Why there won't ever be a fat pill

Philip J. Goscienski, M.D.

March 2013

Every now and then a miraculous solution to the obesity problem surfaces — and then sinks. When scientists discovered leptin, a hormone manufactured by fat cells that turned obese, leptin-deficient mice into the equivalent of a trim Mighty Mouse, it appeared that our national obesity epidemic might be over. Alas, mice and men do not react to leptin in the same way.

Do you remember the hoodia hoopla of a few years ago? Hoodia is still around but the hype has diminished considerably. There is only one published study on hoodia in humans, a placebo-controlled project that found considerable side effects that included nausea, vomiting, elevated blood pressure and changes in liver function. The overweight patients in this thankfully brief (15 day) experiment did not experience appetite suppression or weight loss.

There is no shortage of drugs or herbal preparations that suppress appetite but none that "burn" fat. There is simply no substitute for lowering energy, i.e., calorie, intake in order to make body fat disappear. Even the recently popular (but now illegal) HCG (human chorionic gonadotropin) diet required slashing calories to 500 a day, a high-risk venture.

The problem, of course, is that there are dozens, probably hundreds, perhaps thousands of chemicals that have evolved over millions of years to regulate fat cells. It is naive to think that a single drug, or even several taken at a time, could have more than a temporary effect on this complex phenomenon. Nature intended our bodies to accumulate fat whenever possible because our food supply might vanish tomorrow. Anything that might block one step in this process will result in a compensatory mechanism to preserve fat. The best strategy, therefore, is not to accumulate fat in the first place.

It's true that some persons gain weight more easily than others; some utilize carbohydrate or fat more efficiently. Others are naturally more active and fidget away a hundred or more calories a day. How lucky! Stress causes some of us to store fat more rapidly, an advantage during the Stone Age but a potentially fatal trait today.

Taking fat loss to surgical extremes such as liposuction has only cosmetic value. It won't lower the risk of heart disease and stroke. Stomach stapling is fraught with complications though it does benefit the morbidly obese.

The scientists who spend decades on this problem agree on only one strategy: eat less and exercise more. Don't blame me. I'm just the messenger.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.