Obesity and Overweight Conditions

Paul L. Reller L.Ac. / Last Updated: August 03, 2017


The failure of the allopathic pharmaceutical industry to develop even a single effective medication for the treatment of obesity, our most prevalent medical condition in the United States hinges on the stubborn refusal to explore more holistic treatment protocols

There is no doubt that a half century of intense research to find acceptable and effective treatment for obesity, now considered one of the most devastating and prevalent disease conditions in the world, have failed. The biggest failure is perhaps the emphasis and treatment rather than prevention, but the treatment protocols themselves reveal the failures of our medical system to adequately address a systemic health problem that involves a complex cycles of dysfunction, and the persistent focus on allopathically altering the human metabolism to reverse obesity, rather than a focus on restoration of metabolic homeostasis and the whole cycle of problems. After decades of insisting that patients afflicted with obesity just need to diet and exercise, but that they are perhaps unmotivated, that they must have just inherited some obesity genes and have no chance to reverse their fate, that we can just provide amphetamines and amphetamine derivatives to reduce appetite and speed the metabolism, or that we can just surgically remove or band half of the stomach, we finally came to the conclusion that we need to provide more antidepressant and anticonvulsant medications to alter the signals in the brain that control appetite. This has been very frustrating for the many millions of patients afflicted with obesity, especially the percentage of these patients with associated, or comorbid, health conditions that are threatening. We need to treat obesity holistically and also treat these associated health conditions, and we need to integrate Complementary Medicine realistically into this holistic protocol, not just resort to polypharmacy and the numerous adverse "side" effects on health. We also need to focus on prevention and preventive medicine, along with integration of restorative medicine.

In late 2010 and early 2011, the FDA rejected four new drugs designed to counter obesity. These drugs, Meridia (Sibtramine), Lorcaserin (Lorqess), Qnexa, and Contrave, were designed mainly to block neurological signals that stimulate appetite in obesity. They were all rejected by a panel of medical experts because they failed to show much positive effect (the minimum criteria for efficacy was a 5% weight loss in a majority of subjects over a short time, or a greater than 5% reduction in weight in a higher percentage of subjects than the placebo effect), and evidence that long-term damage to the health and short-term side effects in a considerable percentage of patients was unacceptable. Because of the consistent long-term risks to cardiovascular health, and numerous other metabolic and hormonal problems potentially engendered by these drugs, the FDA now asks the drug makers to demonstrate that long-term use will not create significant negative health risks.

These four new drugs all were combinations of prior drugs used for other diseases, mostly utilizing anti-depressants, which oddly enough, are associated with obesity as a cause with long-term use. Lorcaserin, or Belviq, has serotonergic properties as a 5-HT receptor agonist (hydroxytryptophan) and mildly inhibits appetite. Tryptophan, an essential amino acid, was one of the most popular nutritional supplements in the world in the 1990s, aiding in the treatment of mood disorders, depression and anxiety, before a strange contamination of the main production line in Japan with a rare harmful bacteria ruined its reputation and sales. Since then, 5-HTP (5-hydroxytryptophan precursor) has become a very popular supplement derived from the herb Griffonia seed. Lorcaserin failed to demonstrate significant positive effects over these natural supplements, and demonstrated considerable long-term negative effects. The success of Lorcaserin is linked to patients who apparently have no control over their appetite, and cannot resist an excessive intake of soda and sweets, but for a majority of patients with the problem of obesity, they have succeeded in controlling their appetite and have succeeded in avoiding fattening food, and have succeeded in increasing their daily activity and exercise, and because of their health dysfunction, are still unable to lose weight. Restoration of the serotonin and dopamine balance is just one part of the holistic treatment they need to achieve a homeostasis that finally allows serious weight loss. These patients also need to address the dysfunctions in multiple systems in the body caused by their obesity syndrome, and simply decreasing their appetite with psyche drugs will not achieve these systemic goals. Weight loss alone will not eliminate the health risks associated with obesity, if these are occurring. A most thorough and holistic treatment protocol is needed.

Qnexa was a combination of phentermine (part of the prior anti-obesity drug Phen-fen that was pulled from the market in 1997 due to reports of tens of thousands of cardiovascular deaths attributed to its use) and the drug topiramate (Topomax). Topiramate is an anticonvulsant drug adapted to treat a wide variety of conditions in the last 20 years, with a dismal record of success, but huge profits. It has been marketed to treat migraine headaches, bipolar depression, nerve pain, and other disorders, but long-term studies revealed that it is ineffective in the treatment of bipolar disorder, and eventually creates metabolic acidosis, may cause kidney stones, osteoporosis, glaucoma, peripheral neuropathy, and psychiatric problems, as well as contribute to liver dysfunction, and worsen allergies. Topiramate also can cause cognitive problems with short term memory and attention span, fatique, and may negatively interact with many common medications.

Meridia, or Sibutramine, is a serotonin and norepinephrine reuptake inhbitor (SNRI) that is related to amphetamines. Other SNRI medications include Cymbalta and Effexor, widely prescribed to treat anxiety and depression disorders. Common side effects of these SSRI medications were loss of appetite, weight loss, poor quality sleep, loss of interest in sex, difficulty in reaching orgasm, drowsiness, fatique, headache, nausea, imbalance of central hormones such as oxytocin and prolactin, and elevated blood pressure. Since some of these health problems were often seen in obesity, and considered part of the long-term health threat in obesity syndromes, the FDA panel rejected this drug.

Contrave, or Buproprion/naltrexone, is a combination drug composed of the antidepressant Wellbutrin (norepinephrine and dopamine reuptake inhibitor) and the anti-alcoholic drug Revia (an opioid receptor antagonist). Wellbutrin was initially withdrawn from the market due to alarm at its potential to cause seizures, and subsequently the dosage was reduced. Wellbutrin is also associated with hypertension, and common side effects included dry mouth, nausea, insomnia, tremor, abnormal sweating, and tinnitus. A black box warning was added by the FDA due to the large number of reports of adverse behaviral effects and suicidal ideation in patients under the age of 25. The association of buproprion with high blood pressure, a significant health threat in obesity, prompted the FDA to demand assurance with long-term study that this Contrave would not cause increased cardiovascular risk in obese patients.

Xenical/Alli (Orlistat) (tetrahydrolipstatin), available now without prescription, is presently the only FDA approved long-term weight loss drug, but this drug is useful only as a part of a weight loss protocol based on dietary principles and exercise, and works as a lipase inhibitor, preventing enzymatic digestion and assimilation of fats in the diet. Unfortunately, Orlistat blocks absorption of many important fat-soluble vitamins, including beta-carotene and Vitamins A, D, E and K. Common side effects include diarrhea, flatulence, abdominal pain, irregular menstrual periods, and anxiety. Side effects are reduced only by a substantial reduction of fat content in the diet. Free fatty acids are also inhibited by this drug, leading to potential problems in essential fatty acid deficiencies, which are the building blocks for inflammatory mediators and hormones. The benefits in clinical human trials with a one year use are modest, increasing weight loss by about 6 pounds. To increase benefits, as well as counter side effects, Complementary Medicine may be utilized, and a knowledgeable Licensed Acupuncturist and herbalist may be utilized to provide professional guidance and care. The consumer advocate group Public Citizen has called for a ban on Orlistat, though, citing the potential of significant damage to multiple organ functions and meager benefits with long-term use. Numerous reports of pancreatitis, kidney stones, and liver failure have been reported, with an FDA warning concerning liver injury issued on May 26, 2010.

On Christmas eve of 2014, the FDA approved another drug to treat obesity, Liraglutinide, or Saxendra, an injectable reverse DNA biologic approved for obese individuals with a threatening related health condition such as hypertension or diabetes type 2, and for use as an adjunct to a weight management protocol. Saxendra is a glucagon-like peptide-1 receptor agonist (rGLP-1 agonist), like the newer class of diabetic drugs, such as Victoza, but uses almost twice the dosage as this problematic diabetic drug. In a large company trial of 4800 selected patients with obesity and overweight conditions, Saxendra achieved an average weight loss of 4.5 percent of of total body weight, with 38 percent of patients losing much less than 5 percent of their body weight, and the placebo pill achieving greater than 5 percent of total body weight loss in 34 percent of patients. Saxendra came with a black box warning from the FDA that it may cause thyroid tumors, and adverse "side effects" noted in a significant percentage of the patients included pancreatitis, gallbladder disease, kidney impairment, and altered CNS with suicidal thoughts, as well as tachycardia, diarrhea, nausea, hypoglycemia, fatigue, dizziness, headaches, dry mouth, insomnia, frequent urinary tract infections, and loss of appetite. The FDA stated that an ongoing human clinical trial had to be conducted to study the long-term cardiovascular risk of the drug, since this has been a health problem associated with Victoza and other rGLP-1 agonists. Medical doctors applauded the addition of another "effective" drug to add to the other drugs to achieve a polypharmacy solution in treatment of obesity. In March of 2015, the U.S. FDA issued another black box warning for Victoza (Liraglutide) noting the serious risk of causing thyroid tumors with even the half dose from the dosage in Saxendra. In 2013, the FDA responded to a study of insurance records that noted an apparent doubling of risk of acute pancreatitis after starting any of the incretin mimics such as Victoza and Saxendra. While most patients will not experience clinical pancreatitis or thyroid tumor, one has to wonder what the effects are on a subclinical level. Such risk with so little benefit is a concern.

What can the public learn from this failure of the allopathic pharmaceutical industry to treat obesity with even a single effective drug? The lesson to be learned is that obesity is a systemic disorder, or syndrome, that needs a broad treatment approach, not an allopathic solution. Modern medicine needs to integrate with Complementary Medicine to work on a program that restores normal weight control and fat metabolism homeostasis, and also to prevent the syndrome from developing in the early adult stage, or during periods of increased incidence from hormonal imbalance, such as postpartum and postmenopausal states. While it would be nice to have that simple magic pill to cure obesity, it does not appear that modern science will develop such as drug, and the strategies seen in modern pharmaceutical research demonstrate that there is little hope for a new pharmaceutical approach. Intelligent patients will turn to a more restorative and comprehensive holistic therapy, and the Licensed Acupuncturist and herbalist is the ideal physician to deliver this long-term comprehensive treatment.

Scientific research confirming the efficacy of various herbs and nutrient medicines in the treatment of obesity, as well as acupuncture stimulation

There is no single treatment that will reverse obesity. As explained above, obesity is a syndrome that involves a cycle of feedback mechanisms of various hormones, hormone-like chemicals, and inflammatory mediators. Here is some of the amazing research that shows how a number of herbs and nutrient medicines can be individually prescribed to treat obesity in a step-by-step protocol that is geared to each patient's unique presentation. It is too bad that the U.S. still does not have laws mandating insurance and government coverage and payment of professionally prescribed herbal and nutrient medicines, as the cost of a comprehensive therapy often discourages patients who must pay out of pocket. The public may contact their representatives in Washington DC to bring us up to par with the European Union and other countries on these laws. More and more research is proving that many herbal and nutrient medicines, combined with short courses of acupuncture stimulation, and guidance in healthy activities and dietary protocols, will reverse the underlying dysfunctions that cause obesity. Does this protocol guarantee a miraculous immediate weight loss? No, and intelligent patients must realize that when the syndrome of obesity, with insulin resistance, fatty liver accumulation, neurohormonal imbalance, and a dysfunctional metabolism occurs, that the first step in reversing this obesity syndrome is to treat the underlying health problems in a step-by-step manner. CIM/TCM provides many tools to achieve this goal.

In 2014, the National Resource Council Canada and the University of Prince Edward Island, in Charlottetown, PE, Canada, released findings of a study of a common Chinese Herbal Formula used as part of a holistic treatment protocol for obesity, Liu Wei Di Huang Wan, or 6 Flavor Formula based on Rhemannia. This formula extract was fed to laboratory animals with induced obesity, and after 9 weeks of treatment the levels of C-reactive protein, TNF-alpha, and IL-6 were significantly reduced, showing reduced inflammatory stress on fat cells, and the SOD and adiponectin levels were significantly increased, showing antioxidant benefits and hormonal regulation (PMID: 25292344). Another study of the alcohol extract of this same formula, capturing lipid-based phytohormonal chemicals, found that a 5 week intake of this extract reduced weight gain and visceral fat in study animals with obesity (PMID: 24603076). Such studies shows that this treatment is proven to benefit the obese patient within a more comprehensive protocol. Of course, the effects are dose-dependent and rely on a persistent course of therapy. Without such reassurance of effect, most patients are non-compliant with such herbal prescription. Much misinformation online has led most patients to believe that there may be a single herb or simple solution in treatment for obesity, and the results have been discouraging for such an approach. By following a comprehensive course of therapy, guided by a professional, such studies as this show that much will be achieved. As one can see in the links to studies at the end of this article, there is now increasing evidence-based support for a variety of treatment protocols in TCM to counter obesity, with none of the adverse effects of standard medical care. Standardized extracts with resveratrol, glabridin from medical licorice root, Astragalus, Gymnostemna, and other herbal medicines, combined with L-carnitine, R-lipoic acid, green tea polyphenols, oligosaccharides from the palm, acacia and other nutrient medicines offer the TCM physician a variety of proven options to design and individualized and step-by-step approach to countering obesity.

Adiponectin, a key protein hormone produced by fat cells, is deficient in almost all cases of obesity. Research shows that PPARgamma inhibitors reverse adiponectin deficiency. Studies at the University of Chicago, Illinois, Department of Medicine, in 2006, showed that 1,25-dihydroxyvitamin D3, or calcitriol, the hormonally active form of what we call Vitamin D, markedly suppresses PPARgamma and antagonizes PPARgamma activity, normalizing adiponectin production and exerting significant inhibition of adipogenesis (production of stored fat). The herbal chemical curcumin was also shown to downregulate the expression of PPARgamma, as well as inhibiting fatty acid synthase and suppressing lipid accumulation and adipocyte differentiation in fat cells, proving a strong potential application in the treatment of obesity, and potentially increasing adiponectin (Molecular Cell Biochemistry 2011 Jan 9: Chinese Academy of Sciences, Beijing PMID: 21221723). Research at the University of Hong Kong in 2009 found that two chemicals in the Chinese herb Astragalus (Huang qi) significantly increased adiponectin circulating serum levels, and that this effect alone significantly alleviated insulin resistance to treat obesity (PMID: 18927219; Endocrinology. 2009 February; 150(2): 625–633). Research at Zhejiang University, Hangzhou, China, in 2008, found that two chemicals in Citrus Aurantium (Zhi ke) significantly increased adiponectin levels by activating PPAR and up-regulating adiponectin expression in adipocytes (PMID: 18690615; Phytother Res. 2008 Oct;22(10):1400-3). By combining these various proven herbs and supplements, a dramatic improvement in the obesity syndrome may be seen over a period of a few months.

Regulation of leptin is now a well studied subject. Excess levels of leptin and leptin resistance are a hallmark of most cases of obesity, although some cases of obesity show a normal leptin level, and some a deficient leptin level. Leptin levels vary on a diurnal basis, with an increase at night by about 30%. While studies showed that feeding in the evening did not appear to raise leptin levels, fasting in the evening and night did significantly lower excess circulating levels of leptin. High levels of glucosamine in skeletal muscle and fat tissues increased leptin production, indicating that chronic tissue injury requiring higher concentrations of glucosamine to effect repair may contribute to leptin excess, and perhaps addressing chronic pain and soft tissue problems with physiotherapies may help with modulation of excess leptin. Expression of leptin was also found to be affected by not only levels of insulin, but also TNFalpha, IL-1, and glucocorticoids, key inflammatory mediators. Key glucocorticoids include cortisol, adrenaline and norepinephrine. An analysis of diurnal cortisol levels, and a full hormonal profile, assessed via active hormone metabolite testing with saliva and veinous blood stick samples, is highly recommended in obesity therapy. Normalization of steroid hormones, especially progesterone in relation to estradiol, is very helpful in the overall treatment protocol. Melatonin is a neurohormone that is now known to have dramatic effects in controlling most diurnal metabolism in the body, and a normalization of melatonin production may also be very helpful (a blend of low dose melatonin, active B6, or P5P, 5HTP, and St. John's Wort works best to achieve an adequate bioavailability of melatonin precursors at night. Siberian Ginseng has been found effective to normalize leptin production, and electroacupuncture has also been found to be very effective at key points.

Seven years of research at the University of Minnesota revealed in human clinical trials that a patented blend of prepared high viscosity polysaccharides from the herb acacia gum, and esterfied fatty acids, significantly helped to regulate both leptin and adiponectin, and reduced midsection fat accumulation in obese subjects over time. This research was confirmed at the University of Connecticut. This patented herbal and nutrient medicine is available as LeptinX from Vitamin Research. While this herbal and nutrient medicine alone will not cure obesity, it is a valuable tool in the treatment protocol. Once again, patients afflicted with obesity need to realize that there is not just one medication that reverses this condition, but that a comprehensive and persistent treatment regimen will restore normal fatty metabolism and hormonal balance.

Research links below in additional information also show sound research findings supporting a number of herbs and nutrient medicines in the treatment of insulin resistance and obesity. Resveratrol, a chemical extracted from the Chinese herb Polygonum cuspidatum, or Hu zhang, is proven effective to reverse insulin resistance. Berberine, a chemical found in the Chinese herb Huang lian has been found effective. Chemicals in Astragalus, or Huang Qi, are found effective. As time goes on, the list grows. These herbal and nutrient medicines should be judged by the sound research and findings of long-term utilization, and not judged by whether a significant weight loss occurs in the first few weeks of use. This type of attitude is what has prevented acupuncture, TCM and herbal medicine from working in most patients to date. A knowledgeable Licensed Acupuncturist and herbalist will be able to best guide this therapy in a step-by-step fashion individually tailored for best results.

The actual clinical treatment with CIM/TCM is comprehensive, holistic, individualized and works as a restorative medicine to resolve the healthy issues and dysfunctions that perpetuate obesity. When these health issues are improved, normal dieting and exercise will result in a normal weight loss and improved health. As this treatment protocol progresses, the diseases and conditions that are associated with obesity, cardiovascular disease, PCOS, neurodegenerative disease, hypothyroidism, can all be addressed with the therapy as needed. Acupuncture, too, can add to the treatment success. Experts at University Medical Schools around the world are designing studies to measure the various effects of acupuncture stimulation at specific points, and are showing that while there is no single miraculous cure for obesity from a one-size-fits-all acupuncture treatment protocol, there is the potential for amazing contributions from individualized acupuncture treatments within a holistic treatment strategy. For instance, in 2014, experts at the University of Gothenburg Institute of Neuroscience and Physiology, in Goteborg, Sweden, showed that a single electroacupuncture stimulation at a number of points could improve insulin sensitivity and modulate the insulin metabolism in muscle, with decreased mRNA expression of the adipokines Adipor2, Fndc5, Erk2 and Tfam in muscle tissue, and increased ovarian Adrb2 and Pdf. Manual stimulation produced fewer measured effects, but did decrease ovarian mRNA expression of Erk2 and Sdnd. This showed that, yes, acupuncture stimulation improves insulin sensitivity and modulates glucose and fatty stores metabolism. Use of short courses combining electroacupuncture and manual stimulation with proven protocols with herbal and nutrient medicine can play a significant role in reducing the obesity syndrome, and can be integrated with standard medicine with little expense and no adverse effects. To see this study, click here: http://www.ncbi.nlm.nih.gov/pubmed/25218925 . Prior study at this Swedish University showed also that laboratory animals with induced PCOS and insulin resistance responded to intense electroacupuncture stimulation with a 2 Hz frequency with significant increase in insulin sensitivity and improved lipid profile. There are now many such studies confirming the benefits of acupuncture, although finding a simple and specific acupuncture treatment with no stimulation in a standard human randomized controlled trial with a so-called "placebo" acupuncture treatment control, designed to test pharmaceutical medicine for safety, will be difficult to achieve. The necessity for such a trial is questionable, as this treatment is perfectly safe, and is making no claims that alone it can achieve a cure for obesity for everyone. Integration of the real holistic protocol in CIM/TCM practice, though, is proven, sensible and the only side effect is better overall health.

The role of environmental chemicals in the creation or perpetuation of obesity

Bisphenol-A (BPA) and a host of other common chemicals used in industrial production are proven to have potentially harmful affects that alter hormonal mechanisms and contribute to obesity, and the effects may be cumulative. BPA has been proven to alter the adiponectin metabolism, creating an indirect causative or contributing effect to obesity and metabolic syndrome. While the industry claims that the small amount of such chemicals in one container, or other product, is not enough to cause such problems as obesity, the public is becoming aware that there are many sources for such chemicals in our daily lives now, and synthetic chemicals may be stored in the tissues, exerting a cumulative effect over time. The public is also becoming aware that such problems as hormonal dysfunction and obesity are due to a variety of factors, and eliminating these pieces of the puzzle may be necessary to regain healthy function. Chemicals such as BPA exert an estrogen-like effect in the body, and many studies now prove that a variety of hormones in the body may be affected by these products. While the corporations that utilize these chemicals stubbornly fight all attempts to switch to more benign products, spending enormous sums of money to counter governmental health studies around the world, change is finally occurring because the consumers are demanding it.

BPA, or bisphenol-A, and bisphenol-S, or BPS, used to replace BPA in plastics so that the industry can show on the label that the product is "BPA-free", are still found in a majority of soft plastic drink and food containers and wrappings, and some studies have shown that these xenohormonal chemicals leach BPA and BPS when exposed to microwave heating or even the activity of a dishwasher, and possibly higher heat in storage and transport. These and other xenohormonal chemicals are strongly linked to health problems associated with obesity, and avoidance of such chemicals, while difficult, may be important in restoration of health, along with avoidance of foods such as high fructose corn syrup, processed sugars, transfats, sugar substitutes, glutamates, AGEs, and chemical additives in foods.

BPA has been known to be estrogenic since the 1930s, and many countries now ban the chemical from products used by infants and children because of the evidence of potential hormonal and metabolic harm. BPA has been shown to be able to bind to hormonal receptors, albeit more weakly than natural hormones. A number of hormonal receptors have been identified that BPA binds to, including estrogen, testosterone, and thyroid receptors. Dr. Thomas Zoeller, a biology professor at the University of Massachusetts, has stated that he is unaware of any other single molecule that does this. Due to heavy lobbying against a broader BPA ban in the United States, legislation such as Senator Diane Feinstein's proposed ban of BPA in most baby products in the U.S., which is already in effect in Canada, has been put on hold until the NIH conducts a new series of larger scientific studies. A small study of foods packaged in tin cans lined with a plastic coating containing BPA showed that 89 percent of the foods were significantly contaminated with BPA from this lining. Hundreds of studies around the world show that low doses of BPA, similar to doses humans are exposed to with consumption of canned food, beverages in soft plastic containers exposed to sunlight, and microwaved foods in plastic containers, alter the hormonal function and balance in laboratory animals. The effect on adiponectin is the most dramatic effect found so far in these studies, linking BPA to obesity, but in a complex manner.

Patricia Hunt, a biologist at Washington State University, states that BPA isn't the only endocrine-disrupting chemical in our environment, just the one that a lot of researchers have becomed alarmed with when reviewing scientific findings. To truly protect our children from potential harm, our government has to start exerting some influence on the choices in industry, as well as educating the public to make healthier choices as they purchase products. This latter method may be more effective than regulatory legislation, which is easily blocked by Republican opposition fueled by industrial lobbying. In 2009, an organization called the Endocrine Society, reviewed all studies concerning low dose endocrine affectors, and issued a 34-page report that expressed serious concerns about a host of endocrine disrupting chemicals in industrial use, including BPA, dioxins, PCBs, DDT, phthalates, and DES. This scientific group has about 14,000 members in over 100 countries, who work in research and medical fields, as well as industrial research. These scientists state that there is strong evidence that these chemicals cause epigenetic changes, altering the potential functions of our genes, and exert a wide range of potential endocrine function alterations due to this mechanism, which can also be passed on to future generations. Epigenetic changes have been shown to be reversible in just a couple of generations, though, if the persons affected change the habits that created the harmful epigenetic changes in the first place. When modern science is able to come up with more natural products, there seems to be no reason to persistently stick with these potentially harmful environmental chemicals that may contribute to obesity and other hormonal diseases.

While the evidence for a single environmental chemical being the sole cause for obesity is not proven, the evidence is strong that a combination of chemicals, drugs, dietary factors, epigenetic changes, and other factors comprise a complex of physiological events that create and perpetuate obesity. A 2008 study at the University of Alabama (cited below with a link) reviewed endocrine disrupting environmental chemicals (EDCs) and concluded that the evidence was strong that these chemicals contribute to this multifactorial cause of obesity. The researchers stated: "Public health officials should think of the obesity epidemic as a function of a multifactorial complex of events, including environmental-endocrine disruptors, in addition to more commonly perceived and discussed putative contributors to obesity." The chemicals cited include BPA (bisphenol A), DES, DDT, phthalates, dioxins, PCBs, butyltins, heavy metals airborne pollutants, other pesticides, flame retardant chemicals, and solvents. The researchers concluded: "Individually, in some instances these compounds may pose little risk at the levels that they are typically found. However, in various combinations, weak compounds may interact synergistically and prove to be more potent than either compound alone." When a patient has other hormonal imbalances, epigenetic inheritances or tendencies, and a poor diet, these environmental chemicals and pharmaceutical drugs, may play an even more important role in the complex nature of physiological imbalance that causes and perpetuates true obesity.

The role of pharmaceuticals in the creation or perpetuation of obesity

We take pharmaceutical medicines to get healthier or to avoid health problems, but we all recognize that there are often a wide array of serious side effects that come with most pharmaceutical drugs. The array of side effects is now sometimes so dizzying that we do not pay attention anymore. Even medical doctors that prescribe often ignore the long lists of potential side effects and risks. Medical research, though, continues to uncover the relationships between various pharmaceuticals and obesity with long term use. Often, if the patient does not experience a medical side effect in the short term after starting a medication, the relationship between a developing health problem and the drugs that they are taking is no longer clear. This is why the patient must pay attention to medical research.

Today, medical authorities are alarmed by the fact that the list of prescription medications that are known to cause significant weight gain now exceeds 50 different types of drugs. There is also much concern that there is a lack of research and understanding in this field, despite its dire consequences with the rising rate of obesity in the United States. The list includes steroid medications, such as prednisone, antidepressants, atypical antipsychotics, antiseizure medications, newer diabetes drugs, blood pressure medications, antihistamines, and even heartburn and stomach acid inhibitors. While not 100% of patients experience weight gain, patients with other health factors predisposing to obesity are at higher risk with these medications, and this is being largely ignored. The general attitude in medicine is that the benefits probably outweigh the risks of obesity, and an even more alarming attitude is that other medications can be prescribed to induce weight loss in cases where the medication has created obesity. Of course, each case must be individually assessed to weigh risks versus benefits, but there are options other than adding more prescriptions or continuing with prescriptions drugs that cause obesity. As standard medicine begins to embrace Integrative Medicine, more and more enlightened medical doctors are turning to Complementary Medicine to offer more options in treatment.

Atypical antipsychotics are a group of drugs that are increasingly prescribed to treat off label diseases, especially depression, bipolar disorder, dementia, childhood behavioral problems and irritability, and personality disorders. In 2007, the U.S. Department of Health and Human Services AHRQ (Agency for Healthcare Research and Quality) issued a statement that there was a lack of evidence to support many of these off-label uses, and with some of these drugs, most patients experienced significant weight gain that offset any modest benefit from the drug (see the links below in additional information). Often, the patient does not realize that they are actually taking an atypical antipsychotic, because they do not have a psychosis, and the prescribing medical doctor only uses the commercial name of the drug, not explaining what class of drug it is from, or even the real pharmaceutical name of the chemical. Often, there are many commercial names for the same drug. This system is very confusing to the patient, and lends itself to a lack of attention to the drug itself, and a complete dependency on the prescribing doctor to keep track of the potential health problems that can be caused. Some of the widely prescribed atypical antipsychotics in the United States are called Zyprexa, Abilify, Seroquel, and Risperdal. Some atypical antipsychotics are more associated with weight gain, probably due to the action of inhibiting, or antagonizing, dopamine receptors in the brain more effectively, or 5HT receptors as well. Some of these drugs may affect hormonal balance as well, with increased prolactin secretion typical due to the ill effects on the hypothalamic function.

Antidepressant and antianxiety medications are also found to have a strong association with obesity, metabolic syndrome and unhealthy lipid profiles (see study cited below). SSRIs and SSNRIs are very commonly taken today, and these selective serotonin and norepinephrine reuptake inhibitors are shown to have a strong association with obesity in a subset of patients. The effects associated with weight gain occur with chronic use, and increased serum prolactin has also been noted. Despite such findings, a new obesity drug rejected in January of 2011 by the FDA was actually composed of a combination of the SSRI medication Wellbutrin and