The effect of leptin, caffeine/ephedrine, and their combination upon visceral fat mass and weight loss

Liu, Ann; Smith, Steven R.; Fujioka, Ken; Greenway, Frank L.

doi:10.1002/oby.20416

Cited by 32 publications

(19 citation statements)

References 19 publications

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“…Seven SRs [82–88] and 33 RCTs [89–122] evaluated exclusively pharmacological interventions for weight loss, and 13 RCTs evaluated pharmacotherapy as an adjunct to other interventions. Registered medicines, including anorectics, antidepressants, anticonvulsants and antidiabetics, were highly effective at reducing weight.…”

Section: Resultsmentioning

confidence: 99%

A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders

Peckmezian¹,

Hay

2017

J Eat Disord

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ObjectiveMost weight loss research focuses on weight as the primary outcome, often to the exclusion of other physiological or psychological measures. This study aims to provide a holistic evaluation of the effects from weight loss interventions for individuals with obesity by examining the physiological, psychological and eating disorders outcomes from these interventions.MethodsDatabases Medline, PsycInfo and Cochrane Library (2011–2016) were searched for randomised controlled trials and systematic reviews of obesity treatments (dietary, exercise, behavioural, psychological, pharmacological or surgical). Data extracted included study features, risk of bias, study outcomes, and an assessment of treatment impacts on physical, psychological or eating disorder outcomes.ResultsFrom 3628 novel records, 134 studies met all inclusion criteria and were evaluated in this review. Lifestyle interventions had the strongest evidence base as a first-line approach, with escalation to pharmacotherapy and bariatric surgery in more severe or complicated cases. Quality of life was the most common psychological outcome measure, and improved in all cases where it was assessed, across all intervention types. Behavioural, psychological and lifestyle interventions for weight loss led to improvements in cognitive restraint, control over eating and binge eating, while bariatric surgery led to improvements in eating behaviour and body image that were not sustained over the long-term.DiscussionNumerous treatment strategies have been trialled to assist people to lose weight and many of these are effective over the short-term. Quality of life, and to a lesser degree depression, anxiety and psychosocial function, often improve alongside weight loss. Weight loss is also associated with improvements in eating disorder psychopathology and related measures, although overall, eating disorder outcomes are rarely assessed. Further research and between-sector collaboration is required to address the significant overlap in risk factors, diagnoses and treatment outcomes between obesity and eating disorders.Electronic supplementary materialThe online version of this article (doi:10.1186/s40337-017-0143-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders

Peckmezian¹,

Hay

2017

J Eat Disord

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“…An early study with weekly Fc-leptin designed to assess the potential for synergistic weight loss with caffeine and ephedrine was published recently (Liu et al 2013). The clinical trial evaluated 90 obese individuals spread across three treatment groups: 20 mg Fc-leptin subcutaneously once per week (L), 200 mg caffeine and 20 mg ephedrine three times per day orally (CE), and the combination of the two (LCE).…”

Section: Combination Pharmacotherapy Studies With Leptin To Overcome mentioning

confidence: 99%

20 YEARS OF LEPTIN: Leptin in common obesity and associated disorders of metabolism

DePaoli

2014

Journal of Endocrinology

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The molecular mechanisms of body weight and body composition regulation have long been a research focus in the hopes of identifying tractable pathways for therapeutic interventions for obesity and diabetes, as well as related disorders such as nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and polycystic ovary syndrome. The metabolic consequences of obesity and type 2 diabetes (T2D) were already a focus of the world's attention in 1994 when the discovery of leptin generated enormous enthusiasm for the potential to treat common (non-monogenic) obesity and its associated metabolic disorders with an adipokine hormone that regulated body weight as well as lipid and carbohydrate metabolism. Recombinant human leptin and many leptin analogs were developed and studied in animals and a few in human clinical trials. Overall, the opportunity for leptin as a therapeutic in unselected patients with obesity and T2D has not been substantiated in clinical trials. The potential for combination therapy suggested by clinical studies with leptin and pramlintide supports a path toward obesity treatment through the leptin pathway. The profound metabolic benefits seen with leptin in numerous forms of leptin deficiency, including lipodystrophy, provide hope for the opportunity to identify selected subsets of patients who could benefit from leptin treatment. This review provides a comprehensive overview of the clinical data on a subset of the potential utilities of leptin, specifically as a therapeutic for general or common obesity and its metabolic consequences including T2D and NAFLD/NASH.

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“…This result is consistent with a previous study showing that the decrease in 24-hour energy expenditure seen in the placebo group was 10% at day 1 and 13% at day 56, but was only 7% and 8% in the EC-treated group, and the weight-loss was not different in the two groups after 8-week treatment [26]. On the other hand the results from placebo controlled studies, conducted in different clinical settings and in several countries, were highly consistent that EC is an effective and well tolerated anti-obesity therapy [27]–[33]. Several reasons may justify this discrepancy.…”

Section: Discussionmentioning

confidence: 94%

Muscle Uncoupling Protein 3 Expression Is Unchanged by Chronic Ephedrine/Caffeine Treatment: Results of a Double Blind, Randomised Clinical Trial in Morbidly Obese Females

et al. 2014

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Ephedrine/caffeine combination (EC) has been shown to induce a small-to-moderate weight loss in obese patients. Several mechanisms have been proposed, among which an increased thermogenic capacity of skeletal muscle consequent to the EC-induced up-regulation of uncoupling protein 3 (UCP3) gene expression. We did a parallel group double-blind, placebo-controlled, 4-week trial to investigate this hypothesis. Thirteen morbidly obese women (25–52 years of age, body-mass index 48.0±4.0 kg/m2, range 41.1–57.6) were randomly assigned to EC (200/20 mg, n = 6) or to placebo (n = 7) administered three times a day orally, before undergoing bariatric surgery. All individuals had an energy-deficit diet equal to about 70% of resting metabolic rate (RMR) diet (mean 5769±1105 kJ/day). The RMR analysed by intention to treat and the UCP3 (long and short isoform) mRNA levels in rectus abdominis were the primary outcomes. Body weight, plasma levels of adrenaline, noradrenaline, triglycerides, free fatty acids, glycerol, TSH, fT4, and fT3 were assessed, as well as fasting glucose, insulin and HOMA index, at baseline and at the end of treatments. Body weight loss was evident in both groups when compared to baseline values (overall −5.2±3.2%, p<0.0001) without significant differences between the treated groups. EC treatment increased the RMR (+9.2±6.8%, p = 0.020), differently from placebo which was linked to a reduction of RMR (−7.6±6.5%, p = 0.029). No significant differences were seen in other metabolic parameters. Notably, no changes of either UCP3 short or UCP3 long isoform mRNA levels were evident between EC and placebo group. Our study provides evidence that 4-week EC administration resulted in a pronounced thermogenic effect not related to muscle UCP3 gene expression and weight loss in morbidly obese females under controlled conditions.Trial RegistrationClinicalTrials.gov NCT02048215

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The effect of leptin, caffeine/ephedrine, and their combination upon visceral fat mass and weight loss

Cited by 32 publications

References 19 publications

A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders

A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders

20 YEARS OF LEPTIN: Leptin in common obesity and associated disorders of metabolism

Muscle Uncoupling Protein 3 Expression Is Unchanged by Chronic Ephedrine/Caffeine Treatment: Results of a Double Blind, Randomised Clinical Trial in Morbidly Obese Females

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