Accomplia vs. Byetta

Which one might make a better ally in weight loss?

Byetta has been showing great promise for the treatment of type 2 diabetics; I get letters all the time from people telling me how their once untameable sugar levels are now in the normal zone, how they feel much better,etc.

How is Byetta stacking up as a weight-loss drug? Well, it's not officially prescribed for weight loss yet, though last I heard, Amylin is in phase III trials for a version of Byetta for obesity. However, some doctors out there (my best friend's, for one) is prescribing it for chronically obese patients. There is another drug on the horizon, Acomplia, a drug made specifically for people with addictive behaviors - both for food and smoking. Acomplia works by blocking the CB1 receptor, one of two receptors found in a newly described physiological system called the Endocannabinoid System (EC System), believed to play a critical role in the regulation of food intake and energy expenditure.

On the other hand, Byetta, a drug formulated specifically for the treatment of diabetes, works through several actions, including the stimulation of insulin secretion only when blood sugar is high and by restoring the first-phase insulin response, an activity of the insulin-producing cells in the pancreas that is lost in patients who have type 2 diabetes. As a "side effect", this action also makes the user feel fuller on much less food, and slows the digestive process, so they have that full feeling longer. Byetta is the first in a new class of drugs for the treatment of type 2 diabetes called incretin mimetics and exhibits many of the same effects as the human incretin hormone glucagon-like peptide-1. Basically, it mimics your body's natural response to blood sugar.

So there you have the two contenders. Acomplia works by blocking your ability to receive pleasure from an addictive activity, like smoking or eating. Byetta (when used for obesity), works by making you feel full sooner, and keeping that feeling longer.

In a recent study done on Acomplia in the US, 2/3s of the participants quit the study, even though they were losing weight. The researchers aren't sure why. My guess - and this is only a guess - is that people wanted to get a good feeling by eating, and when they didn't it they went off the drug. It would be akin to eating food without being able to taste it - more work than pleasure. Again, just speculation on my part.

As for Byetta, we don't know what the results of the phase III trials are yet. At least with Byetta, the food you do eat will be pleasurable - you just don't feel like eating much of it.

My money is on Byetta. Here's why: Byetta is mimicking what the body does naturally; if you eat too much food, you stop eating, and don't want to eat for quite a while (think Thanksgiving). Byetta seems to over-drive that response, so you have a Thanksgiving-size meal on 1/4 of what you used to eat, and you don't want to eat for a long time after. The resulting decrease in caloric intake indicates weight loss. On the other hand, Acomplia denies you the pleasure you do get from eating, which I believe you should have. There's a reason God made eating pleasurable - so we will sustain ourselves! When you shut that off, I'm speculating, that something deep inside you seeks to overcome that. I don't know that, I'm just guessing. As for smoking, or other addictive, non-natural behaviors, Acomplia might be appropriate.

Now, if I could just get my hands on Byetta!