紋:肌肉結締組織鬆垮
5)魚尾紋:聽力下降
6)臉部皺紋:血管代謝
7)鼻皺紋:心臟不好的徵兆
8)嘴上垂直細紋:女性雌激素下降
9)唇周細紋:消化臟器相關問題
 
(照片摘自網路)
 
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標題:諾美婷與我在美美潘朵拉診所減重經驗談(一)
 
(照片摘自網路)
 
最近因為諾美婷被禁使,得一時之間減重市場上
從醫師下至病患大家人心惶惶,
其實筆者早在五年多前,就不主張使用小諾, 我滴患者都知道我最討厭諾美婷.
我記得當時一個美國滴精神科教授告訴我,
其實小諾是一種抗憂鬱劑和近似安非他命結構滴混合體(正腎上腺素接受器抑制劑),
在臨床上這些藥必然使血管內壓大幅上升,即使它有促進體重下降滴好處也是惘然.
筆者在我十多年來滴行醫經驗中所聽聞,滴是男性病患使用後血壓長時期大幅上升,引起痣瘡爆發
(因為女患者大多初始血壓是偏低的,但也會上升)也有女性患者吃了以後 公司體檢安非他命成陽性反應的.
所以大家便知這樣危險滴東西~老外為了賺錢硬是拖了那摸長的專利期才下架
(原廠享用了大約十三年專利 ,一年多前全球釋出六百多張藥證至今全面回收)
其實國外學者早已大加撻伐,血管內壓上升,所以會頭痛,眼模糊,心悸,口乾.同時促進了交感症狀,
所以連腸動都慢. 會噁心,吐,盜汗,但是體質弱者就會引發心血管疾病了.
也就是說因為人類無法長時期忌口或從事有氧運動
(事實上是缺氧拉,喘到快死之意.1公斤肥油=7000大卡熱量)
使外國藥商自1940年代以來一直在以安非他命為基礎研發藥物上打轉,認為只有它才能觸動腎上腺素的分泌去燃酯.
其他所謂瘦素應是杯水車薪,至於甲狀腺的調整則是違反生理原則
(所以幾年前水果日報專欄說減重最快是甚麼:被抓姦在床 .一點都不錯 ,為和小學課本寫的一樣,火災時扛冰箱走.
所以那些失戀的,被關的 吃再多也不胖直到生理習慣為止就是如此狀況.總之由藥物發展史來說中西醫都是一樣的,原理是一致的
,否則早就得諾貝爾獎了.
只是說目前所謂合法藥物(諾美婷,rimonaband , 羅氏鮮)除了羅氏鮮較安全(但無明顯效果)其他都已下架(因為都有致命的副作用)......
待續 (小林醫師林金龍)
 
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標題:正常吃喝還能減重的新減重藥ZGN-433(原文)(待續)
 
(照片摘自網路)
FROM ZAFGEN
Zafgen Announces Positive Topline Phase 1b Data for ZGN-433 in Obesity
NEWS RELEASE
FOR IMMEDIATE RELEASE
CONTACT:
Michele Rozen
Pure Communications, Inc.
617-730-8284
 

Zafgen Announces Positive Topline Phase 1b Data for ZGN-433 in Obesity
Findings Show MetAP2 Inhibition Treatment Drives Significant Weight Loss with Excellent Tolerability and Favorable Metabolic Effects
CAMBRIDGE, Mass., January 5, 2011 – Zafgen, Inc., a pharmaceutical company pioneering novel obesity therapeutics to help the body regain and sustain a lean, healthy state by targeting imbalances in fat metabolism, today announced positive topline results from its Phase 1b study of ZGN-433, a methionine aminopeptidase 2 inhibitor (MetAP2), for the treatment of severe obesity. The Phase 1b study met its primary and secondary objectives and showed that ZGN-433 at a dose of 0.9 mg/m2 was well tolerated and reduced body weight by a median value of 1 kg per week and 3.1 percent over 26 days relative to placebo in severely obese subjects. MetAP2 inhibitors work by re-establishing balance to the ways the body metabolizes fat, leading to substantial loss of body weight.
The results of the study also demonstrated a decline in hunger as well as meaningful changes in lipid parameters following treatment at 0.9 mg/m2. These changes included a 38 percent reduction in triglyceride levels and a 23 percent reduction in low-density lipoprotein (LDL) cholesterol levels (p<0.05). Additionally, beta-hydroxybutyrate, an indicator of fat oxidation, increased to levels seen with very low-energy diets. No treatment-related serious adverse events were observed. The data will be presented at the Keystone Symposia on Obesity in Keystone, Colo., on January 15, at 2:30 p.m. MST during the “Hot Topics in Obesity Therapy” workshop.
“These findings are significant as they show MetAP2 inhibition has the potential to drive impressive weight loss with excellent tolerability and favorable metabolic effects in severely obese individuals, and demonstrate that the preclinical pharmacology of ZGN-433 is translating well to human studies,” said Thomas Hughes, Ph.D., president and chief executive officer, Zafgen, Inc. “The results show the magnitude of weight loss approaches the commonly recommended maximal rate of safe weight loss, which is exceeded only by gastric bypass surgery, duodeno-jejunal bypass liner and restrictive therapy. If sustained, the rate of weight loss would be consistent with a 6-9 month course of treatment in individuals requiring a 20-40 percent reduction in weight.”
A double-blind, placebo-controlled multiple ascending dose study was performed to evaluate the safety and preliminary efficacy of ZGN-433 in reducing weight in severely obese females with a body mass index (BMI) between 32-45 with co-morbidities allowed. Twenty-four people were enrolled in the core study. The primary objective of the study was to evaluate the safety and tolerability, and determine the pharmacokinetics and pharmacodynamics of ZGN-433 in obese individuals. The secondary objective was to obtain information on weight loss in obese individuals exposed to eight intravenous doses of ZGN-433 administered over a four-week period. Patients were allowed to eat normally and were not counselled to exercise. Individuals received ZGN-433 or placebo twice weekly by intravenous administration over a four-week treatment period for a total of eight doses at three different dose levels (0.22, 0.65, and 1.96 mg per administration).
“ZGN-433 has the potential to be the first drug to produce weight loss approaching that of bariatric surgery,” said Steven R. Smith, M.D., scientific director of the Translational Research Institute for Metabolism and Diabetes and professor at the Sanford-Burnham Medical Research Institute in Orlando. “Given the excellent tolerability and safety seen in this four-week study, the program shows early promise to provide a positive risk/benefit proposition. While the long-term safety and efficacy of the compound remain to be established, there is nothing in the industry drug pipeline this advanced that has shown this kind of efficacy. These early results are very encouraging, and there remains a significant unmet medical need for new obesity therapeutics that are both safe and efficacious.”
“While Zafgen’s understanding of the compound’s mechanism of action has evolved significantly since the company’s early days, MetAP2 inhibition for the treatment of obesity and diabetes appears to translate well across species,” said Alan D. Cherrington, Ph.D., professor of medicine and molecular physiology and biophysics, Vanderbilt University, and former American Diabetes Association president. “These positive initial clinical and preclinical findings show that MetAP2 inhibitor actions point to utility for the treatment of severe obesity, and also show intriguing potential for use in broader indications related to control of glucose, lipid and cholesterol metabolism, including hepatic glucose intolerance, fatty liver and dyslipidemia.”
Zafgen is pioneering novel obesity therapeutics to help the body regain and sustain a lean, healthy state by targeting imbalances in fat metabolism. Research has shown that fat metabolism differs between obese and lean individuals. Recent studies indicate that once a person becomes obese, the body undergoes certain changes and is “programmed” to make and store more fat. These metabolic adaptations that take place in obese people impair the normal release of fatty acids from adipose tissue and restrict the ability to stimulate formation of ketone bodies (a byproduct of the breakdown of fatty acids). Simultaneously, the body becomes much more efficient in diverting calories from food and storing them as fat.
About ZGN-433
Zafgen’s lead compound, ZGN-433, is being studied as a pharmacological alternative to bariatric surgery for severe obesity. The company plans to initiate Phase 2a studies with ZGN-433 administered via subcutaneous injection in 2011. Zafgen is also developing new compounds suitable for oral administration for use in broader indications as part of its second generation program. ZGN-433 was initially developed by CKD Pharmaceuticals. The molecule was
originally profiled for efficacy in the treatment of solid tumors. Zafgen holds exclusive worldwide rights (exclusive of Korea) for development and commercialization of ZGN-433.
About Obesity and Fat Metabolism
Obesity continues to be one of the world’s most costly and underserved health issues. As such, there exists a tremendous unmet medical need for effective drug therapies to treat obesity, which has reached epidemic proportions and is growing at an alarming rate. According to the Worldwide Health Organization (WHO), the number of obese adults had increased to at least 400 million worldwide in 2005, with more than 700 million projected by 20151. If current trends continue, 103 million American adults will be considered obese by 20182. The U.S. is expected to spend $344 billion on health care costs attributable to obesity in 2018 if rates continue to increase at their current levels with obesity‐related direct expenditures expected to account for more than 21 percent of the nation’s direct health care spending in 20182.
Obesity leads to serious health consequences. As BMI increases, so does one’s risk for chronic diseases such as cardiovascular disease, diabetes, musculoskeletal disorders and some cancers, compounding the urgency for new and effective treatment options1. Currently available weight loss treatments function by blocking fat absorption or signalling feelings of fullness or diminished appetite in the brain. These drugs are often associated with undesirable side effects and limited efficacy that fails to provide sustainable weight loss in many patients.
About Zafgen, Inc.
Zafgen is pioneering novel obesity therapeutics that directly target fat metabolism to help the body regain and sustain a lean, healthy state. The company’s approach focuses on restoring control of key metabolic processes, releasing stored fat which then is used by the body as fuel. Zafgen’s first generation product, named ZGN-433, is being studied in a Phase 1b clinical trial for its use as a pharmacological alternative to bariatric surgery in the treatment of severe obesity. Zafgen's leadership and scientific advisors include leading experts in obesity, metabolic disorders and medicinal chemistry. Founded in 2005, the company is located in Cambridge, Mass. For more information, visit http://www.zafgen.com/
1 World Health Organization, http://www.who.int/mediacentre/factsheets/fs311/en/index.html
2 The Future Costs of Obesity: National and State Estimates of the Impact of Obesity on Direct Health Care Expenses, A collaborative report from United Health Foundation, the American Public Health Association and Partnership for Prevention, Based on research by Kenneth E. Thorpe, Ph.D. of Emory University, November 2009

 
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標題:減重新藥ZGN-433簡譯文摘要一
 
位於美國麻州的 Zafgen 生技公司剛發表了一種尚在Ib藥試階段的減重新藥ZGN-433,是一種methionine aminopeptidase 2
抑制劑(MetAP2) 號稱能重新建立體內酯肪代謝的秩序.而在先前的藥物試驗中使用劑量0.9mg/m2可使受測者平均減少體重
1 kg/week(相對於安慰劑 ,在26日的試驗中).因此Zafgen的主席Thomas博士認為ZGN-433的效果只有胃分流, 容積縮小
等外科減重手術可媲美.據此推論若能承受此藥物6-9個月理論上尚可減體重之20%-40%.
 
標題:諾美婷與我在美美潘朵拉診所減重經驗談(二)
 

其實減重並無僥倖,就是減少熱量的攝取.(一般人若無特別的熱量消耗大約一天都只需要1200大卡以下.)以及消耗熱量.

進行高耗能運動很痛苦,往往大家都無法持之以恆,於是每天多累積一點熱量就會形成肥油了.
在這種情形之下,愛美的女性只能求助於醫療協助;有體力的男生至少可去運動來消耗熱能 .
中醫治療通常有輔助性針灸及埋線(即使用可吸收線埋入穴位中已達成持續針灸的效果).
常需要配合嚴格食譜即所謂蛋白質飲食法, 在藥物方面多以風藥及瀉為主,例如 排水腫的車前草.茯苓,荷葉,薏仁 ,
玫瑰和紅花.消脂的大約有山楂,陳皮.及排除宿便的番瀉葉, 大黃,浦公英以及子實類的藥物.有時還添加了一定量的麻黃.
甚至有不法人士為了效果違法添加西部曲明.
西藥方面主要包含了大家所熟知的利尿劑(但利尿劑有分多種,端看醫師如何使用.主要是可去除水腫 ,
缺點是有時會引起電解質失衡)以及凝交感興奮劑像麻黃素,類麻黃素或其他同族的藥物.
在結構上這類藥物頗類似也常引發一些副作用例如頭痛, 暈, 噁心想吐,盜汗,心悸, 有些會引起血壓上升.
但也是減重的的核心成分.中藥裡的麻黃鹼是屬於此類前驅物這因此大多的病患在使用中藥後仍有躁熱
即發汗和心跳加速失眠等情況出現其他還有些不肖業者會在中藥或健康食品內加入西藥粉末例如西部曲明.
所以中藥作用於人體其原理應也是與西藥是一致的,即刺激中樞神經系統及腎上線系統以抑制食慾,增加能量代謝.
未完 待續 (小林醫師林金龍)
 
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