How I Lost Half My Body Weight

Weight loss surgery, exercise, and determination helped a WebMD user shape up.By William Streetman
WebMD Magazine - Feature

Four years ago I was 54 years old and weighed 404 pounds. Being overweight was something that sort of crept up on me. In my early 20s, I wasn’t fat -- I played softball and soccer with pickup teams and rode my bicycle.

Then I got married, had kids, and started a career. I was traveling, building my career, and overeating, over-drinking, not sleeping enough, and not taking care of myself. I didn’t exercise because I felt too heavy to do it, and those destructive cycles just took over.

Weight Loss Surgery for Obesity

The first weight loss surgery Garrick Pedersen underwent nearly killed him. Doctors placed an elastic band around Pedersen's stomach just below the esophagus to restrict how much food he could eat. Pedersen, who weighed close to 300 pounds, began to lose weight almost immediately after the surgery. "I was overjoyed," says Pedersen, 52, a lawyer in the San Francisco Bay area. "I felt better. I looked better." What's more, very small portions of food left him feeling full. Then came trouble...

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I was so big that I couldn’t fit in theater seats, and I couldn’t attend sporting events. I was deathly afraid of asking for a seatbelt extender on an airplane, or going to a restaurant and getting stuck sitting at a booth. My cholesterol was high.

One Saturday, I talked to my business partner about how we needed to take better care of ourselves. We were both out of shape and overweight -- and I realized this was the 20th weekend in a row we were saying this. I thought to myself, "You either mean it or you don’t. Which is it?"

I had tried to lose weight for about 20 years. My sister had suggested gastric bypass, and I had a cousin who had the surgery. So I researched the different kinds of surgeries, met with a doctor at a weight-loss center, and everything just fell into place.

I had gastric bypass surgery on Oct. 4, 2010, a procedure called Roux-en-Y, where the doctor cut the top part of my stomach to make a small pouch and rerouted part of my small intestine.

I couldn’t eat like I did before. If I ate too fast or 1 ounce too much, I would throw up. I looked at gastric bypass as a tool that allowed me to eat to fuel my body and not for pleasure. I couldn’t eat six Big Macs anymore -- nor did I want to. Instead, I ate a lot of little meals throughout the day, focusing on the vitamins, minerals, and protein my body needed.

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Many Insurers Do Not Cover Drugs Approved To Help People Lose Weight

Many Insurers Do Not Cover Weight Loss DrugsDespite the increasing efforts to fight the obesity epidemic and the approval of four new weight-loss medications, Medicare and many private plans are reluctant to pay for the medicines because of serious safety problems with other drugs in the past.WebMD News from Kaiser Health News

By Michelle Andrews

Tue, Jan 6 2015

In December, the Food and Drug Administration approved a new anti-obesity drug, Saxenda, the fourth prescription drug the agency has given the green light to fight obesity since 2012. But even though two-thirds of adults are overweight or obese — and many may need help sticking to New Year’s weight-loss resolutions — there’s a good chance their insurer won’t cover Saxenda or other anti-obesity drugs.

The health benefits of using anti-obesity drugs to lose weight—improvements in blood sugar and risk factors for heart disease, among other things—may not be immediately apparent. “For things that are preventive in the long term, it makes plan sponsors think about their strategy,” says Dr. Steve Miller, the chief medical officer at Express Scripts, which manages the prescription drug benefits for thousands of companies. Companies with high turnover, for example, are less likely to cover the drugs, he says.

“Most health plans will cover things that have an immediate impact in that plan year,” Miller says.

Miller estimates that about a third of companies don’t cover anti-obesity drugs at all, a third cover all FDA-approved weight-loss drugs, and a third cover approved drugs, but with restrictions to limit their use. The Medicare prescription drug program specifically excludes coverage of anti-obesity drugs.

Part of the reluctance by Medicare and private insurers to cover weight-loss drugs stems from serious safety problems with diet drugs in the past, including the withdrawal in 1997 of fenfluramine, part of the fen-phen diet drug combination that was found to damage heart valves.

Back then, weight-loss drugs were often dismissed as cosmetic treatments. But as the link between obesity and increased risk for type 2 diabetes, heart disease, cancer and other serious medical problems has become clearer, prescription drugs are seen as having a role to play in addressing the obesity epidemic. Obesity accounts for 21 percent of annual medical costs in the United States, or $190 billion, according to a 2012 study published in the Journal of Health Economics.

The new approved drugs — Belviq, Qsymia, Contrave and Saxenda — work by suppressing appetite, among other things. Saxenda is a subcutaneous injection, the other three drugs are in pill form. They’re generally safer and have fewer side effects than older drugs. In conjunction with diet and exercise, people typically lose between 5 and 10 percent of their body weight, research shows, modest weight loss but sufficient to meaningfully improve health.

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Drug for Bladder Problems May Help Control Weight, Too

But small study showed increase in heart rate in young, lean volunteers

By Kathleen Doheny

HealthDay Reporter

TUESDAY, Jan. 6, 2015 (HealthDay News) -- A drug already used to treat overactive bladder may also someday help control weight by boosting the metabolic powers of brown fat, a small study suggests.

While white fat stores energy, brown fat burns energy to generate body heat. In the process, it can help maintain body weight and prevent obesity, at least in animals, previous studies have shown.

In the new study, researchers gave 12 healthy, lean young men a high dose of the drug mirabegron (Myrbetriq), and found that it boosted their metabolic rate.

The drug "activates the brown fat cells to burn calories and generate heat," said study researcher Dr. Aaron Cypess. He is section head of translational physiology at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

When the activity of the drug peaked, "the metabolic rate went up by 13 percent on average," Cypess said. That translates to about 203 calories, he said.

However, Cypess said that doesn't necessarily mean the men would burn an extra 203 calories a day over the long-term. The researchers don't yet know how long the calorie-burning effect might last, as they didn't follow the men over time.

The researchers projected the three-year weight loss would be about 22 pounds.

The study was published Jan. 6 in Cell Metabolism.

Cypess conducted the research while working at the Joslin Diabetes Center and Harvard Medical School. The study was funded by the U.S. National Institutes of Health, with no drug company involvement.

The men, whose average age was 22, took a single dose of the drug in one session and took a single dose of a placebo in another, serving as their own comparisons. The researchers measured metabolic rate by scans, including positron emission tomography (PET) and CT scans.

The effects of the drug on fat-burning, Cypess said, would be "mild to moderate if sustained."

The drug works by activating what is known as a beta 3-adrenergic receptor, found on the surface of brown fat cells. It is also found on the urinary bladder cells, and the drug works to calm an overactive bladder by relaxing muscle cells there, he said.

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