By Lubna Abdel-Aziz Now that we have devoured our last exquisitely, dainty, delectable, dulcet, delicacy; nibbled and gnawed on every rich, luscious, sugary, succulent morsel of Ramadan and Bairam, we look aghast at our waistlines, and moan. For those of us whose weight goes up and down periodically, frequently, or intermittently, it is time to seek the strict regimen of a diet before we are flooded with the next avalanche of toothfull, bonnne-bouche tit-bits. The year 2004 was a fat year; it was a fat year for those of us who have a weight problem, but then every year is a fat year, leaving us constantly seeking the ultimate diet that will take care of those extra kilogrammes once and for all. Well, there are good news and bad news. The good news is that there are new discoveries and novel ideas out there that can help some of us. The bad news is that it will be some time before they are available to the public. In any case, there is always your garden variety standard diets that have stood the test of time like the Atkins diet (fat, protein, no carbs), the South Beach Diet (protein, fat, few carbs), the Scarsdale diet (any amount of meat & veggies), etc, etc. Simplest of all formulas is to "eat less and exercise more", but no one seems to heed it. A ground breaking discovery of a natural hormone, PYY3-36, has been found to curb our appetites and limit the amount of food we eat. Its discoverers are hopeful that this will finally stop the worldwide obesity epidemic. More than a billion people are either overweight or obese. Even Asia is now plagued with obesity where it was once virtually unknown. Obesity is defined by the Body Mass Index (BMI), which is calculated by the ratio between the weight of an individual in kilogrammes divided by the height in metres squared. A BMI of less than 18.5 is considered underweight, 18.5--25 normal, 25-30 overweight, and above 30 obese. For example, if a person weighs 98 kilos, and is 175 cms tall, his BMI is 98/1.75� = 32.6 (obese). British scientists have discovered that PYY3-36 tells the brain when the stomach is full. Injecting this hormone in the manner that diabetics inject insulin could provide a safe and long-term treatment for obesity. "It stops you eating because you feel less hungry," says Caroline Small, a member of the research group, "it is part of your natural physiology." Professor Stephen Bloom of Imperial College, London, believes that it may even be possible to identify specific foods that cause the release of more PYY3-36 so appetite could be stopped naturally, even though we have eaten less. If you do not fancy injecting yourself before each meal, treatment with nasal PYY may also result in considerable weight loss. A trial demonstration of PYY in the form of a nasal spray by Nastech Pharmaceutical Company (NSTC) showed a significant caloric reduction. A weight reduction of a 0.5 kilo per week was achieved following three times a day nasal doses, and this amounts to about 2.5 kilos a month. The results are encouraging and provide a new treatment option for obesity that is easy to administer, non-invasive, and besides, it results in an average of six per cent reduction in cholesterol levels, as well as a decrease in the desire to smoke. Pill popping dieters will be happy to learn that the best of all pills is yet to come our way and may well be the answer to all our dreams. Described as the long awaited "wonder pill", Rimonabant is being developed for the management of cardiovascular risk factors including reduction of abdominal obesity, improving lipid and glucose metabolism, and as an aid to smoking cessation. Industry analysts predict it could be a one-in-a-decade blockbuster. The latest results of a two-year trial involving 3,000 patients in the US and Canada, introduced 9 November 2004 at the American Heart Association Scientific Session in New Orleans, revealed that individuals taking rimonabant lost more weight around their waist than those receiving a placebo. After two years, patients taking a 20mg daily dose of the medication lost 8cms around their waist compared to 4.9cms for those taking a 5mg dose and 3.8cms in the placebo group. Excessive weight is linked to an increased risk of diabetes, heart disease, strokes and several cancers. It also costs governments an incredible expense. Studies in the UK find one of every five Britons obese and in the US, two out of three. Deaths linked to obesity are on the rise costing the UK National Health Service �500 million annually and in the US $99.2 billion in 1995. "Obesity is now the number one health problem facing Americans", writes George L Brackburn of Harvard Medical School. "Its rates among adults and even children speaks for the urgent need of treatments that may help address this epidemic." Some scientists have called for a ban of advertisements for fizzy drinks and fatty foods after hearing of the high frequency of childhood obesity. Chairman David Halsam of The UK's National Obesity Forum describes rimonabant as "a completely unique drug with very impressive results". It reduces weight, helps in quitting smoking, and reduces cholesterol levels. "We can really save some lives as well as reducing the costs of treating obesity and its related complications." As we wait for the pill to be available, now being manufactured by a French drug company and will be sold under the trade name of Acomplia, we have other alternatives. One more best-seller diet book is out and seems to contribute some novel ideas. Just count your bites. Do not exceed 80 bites per day, and divide them over three meals and one snack. Absolutely no eating between meals. The best part of the diet is that it does away with all the water drinking that is so highly touted by everyone else. According to the author the idea is to shrink the size of your stomach. In time you will feel fuller with much less food intake. Avoid big salads. All that munching distends the intestines, and the next time you eat, you may fill up with higher caloric foods, which will take you back to where you started. Another book gaining acceptance claims that each blood type needs a different list of foods that are beneficial. Author Peter d'Amado's theory introduces the concept of genetically individualised nutrition, according to the four blood types. Type A (high carbs, low fats, basically fruits and veggies). Type B (a balanced diet of meats, fish, grains, dairy, fruits and veggies -- avoid chicken). Type AB (mostly vegetarian, meats and fish on rare occasions). Type O (very high protein, low carbs, veggies and fruits). Would we not give anything to rid ourselves of these hunger sensations that plague us throughout the day. Knowledge on the subject is incomplete. We do know that the area of the brain that controls hunger and satiety is the hypothalamus. In experimental animals the electrical stimulation of the hypothalamus results in hyperphagia (uncontrolled eating) whereas destruction by surgery or injection of neurotoxins results in aphagia (not eating or starving). Some drugs, such as amphetamines take advantage of this, and have been shown to be effective appetite suppressants. We need food but we only need that much of it. Exceeding that limit may lead to obesity, disease and in many cases, death. We are constantly reminded of the need to exercise daily, but it is easier said than done. Shedding the weight is not easy. While we all possess a fair amount of vanity, the price is often too high: "the soul is willing, but the flesh is weak!" Most of us need help, and there must be a diet out there for each one of us. But whatever the diet, it is indubitably hard work. Those who succeed are the ones that possess unshrinking dedication, unflinching concentration, and unyielding determination. Would that I were one of them! "Animals feed themselves, men eat; But only wise men know the art of eating" Physiologie du gout, Jean Anthelme Brillat-Savarin (1755-1826)
