On another note, I am in awe of how efficient our bodies are. We are obviously programmed to walk all day long, and all the interventions listed above either fight that program or attempt to use it.

Cheers,
Dave

The trick to losing weight is you have to trick the body into ‘thinking’ that excess fat is costing it alot. They way to do this is climbing exercies like walking up stairs for a long period of time, doing lots of leg exercies like squats, biking up hills. The body then starts to think that ‘hey it is costing me alot of calories to keep carrying this fat’ up the hill and it will start to adjust the amount of fat it has.

http://abcnews.go.com/Technology/DyeHard/Story?id=3922069&page=1

I would agree with you that treatments are getting better and more sophisticated all the time. This is in part because overweight and obesity rates have been skyrocketing for decades and the health problems it causes are enormous.

What you might find interesting is that Metformin is now being used as a weight loss drug, as you mention in your list. What you may not know is that it’s been around for a long, long time as a treatment for Type II Diabetes. Its exact mechanisms are not fully understood, however, it’s not an appetite suppressant or a stimulant or a nutrient-blocker, which is what most diet drugs do. It was simply noticed that diabetics on the drug tended to lose weight fairly spontaneously. In the last 20 years it’s become increasingly evident that most obese people are diabetic or at least pre-diabetic, so doctors who treat obesity began trying it on their patients, even those without formal diabetes diagnoses, and guess what? A lot of obese people respond very well to it.

What it seems to do is give people with insulin control problems better insulin control. Insulin is linked to appetite, but its main function appears to be to cause the body’s fat cells to store energy. Better insulin control would tend, therefore, to reduce fat storage in fat people.

This all goes back to the “thought experiment” I posted a couple of days ago; if your fat cells work abnormally hard to store energy, and/or are abnormally reluctant to release energy, then, you’re going to have a much easier time gaining weight and a much harder time losing it.

Insulin’s not the only key of course, but it’s clearly got a role here, as do a lot of other things, some of which we almost certainly don’t really know about.

I’m pretty sure by the 2020s we’ll have the problem solved, as the medical and scientific community is working hard on solutions that go beyond the 3000 year old advice of “just watch what you eat and exercise more.”

Good point. I should have mentioned myostatin inhibitors. I said I wouldn’t want to take any of those “weight-loss” drugs, but I would sign up for follistatin or another established myostatin inhibitor as soon as it become available. Per Stephen’s point, this is another line of research with a huge commercial upside — “the Viagra of muscles.”

Myostatin article

Each pound of lean body mass, which includes skeletal muscle, burns a bit over 13 calories a day at rest. 910 calories from body fat in a week for an extra 10 pounds of muscle. It will take about 27 days to lose a pound of body fat (12 pounds per year, IF the person does not increase food/calorie intake). So with some cardio exercise it would be a substantial help for weight control.

I believe myostatin/follistatin control will be the safe and more effective version of steroids.

It would definitely make the TNT diet more effective. Any health risks like possible increase in tendon injuries needs to be offset against health gains from weight control.

If I were a betting man, I’d say that the most likely winner will be a drug that inhibits the insulin receptor gene.

Ten years ago Pfizer stumbled on a certain blockbuster drug called Viagra. That success would be nothing compared to a safe and effective thin pill.