Weight Reduction Medications and Programs

What did the study find?

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You should have enough information right here to know how much you should eat at each meal, and between meals. Weight loss medications--where do they fit in? Will try something else. Doubt, you just breakfast the coffe? I lost about 1 pound a week.

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How to Break a Weight Loss Stall on the Ketogenic Diet

Because for many years we have been told fat is so bad for you. My test was ground beef and butter for a few days in a row. Then I would serve myself about a cup of ground beef in a bowl and top it with about 3 tablespoons of butter.

I love the salted KerryGold butter myself but any real butter will do. I ate just enough to fill me up. My ground beef meal was swimming in butter. The first day I was down a whole pound in one day! I was ecstatic to lose a whole pound overnight!

A reader asked if having a cup of ground beef a day would put me over my protein amount when tracking my macros. The answer was no. I decided to capture my macro numbers in a screenshot and share them here with you. Yesterday, I had my 2 cups coffee with butter and cream in the morning, ground beef with butter for lunch and dinner. Then I ate about 4 crunchy pork rinds. I drank plenty of water and took my supplements. I am down another 1. This is what my tracking looks like.

The next day I lost another pound overnight! I broke my weight loss stall! I still consumed my morning coffee with butter of course. Then I basically ate two meals a day that consisted of ground beef and butter.

Talk about easy meals. I might even do the egg fast again too. Both fasts are similar. As long as you eat protein with fats and very little to no carbs, you will lose weight. If you find yourself in a weight loss stall on the Ketogenic diet, you might try something similar. I personally believe the substitute sugars, even Keto approved ones, might cause you to stall at some point.

I also think dairy may have stalled me a bit too. Gosh, I love cheese. I suggest you do different tests of your own. This is the only way you will figure out what is making you stall in your weight loss efforts.

I never once felt as though I was deprived when I ate ground beef with butter. I also only ate twice in a day. I had coffee with butter in the morning 2 cups , and lunch and dinner were both ground beef with butter. Now when I look at my diet, I see more fat intake with moderate protein.

When you think about your diet, what do you see? Head over here and sign up to get a free 7 day Keto Meal plan printable.

We have a lot of fun and share tons of knowledge! This is what my breakfast looks like on a daily basis now! Bacon, Eggs, Avocado, and lots of butter! Join our Private Facebook Group for this challenge: Magnesium, Potassium and make sure to up your salt intake too! I heard this advice over and over again from all the Keto experts at KetoCon too. I found your page through Pinterest, because the picture of the meat, cream cheese?

Do you actually have that? I was glad I found this, because it is so nice to have an arsenal of techniques for keto! How has this affected your overall health blood work, etc? What supplements do you take besides magnesium, potassium, and salt? This is very interesting. I have been stalled for weeks and have been trying to figure out what is going on.

I usually fast until after I workout, but then eat 3 meals. I also usually eat pretty close to my 25 net carbs everyday, I find it helps with volume. Do others find they need to cut out the carbs completely? If you suffer from leg cramps the quickest way to get rid of them is to soak in a bathtub with a cup of epsom salts as your body absorbs magnesium quicker through your skin than in a supplement of buy a spray, this stops the leg cramps immediately.

How do I find you on Facebook? Hi Ronni, We have a facebook group and a page! I started to think that was it for my weight loss. I am so happy I found this pin. I was starting to gain weight again. I started to eat the beef with butter for lunch every day for five days and lost 4 pounds.

I look amazing I feel amazing and I just have to thank you for your amazing advice. Anyone know if coconut like a fresh, real coconut, not dried or sweetened is ok on the keto diet? I love it, and it tastes like a treat!

I did this fast for 4 days and lost 4. After the 4 days I made sure to track my food and fat intake so I could on the plan and figure out what caused me to stall in the first place. Most of my protein I ate after the stall had the same amount of fat in either butter or oils. Doubt, you just breakfast the coffe? Then lunch and dinner meat with butter? Hello, i was interested in doing this. On the second day I added a small amount of grilled onion to the beef but very little because of the carb count.

I also second the issues with keto approved sweeteners. I made some keto mini cheesecakes last weekend and my weight went up I only ate 2 in 2 days, everything else was normal keto for me Only time I have issues with major stalling or reversals is when I use sweeteners.

Not going to make that mistake again! I did this and I lost weight. Thank you for sharing this. I wanna do this again but I kinda wanna try something other than ground beef. Something simple and quick. Again thank you so much for sharing. Thank you for you post and all this information. I am still gathering as much info as I can. This was a great article. I had a question about the app you use. Does it have a bar code scanner or do you have to manual put in the nutrition values?

When looking at your macros, how does your ground beef come out so low? With a cup twice a day and 3 tbs butter each time my calories were at a little over with just those 2 meals, but yours also includes bpc and are still lower than mine.

What app are you using to track it? Hi, I, too, had a stall on Keto. How did your body react when you went back to regular Keto? Did your weight fluctuate or did you keep losing?

When I went back to my normal keto diet, I continued to lose but at a slower pace. These investigators conducted a meta-analysis investigating the potential effects of capsaicinoids on energy intake, clarified previous observations and formed evidence-based conclusions about possible weight management roles. Medical databases Medline, Web of Knowledge and Scopus were systematically searched for papers.

Of the 74 clinical trials identified, 10 were included, 8 of which provided results suitable to be combined in analysis participants. From the studies, 19 effect sizes were extracted and analyzed using MIX meta-analysis software. Data analysis showed that capsaicinoid ingestion prior to a meal reduced ad libitum energy intake by Study findings suggested a minimum dose of 2 mg of capsaicinoids is needed to contribute to reductions in ad libitum energy intake, which appears to be attributed to an altered preference for carbohydrate-rich foods over foods with a higher fat content.

The authors concluded that meta-analysis findings suggested that daily consumption of capsaicinoids may contribute to weight management through reductions in energy intake. Subsequently, there may be potential for capsaicinoids to be used as long-term, natural weight-loss aids. They stated that further long-term randomized trials are now needed to investigate these effects. In a systematic review, Onakpoya et al a evaluated the evidence for or against the effectiveness of glucomannan, a soluble fiber, in body weight reduction.

Hand searches of bibliography were also conducted. Outcomes of interest were body weight and BMI. A total of 18 trials were identified, and 9 were included.

There was a variation in the reporting quality of the included RCTs. A meta-analysis random effect model of 8 RCTs revealed a non-statistically significant difference in weight loss between glucomannan and placebo mean difference [MD]: Adverse events included abdominal discomfort, diarrhea, and constipation. The authors concluded that the evidence from available RCTs does not show that glucomannan intake generates statistically significant weight loss.

They stated that future trials should be more rigorous and better reported. Onakpoya et al b noted that several slimming aids being sold as food supplements are widely available. One of them is pyruvate. Its effectiveness in causing weight reduction in humans has not been fully established.

The objective of this systematic review was to examine the effectiveness of pyruvate in reducing body weight. Electronic and non-electronic searches were conducted to identify all relevant human RCTs. The bibliographies of all located articles were also searched. No restrictions in language or time were applied. Two independent reviewers extracted the data according to predefined criteria. A total of 9 trials were identified and 6 were included.

All had methodological weaknesses. The meta-analysis revealed a statistically significant difference in body weight with pyruvate compared to placebo MD: The magnitude of the effect is small, and its clinical relevance is uncertain. Adverse events included gas, bloating, diarrhea, and increase in low-density lipoprotein LDL cholesterol. The authors concluded that the evidence from RCTs does not convincingly show that pyruvate is effective in reducing body weight; limited evidence exists about the safety of pyruvate.

They stated that future trials involving the use of this supplement should be more rigorous and better reported. The labeling of Saxenda states that liraglutide should not be used with insulin FDA, It also states that the the effects of liraglutide on cardiovascular morbidity and mortality have not been established. The labeling states that the safety and efficacy of coadministration with other products for weight loss have not been established.

In addition, liraglutide has not been studied in patients with a history of pancreatitis. Liraglutide for chronic weight management is contraindicated in the following conditions: Trial data showed that liraglutide, in combination with a reduced-calorie diet and increased physical activity, resulted in significantly greater weight loss than diet and physical activity alone.

The SCALE phase 3 clinical trial program of the safety and effectiveness of liraglutide for chronic weight management included three clinical trials that included approximately 4, obese and overweight patients with and without significant weight-related conditions FDA, All patients received counseling regarding lifestyle modifications that consisted of a reduced-calorie diet and regular physical activity. Results from a clinical trial that enrolled patients without diabetes showed that patients had an average weight loss of 4.

In this trial, 62 percent of patients treated with liraglutide lost at least 5 percent of their body weight compared with 34 percent of patients treated with placebo. Results from another clinical trial that enrolled patients with type 2 diabetes showed that patients had an average weight loss of 3.

In this trial, 49 percent of patients treated with liraglutide lost at least 5 percent of their body weight compared with 16 percent of patients treated with placebo. The FDA approved labeling states that patients using liraglutide should be evaluated after 16 weeks to determine if the treatment is working FDA, If a patient has not lost at least 4 percent of baseline body weight, liraglutide should be discontinued, as it is unlikely that the patient will achieve and sustain clinically meaningful weight loss with continued treatment.

Saxenda is a glucagon-like peptide-1 GLP-1 receptor agonist and should not be used in combination with any other drug belonging to this class, including Victoza, a treatment for type 2 diabetes FDA, Saxenda and Victoza contain the same active ingredient liraglutide at different doses 3 mg and 1. However, Saxenda is not indicated for the treatment of type 2 diabetes, as the safety and efficacy of Saxenda for the treatment of diabetes has not been established.

Saxenda has a boxed warning stating that thyroid C-cell tumors have been observed in rodent studies with liraglutide but that it is unknown whether liraglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma MTC , in humans FDA, Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice.

It is unknown whether liraglutide causes thyroid C-cell tumors, including MTC, in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. The labeling states that liraglutide is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 MEN 2 FDA, The labeling states that patients should be counseled regarding the risk of MTC with use of liraglutide and informed of symptoms of thyroid tumors e.

The labeling states that routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with liraglutide. Serious side effects reported in patients treated with liraglutide for chronic weight management include pancreatitis, gallbladder disease, renal impairment, and suicidal thoughts FDA, Liraglutide can also increase heart rate and should be discontinued in patients who experience a sustained increase in resting heart rate.

Based on spontaneous postmarketing reports, acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with liraglutide Novo Nordisk, After initiation of liraglutide, patients should be observed for signs and symptoms of pancreatitis including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting.

If pancreatitis is suspected, liraglutide should promptly be discontinued and appropriate management should be initiated. If pancreatitis is confirmed, liraglutide should not be restarted. Substantial or rapid weight loss can increase the risk of cholelithiasis; however, the incidence of acute gallbladder disease was greater in liraglutide-treated patients than in placebo-treated patients even after accounting for the degree of weight loss Novo Nordisk, If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated.

When liraglutide is used with an insulin secretagogue e. The labeling recommends lowering the dose of the insulin secretagogue to reduce the risk of hypoglycemia. Renal impairment has been reported postmarketing, usually in association with nausea, vomiting, diarrhea, or dehydration, which may sometimes require hemodialysis Novo Nordisk, The labeling recommends using caution when initiating or escalating doses of liraglutide in patients with renal impairment.

Serious hypersensitivity reactions e. The labeling recommends that patients stop taking liraglutide and seek medical advice if symptoms of hypersensitivity reactions occur. Liraglutide should be discontinued in patients who experience suicidal thoughts or behaviors. Liraglutide should be avoided in patients with a history of suicidal attempts or active suicidal ideation. The labeling states that nursing mothers should either discontinue liraglutide for chronic weight management or discontinue nursing Novo Nordisk, The labeling states that the safety and effectiveness of liraglutide have not been established in pediatric patients and is not recommended for use in pediatric patients.

In addition, the cardiovascular safety of liraglutide is being investigated in an ongoing cardiovascular outcomes trial. Lingwood stated that there is a critical need for improved technologies to monitor fluid balance and body composition in neonates, particularly those receiving intensive care.

Bioelectrical impedance analysis BIA meets many of the criteria required in this environment and appears to be effective for monitoring physiological trends. These researchers reviewed the literature regarding the use of bioelectrical impedance in neonates. It was found that prediction equations for total body water, extracellular water and fat-free mass have been developed, but many require further testing and validation in larger cohorts.

Alternative approaches based on Hanai mixture theory or vector analysis are in the early stages of investigation in neonates. The authors concluded that further research is needed into electrode positioning, bioimpedance spectroscopy and Cole analysis in order to realize the full potential of this technology. These investigators reviewed available information on the short- and long-term effects of intervention treatment on body fat composition of overweight and obese children and adolescents and, to obtain a further understanding on how different body composition techniques detect longitudinal changes.

A total of 13 papers were included; 7 included a multi-disciplinary intervention component, 5 applied a combined dietary and physical activity intervention and 1 a physical activity intervention. Body composition techniques used included anthropometric indices, BIA, and dual energy X-ray absorptiometry.

Percentage of fat mass change was calculated in when possible. Findings suggested, no changes were observed in fat free mass after 16 weeks of nutritional intervention and the lowest decrease on fat mass percentage was obtained. However, the highest fat mass percentage with parallel increase in fat free mass, both assessed by DXA was observed in a multi-component intervention applied for 20 weeks.

The authors concluded that more studies are needed to determine the best field body composition method to monitor changes during overweight treatment in children and adolescents. Two reviewers independently screened titles and abstracts for inclusion, extracted data and rated methodological quality of the included studies.

These investigators performed a best evidence synthesis to synthesize the results, thereby excluding studies of poor quality. They included 50 published studies. Mean differences between BIA and reference methods gold standard [criterion validity] and convergent measures of body composition [convergent validity] were considerable and ranged from negative to positive values, resulting in conflicting evidence for criterion validity.

These investigators found strong evidence for a good reliability, i. However, test-retest mean differences ranged from 7. However, they stated that validity and measurement error were not satisfactory.

Goldberg et al stated that the sensory and gastro-intestinal changes that occur with aging affect older adults' food and liquid intake. Any decreased liquid intake increases the risk for dehydration. This increased dehydration risk is compounded in older adults with dysphagia. The availability of a non-invasive and easily administered way to document hydration levels in older adults is critical, particularly for adults in residential care.

This pilot study investigated the contribution of BIA to measure hydration in 19 older women in residential care: The authors concluded that if results are confirmed through continued investigation, such findings may suggest that long-term care facilities are unique environments in which all older residents can be considered at-risk for dehydration and support the use of BIA as a non-invasive tool to assess and monitor their hydration status.

Buffa et al defined the effectiveness of bioelectrical impedance vector analysis BIVA for assessing 2-compartment body composition.

Selection criteria included studies comparing the results of BIVA with those of other techniques, and studies analyzing bioelectrical vectors of obese, athletic, cachectic and lean individuals. A total of 30 articles met the inclusion criteria. The ability of classic BIVA for assessing 2-compartment body composition has been mainly evaluated by means of indirect techniques, such as anthropometry and BIA.

Classic BIVA showed a high agreement with body mass index, which can be interpreted in relation to the greater body mass of obese and athletic individuals, whereas the comparison with BIA showed less consistent results, especially in diseased individuals.

The authors concluded that specific BIVA is a promising alternative to classic BIVA for assessing 2-compartment body composition, with potential application in nutritional, sport and geriatric medicine. Haverkort et al noted that BIA is a commonly used method for the evaluation of body composition. However, BIA estimations are subject to uncertainties. These researchers explored the variability of empirical prediction equations used in BIA estimations and evaluated the validity of BIA estimations in adult surgical and oncological patients.

Studies developing new empirical prediction equations and studies evaluating the validity of BIA estimations compared with a reference method were included. Only studies using BIA devices measuring the entire body were included. Studies that included patients with altered body composition or a disturbed fluid balance and studies written in languages other than English were excluded.

To illustrate variability between equations, fixed normal reference values of resistance values were entered into the existing empirical prediction equations of the included studies and the results were plotted in figures.

Estimates of the FM demonstrated large variability range relative difference The authors concluded that application of equations validated in healthy subjects to predict body composition performs less well in oncologic and surgical patients.

They suggested that BIA estimations, irrespective of the device, can only be useful when performed longitudinally and under the same standard conditions. Gibson et al stated that VLEDs and ketogenic low-carbohydrate diets KLCDs are 2 dietary strategies that have been associated with a suppression of appetite. However, the results of clinical trials investigating the effect of ketogenic diets on appetite are inconsistent.

To evaluate quantitatively the effect of ketogenic diets on subjective appetite ratings, these researchers conducted a systematic literature search and meta-analysis of studies that assessed appetite with visual analog scales VAS before in energy balance and during while in ketosis adherence to VLED or KLCD. Although these absolute changes in appetite were small, they occurred within the context of energy restriction, which is known to increase appetite in obese people.

Thus, the clinical benefit of a ketogenic diet is in preventing an increase in appetite, despite weight loss, although individuals may indeed feel slightly less hungry or more full or satisfied. Ketosis appears to provide a plausible explanation for this suppression of appetite.

The authors concluded that future studies should investigate the minimum level of ketosis required to achieve appetite suppression during ketogenic weight loss diets, as this could enable inclusion of a greater variety of healthy carbohydrate-containing foods into the diet. Bueno and colleagues examined the effect of replacing dietary long-chain triacylglycerols LCTs with medium-chain triacylglycerols MCTs on body composition in adults. These researchers conducted a meta-analysis of RCTs, to examine if individuals assigned to replace at least 5 g of dietary LCTs with MCTs for a minimum of 4 weeks show positive modifications on body composition.

Two authors independently extracted data and assessed risk of bias. Weighted mean differences WMDs were calculated for net changes in the outcomes. These investigators assessed heterogeneity by the Cochran Q test and I 2 statistic and publication bias with the Egger's test. Pre-specified sensitivity analyses were performed.

A total of 11 trials were included, from which 5 presented low risk of bias. The overall quality of the evidence was low-to-moderate. Trials with a cross-over design were responsible for the heterogeneity. The authors concluded that despite statistically significant results, the recommendation to replace dietary LCTs with MCTs must be cautiously taken, because the available evidence is not of the highest quality. Changes in blood lipid levels were secondary outcomes.

Identified trials were assessed for bias. Mean differences were pooled and analyzed using inverse variance models with fixed effects.

Heterogeneity between studies was calculated using I 2 statistic. No differences were seen in blood lipid levels. Many trials lacked sufficient information for a complete quality assessment, and commercial bias was detected.

Although heterogeneity was absent, study designs varied with regard to duration, dose, and control of energy intake. The authors concluded that replacement of LCTs with MCTs in the diet could potentially induce modest reductions in body weight and composition without adversely affecting lipid profiles. However, they stated that further research is needed by independent research groups using large, well-designed studies to confirm the effectiveness of MCT and to determine the dosage needed for the management of a healthy body weight and composition.

They performed a search of English-language articles in the PubMed and Embase databases through April 30, Differences in weight loss between FTO genotypes across studies were pooled with the use of fixed-effect models. A meta-analysis of 10 studies comprising 6, participants that reported the results of additive genetic models showed that individuals with the FTO TA genotype and AA genotype those with the obesity-predisposing A allele had 0.

A meta-analysis of 14 studies comprising 7, participants that reported the results of dominant genetic models indicated a 0. In addition, differences in weight loss between the AA genotype and TT genotype were significant in studies with a diet intervention only, adjustment for baseline BMI or body weight, and several other subgroups. However, the relatively small number of studies limited these stratified analyses, and there was no statistically significant difference between subgroups.

Hypoxic conditioning has been previously used by healthy and athletic populations to enhance their physical capacity and improve performance in the lead up to competition. Recently, HC has also been applied acutely single exposure and chronically repeated exposure over several weeks to over-weight and obese populations with the intention of managing and potentially increasing cardio-metabolic health and weight loss.

At present, it is unclear what the cardio-metabolic health and weight loss responses of obese populations are in response to passive and active HC. Exploration of potential benefits of exposure to both passive and active HC may provide pivotal findings for improving health and well-being in these individuals.

These researchers carried out a systematic literature search for articles published between and Studies investigating the effects of normobaric HC as a novel therapeutic approach to elicit improvements in the cardio-metabolic health and weight loss of obese populations were included. Inconclusive findings, however, exist in determining the impact of acute and chronic HC on markers such as triglycerides, cholesterol levels, and fitness capacity. The authors concluded that normobaric HC demonstrated observable positive findings in relation to insulin and energy expenditure passive , and body weight and BP active , which may improve the cardio-metabolic health and body weight management of obese populations.

However, they stated that further evidence on responses of circulating biomarkers to both passive and active HC in humans is needed. The following indicates maximum ideal weight in shoes with one-inch heels based on body frame and height:. Clinical Policy Bulletin Notes. Links to various non-Aetna sites are provided for your convenience only. Weight Reduction Medications and Programs. Aetna considers the following medically necessary treatment of obesity when criteria are met: Weight reduction medications, and.

Dexamethasone suppression test and hour urinary free cortisol measures if symptoms suggest Cushing's syndrome. Rice diet or other special diet supplements e. American Obesity Association, C. Guidance for treatment of adult obesity. Accessed March 16,

How Did Medical Weight Loss Clinic Start?