The surprising success of weight loss through psychological adjustment, the unexpected benefit of sibutramine, and weight loss through lipase inhibitors

Why does psychological adjustment have such a remarkable effect on weight loss?

While various weight loss methods have emerged one after another, psychological adjustment for weight loss has not attracted much attention. However, if used properly, psychological adjustment for weight loss can achieve surprisingly good results.

Psychologists believe that eating is a major cause of obesity, but eating is merely a behavior; behind it lies a psychological issue. For example, due to extreme scarcity, our ancestors had to eat as much as possible to survive, seizing every opportunity to eat. This subconscious tendency has been passed down to us, and even in this age of abundant resources, people still indulge in unrestrained and uninhibited eating without resistance, and are even hailed as "gourmets."

Patients who become obese due to overeating may feel the harm of obesity and join the ranks of those trying to lose weight, sometimes achieving some results. However, once they encounter delicious food, their rational restraint decreases, their subconscious urge to eat resurfaces, and they eventually return to their pre-diet state, which may even be more severe than before.

For example, passive psychology, doubt, gluttony, laziness, the desire for quick results, the desire to avoid rebound weight gain, and the mentality of only dieting without exercise can all affect the effectiveness of weight loss. These psychological factors should be addressed through psychological adjustment therapy.

There are many methods of psychological adjustment therapy, among which the commonly used ones include the "psychological rejection reaction method" (i.e., aversion training), the imagery method, and the distraction method. Taking the "psychological rejection reaction method" as an example, it refers to people's psychological aversion to certain foods that are likely to affect obesity.

Specifically, obese individuals may imagine things while eating, such as "there's dust on this hot dog," "flies have been on this grilled meat," or "ants have crawled on this cake." These imaginings can gradually cause obese individuals to develop a "psychological aversion" to food, believing it to be unhygienic and refusing to eat, thereby reducing their calorie intake.

"Psychological rejection" can also excite the sympathetic nervous system, thereby inhibiting gastrointestinal motility and reducing appetite, which is very effective for weight loss. Therefore, psychological adjustment for weight loss is a fairly effective method, but it is best done under the guidance of a psychologist.

Why is it said that sibutramine's weight loss effect was a lucky accident?

Among the many weight-loss drugs, suppressing appetite and increasing a feeling of fullness is a relatively important weight-loss method. Sibutramine is the most well-known among them and is the only weight-loss drug that acts on the central nervous system and has been approved by the US FDA and China National Medical Products Administration.

Sibutramine was originally developed as an antidepressant by a major foreign company. However, clinical trials revealed that it had virtually no antidepressant effect, but unexpectedly, it resulted in widespread weight loss among the participants. Since it lacked antidepressant properties, experts shifted their focus to developing it as a weight-loss drug.

As it turned out, by sheer coincidence, sibutramine not only suppressed appetite and increased satiety to reduce food intake, but also stimulated thermogenesis, increased calorie expenditure, and inhibited fat storage. It was truly a case of "searching high and low without finding it, only to have it come to you effortlessly."

After entering clinical trials, the weight loss efficacy of sibutramine was further verified. Sibutramine can not only help with weight loss, but also accelerate the breakdown and utilization of glucose in adipose tissue and thermogenesis, lower cholesterol and triglycerides in the blood, and increase high-density lipoprotein, which is beneficial to the cardiovascular system.

Taking 10-15 mg of sibutramine daily for six months can result in an average weight loss of 3 to 5 kg, and this weight loss effect can last for more than a year.

Of course, all medications have some degree of toxicity, and sibutramine also has certain side effects. The most common side effects include dry mouth, insomnia, loss of appetite, constipation, dizziness, headache, fatigue, high blood pressure, and menstrual irregularities. Because sibutramine acts on the central nervous system and has a stimulating effect, it is not suitable for use by patients with coronary artery disease, congestive heart failure, arrhythmia, stroke, or severe liver and kidney dysfunction.

Why can inhibiting lipase lead to weight loss?

Most weight-loss drugs currently available work by controlling the central nervous system and suppressing appetite. While these drugs are effective for weight loss, they also have significant side effects. For example, they can stimulate the central nervous system and cause sympathetic nerve excitation. In excessive doses, they can even cause hallucinations, delusions, and other symptoms resembling schizophrenia.

To overcome these side effects, an inhibitor specifically designed to suppress lipase was developed. This lipase inhibitor is said to block up to 30% of dietary fat from entering the body.

This is because dietary fat, after entering the gastrointestinal tract, must be hydrolyzed by lipases before being absorbed in the small intestine. Medical experts have also discovered that the structure of this inhibitor is remarkably similar to that of triglycerides.

When you take a lipase inhibitor before eating, an interesting phenomenon occurs: the lipase thinks that triglycerides have arrived and competes to bind with the lipase inhibitor. However, when the actual triglycerides enter the body with food, the lipase has been significantly reduced and cannot bind with all the triglycerides. As a result, about 30% of the triglycerides are excreted in the feces.

When the amount of fat entering the body is equal to or even less than the calories the body burns, the body has to use stored fat to meet its energy needs. Over time, the person naturally loses weight.

The biggest advantage of lipase inhibitors is that they do not affect the brain, do not suppress appetite, rarely enter the bloodstream, and there is no possibility of residual drug accumulation in the body. They also do not cause symptoms such as palpitations, dry mouth, or nervousness.

Of course, lipase inhibitors also have side effects, such as oily stools, increased bowel movements, and even urgency and difficulty in controlling bowel movements. In addition, fat-soluble vitamins A and E, and beta-carotene contained in fat will also be excreted along with the lipase. Therefore, when taking lipase inhibitors, vitamins should be taken to replenish the lost nutrients.