This time of the year, most people I know are on some kind of health kick. It may be just more exercise but for many people, dieting in January is common place.
Many of my overweight and obese patients ask for a pill to help them lose weight and are surprised that there is nothing that I can give them that works really well.
I was interested to read about fexaramine recently, which works in a different way to other medication to help weight loss.
The farnesoid X receptor (FXR) is a protein which affects digestion and the string of fats and sugars in the body. Bile acid release during meal selectively activates intestinal FXR. Fexaramine is a gut-restricted FXR which induces enteric fibroblast growth factor 15 (FGF15), leading to alterations in bile acid composition. Fexaramine does not activate FXR in other organs, such as the liver.
Results from this study have shown that fexaramine has been shown to reduce diet-induced weight gain, body-wide inflammation and hepatic glucose production, while enhancing thermogenesis and browning of white adipose tissue. It also lowered cholesterol and blood glucose.
These pronounced metabolic improvements suggest tissue-restricted FXR activation as a new approach in the treatment of obesity and metabolic syndrome. I wonder if we will read more about this in the future.
Fang, et al. Intestinal FXR agonism promotes adipose tissue browning and reduces obesity and insulin resistance. Nat Med. 2015 Jan 5. doi: 10.1038/nm.3760.