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			 Orlistat, an obesity drug, may also be effective when taken at 
			higher doses, researchers found. 
 More than one third of U.S. adults are obese, and obesity raises the 
			risk of heart disease, type 2 diabetes and some types of cancer. 
			Losing weight - and keeping it off - can reduce those risks.
 
 “Long term weight loss through changes in eating and physical 
			activity is possible, even in adults who have already acquired 
			obesity related illness, and effective weight loss programs are now 
			available,” researchers led by Stephan Dombrowski of Newcastle 
			University in the UK write.
 
 They pooled data from 45 studies that included a total of 7,788 
			adults who had lost at least five percent of their body weight. The 
			studies looked at people’s ability to keep the weight off for a 
			minimum of one year.
 
 Forty-two of the studies included an initial phase meant to produce 
			weight loss. The participants in those studies lost an average of 
			about 24 pounds.
 
 
			
			 
			The studies all looked at medication or lifestyle changes such as 
			diet, physical activity and meal replacements, either alone or in 
			combination, to help with weight loss maintenance.
 
 The researchers found that people participating in programs that 
			combined diet and exercise gained back 3.4 fewer pounds after one 
			year compared to people receiving no extra help with weight 
			maintenance or standard treatment only.
 
 They also found that combining Orlistat with behavioral changes 
			resulted in 4 fewer pounds regained after one year compared to 
			participants who took a drug-free placebo.
 
 Orlistat appeared to be more effective at larger doses, according to 
			results published in the British medical journal BMJ. But the drug 
			also came with gastrointestinal side effects.
 
 Lori Rosenthal said the findings echo previous research and that it 
			was “interesting” that the authors included data from so many 
			studies.
 
 Rosenthal is a dietician at Montefiore Medical Center in Bronx, New 
			York. She was not involved in the new review.
 
 “I think it’s great that they covered so many different studies but 
			there’s also so much variety and the long-term research isn’t there, 
			you know - going beyond 24 months,” she told Reuters Health.
 
 Still, “We know that interventions like diet and physical activity 
			are really important in preventing weight regain after losing,” she 
			said.
 
            [to top of second column] | 
 
			Rosenthal noted that participants who had dropped out of the 
			programs were not always included in the findings, and that could 
			affect the review’s results.
 “Weight management is hard,” she said. “People have to realize that 
			it’s not just the losing it - it’s for life, and if you don’t like 
			what you’re doing, if it doesn’t work for you, you’re not going to 
			stick with it.”
 
			Support during the weight management phase is important, Rosenthal 
			added. There are support groups and dietitians who can give people 
			tricks and tools to help make it easier, she said.
 She offered some advice for people who have lost weight and are 
			moving into a maintenance phase.
 
 “It’s really important to remember that weight management is a mind 
			and a stomach game,” she said. “You have to feel good about what 
			you’re having.”
 
 “Really make sure you find foods you like - that you’re choosing 
			foods not because you’re on a diet but because you like them,” 
			Rosenthal said. “You have to like them more than the other things 
			you were eating before.”
 
 Rosenthal said that if people don’t like the new foods they eat or 
			their new routine, they will be more likely to go right back to old 
			habits.
 
 She said being mindful and chewing slowly also allows people to 
			enjoy their food and eat less.
 
 SOURCE: http://bit.ly/REgqxK BMJ, 
			online May 14, 2014.
 
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				reserved.] Copyright 2014 Reuters. All rights reserved. This material may not be published, 
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