Climbing Mt. Kilimanjaro: A Personal Account (Part 2)

Click here to read part 1 of this story.

Like a procession of overdressed zombies holding walking poles, we’ve been staggering uphill on this loose volcanic rock since midnight. My watch reads 4:14am.

Although our pace rivals that of a snail, my chest heaves laboriously as my lungs struggle to extract oxygen from the stingy air. The five layers of clothing are strangling me like a Gore-Tex, down-filled anaconda.

I can no longer feel my toes.

A full moon hangs overhead, but does little to illuminate the barren landscape before us. The headlamp I’ve been carrying for days has finally become more than just a fashion accessory, helping me to avoid lurching off a cliff.

Our Tanzanian guides – James, Julius, Alpha, and Cerafin – sing in hushed Swahili harmony as we plod along, delirious and exhausted.

“Wageni, mwakaribishwa! (Welcome guests!)

Kilimanjaro? Hakuna matata! (Kilimanjaro? No worries!)”

The blistering wind blows fine dust into my face but I keep my eyes squinted, focusing only on the turquoise backpack ahead of me.

That backpack belongs to Marina.

She seems completely unfazed by the altitude. Over the past seven days I’ve trudged behind her, I’ve become intimately acquainted with that damned backpack – so smug in its cleanliness, so taunting in its cheerful colouring.

It was Marina’s idea to climb Mt. Kilimanjaro – the highest peak in Africa and the highest free-standing mountain in the world.

I was less than thrilled to head higher than I’ve ever been –5,895 metres – especially given the throbbing migranes and severe nausea I’ve experienced at lower altitudes. As a compromise, we took the long way up, which promises a higher chance of summit success, and a lower chance of vomiting.

Looking up in the distance, I notice dozens of headlamps bobbing up and down across the never ending series of switchbacks up the mountain.

There appears to be no end in sight to this torture.

With increasing frequency, we pass fellow climbers. Some are hunched over on the side of the trail forcefully emptying the contents of their stomach, others are stumbling around and babbling incoherently, while a few particularly unlucky souls are carried down the mountain, barely conscious.

To prevent my mind from entertaining ideas of sickness and failure, I ignore the fallen and regain myopic focus on Marina’s backpack.

As the sun starts to rise, nearly six hours since leaving our base camp, we finally step onto some even ground. Reaching Stella Point, on the rim of Mt. Kilimanjaro’s volcano, we’ve completed the first section of the summit.

“Here, we rest,” declares our lead guide.

I sit on a rock, barely lucid, and try to catch my breath. For the first time since we started hiking over a week ago, I believe that I may actually make it to the top. All that remains between me and Uhuru Peak is a gentle walk around the crater rim that ascends the final 210 metres.

After a brief respite to gnaw on a hardened granola bar and to try unsuccessfully to drink water from my frozen hydration pack, I’m again shuffling my numb feet forward.

Peter's Kilimanjaro misery

That’s me in the red jacket. Don’t I look miserable?

Not only is Marina once again in the lead, she’s actually jogging ahead to snap photos of me in my misery. Fortunately, I’m much too detached and numb to feel humiliated.

Before long, the two of us are standing on the roof of Africa, posing for pictures. As I summon all my strength to look more excited than exhausted, I confess to Marina; “This was definitely the hardest thing I’ve ever done.”

“Oh, really? I actually didn’t find it that difficult,” she says, beaming.

And with those words, the greatest physical feat of my life became just another leisurely hike.

At the top

At least one of us looks happy!

 

Peter

Note: An edited version of this story was published in the Globe and Mail on March 10, 2015

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Climbing Mount Kilimanjaro: A Personal Account (Part 1)

IMG_3655When most people think of vacations, they envision themselves lounging on a sunny beach, sipping a drink out of a coconut, while hotel staff tend to their every need. Although there is nothing especially wrong with this type of holiday, my wife and I tend to favour something more adventurous and active.

This past summer Marina and I took some time off to travel in Africa, visiting Tanzania, Kenya, Uganda, Namibia and South Africa. One of the highlights of our time in Africa was our summit to the top of Africa’s highest mountain, Mt. Kilimanjaro. In this two-part post I will summarize the 8 day hike using notes I made each evening in our tent.

Day 1 – final altitude 2650m (8694 ft)

Despite our best efforts, Marina and I got severe food poisoning two days ago. Personally, I’ve never been that violently ill. I’ll spare the details, but at one point, when I fainted, fell over and threw up on the floor, we both thought we’d be heading home much sooner than expected. Luckily, after holding down some water mixed with rehydration powder, and starting antibiotics, we both began to recover. Last night, when everyone was enjoying the last regular meal prior to the hike, Marina and I were struggling to eat plain white rice. Great start, to be sure.

Our group consists of 10 hikers: a father and son from the US, two couples and a girl from the UK, one Aussie, and the two of us. Our support staff consists of 40 Tanzanian individuals – porters, cooks, guides, etc. This fact makes me somewhat embarrassed and uncomfortable. We learn later that for the locals, getting a stint on a Mt. Kilimanjaro expedition is one of the most lucrative gigs around. This eases some of the guilt, but I still feel a bit like a spoiled tourist. The porters carry most of our stuff – clothes, tent, sleeping bags – while we carry our day packs consisting of water, change of clothes, snacks, and medical supplies. Also, one of the porters gets the honour of carrying our portable toilet. (For over a week we either did our business behind a bush [when available at lower altitude], behind a rock, or using the limited-capacity portable toilet.)

Today was an “easy day”, consisting of about 4.5 hrs of walking up a moderate grade. I certainly noticed the increased effort required to walk even at this altitude. My heart rate during the hike was approximately 117 bpm, as we were constantly reminded by our guides to walk “pole, pole” (slowly, slowly). Since we’ve been told to drink as much water as possible, I managed to drink about 2L during the walk.

As we’re still in the jungle at this altitude, a ranger kept watch over our camp during the night. A couple of times during the night, the sounds of monkeys up in the trees woke me up. As did the sharp pain in my stomach.

Day 2 – final altitude 3550m

Packing up in the morning is a major pain in the butt. We’re woken up very early in the morning, at which point we have 30 minutes until breakfast. During this time, we change out of our pyjamas into our hiking clothes, pack our daypacks, pack the rest of our stuff in another bag, pack up the sleeping bags, get cleaned up – all the while inside of a 2 man tent.

The highest altitude we reached today, while trekking for about 6 hrs, was 3700m. So, we gained about 1km in altitude since yesterday – and you can certainly feel it. As soon as we got to our camp, I developed a pretty bad headache. After a couple of Tylenols and some water, the headache was largely under control. Throughout the hike, I managed to drink 4.5L of water, which meant I was running to the bathroom every 5 steps.

As we arrived at camp, having walked above the tree line, we caught our first glimpse of Mt. Kilimanjaro. It’s quite motivating finally being able to see the challenge we’re facing.IMG_0284

Day 3 – final altitude 3840m

The temperature is starting to dip – we had frost on our tent over night.

Today was billed as a “short day” by our lead guide, Passian. However, it actually ended up being the longest and hardest day thus far. Part of the reason for this is that we went off on an acclimatization walk after making our camp for the night. This walk got us up to 4000m, and added another 2.5 hrs to our day’s walk. Once again, I developed a headache that was mostly alleviated with some Tylenol. The discussion around the dinner table in the mess tent now revolves around if and when people will be taking Diamox – the medication that is supposed to help you acclimatize to the altitude. So far, no one has admitted to taking any, but a few are now complaining of headaches.

In the middle of the night, I woke up to go to the bathroom. As I unzipped our tent, I looked up to see the moon overhead, and more stars than I’ve ever seen dotting the sky. The glaciers on the face of Mt. Kilimanjaro appeared to be illuminated. With everyone sleeping in their tent, the world was perfectly still and silent. Despite the biting cold and the beckoning of my warm sleeping bag, I stood there for a while, captivated by the beauty and the serenity.

Day 4 – final altitude 3900m

In the morning all the tents were covered with frost; getting out of the tent was an even greater struggle than usual.

Today we walked for approximately 8.5 hrs, from 3850m up to 4600m and then back down to 3900m to our current camp. At the highest altitude it was freezing – despite layering all the clothes in my pack, I was still shivering as we ate our lunches, leaning against the rocks.

Later that day, as we sit in our tent, listening to Patrick Watson on our iPod, a thought crosses my tired and foggy mind that I must share with Marina:

“For the first time since we started walking, I actually feel that I can do this. I can make it to the top.”

“Do you have tears in your eyes?” asks Marina.

“This music is making me really emotional…”

“Me too.” Marina’s eyes also get watery.

Clearly the altitude is making us delusional and emotional.

But in truth, until this very moment, I had been counting down the hours until I got so sick, my headaches became so severe, that I’d be taken down the mountain prematurely to wait in a hotel for Marina to finish the climb. From prior travels in South America, I was well aware that while Marina deals quite well with altitude, I do not.

On today’s walk, I got to chat quite a bit with our assistant guides – Cerafin, James, Julius, and Alpha. They’re such gentle and encouraging souls. I can foresee them being vital in keeping us all focused and relaxed on summit night.

As we were having dinner this evening, the mess tent suddenly started flapping around violently. As if someone flipped a switch and turned on the wind, a dust storm had fallen upon our camp. As we left the mess tent to get to our individual tents, we could barely see through the sand blowing around in the dark. Once Marina and I got into our tent, we quickly realized we wouldn’t be sleeping tonight as the sides of our tent were being battered by the wind and dirt. To make matters worse, fine dust was getting blown into our tent, getting into our eyes and mouth. It was becoming uncomfortable to breathe. We both covered our mouths with t-shirts, using them as face masks, closed our eyes and tried to weather the storm. Every few minutes the condensation from my breath and the swirling dirt would clog up the fabric of the shirt, forcing me to find a new patch of fabric to breathe through. As if breathing at ~4000m wasn’t challenging enough…

Eventually, despite the dust, the noise, we both drifted off to sleep.

Day 5 – Final altitude 4000m

When we woke up in the morning, shirts still wrapped around our mouths, we were relieved that the dust storm had passed. Unfortunately, everything inside of our tent was covered in a film of fine reddish-brown sand. That stuff got in everywhere. Normally, being covered in dirt wouldn’t be too much of a problem, since you could easily clean it off with a quick shower. However, there are no showers on Mt. Kilimanjaro. Our daily “wash-wash” consisted of 400ml of warm water in a shallow pail. There is only so much you can do with that little water, hunched over inside your tent. Thus, we’d be carrying much of this dirt with us all the way to the top of Africa.

Today we climbed the Barranco wall – one of the harder parts of the trek, which required the use of hands and feet. At sea-level, this would have been quite easy, but at this altitude, when every step forward makes you gasp for air, it was a bit more challenging.IMG_3647

Again I developed a bit of a headache today – seems to occur when we go up and back down again numerous times.

Tonight will be our last “wash-wash” for a couple of nights, as there is no more water source above this altitude. All the water that we will need has to be carried up. Not surprisingly, the priority is drinking water.

Around midnight, as I headed out to the bathroom, I came across a woman walking alone in the dark.

“Do you know what time it is?” she asked me.

“Not sure – around midnight I think…”

“In the morning?”

“Ummm… no, at night.” It was clearly pitch black outside.

“Oh, cause I’m packed and ready to go,” she continued, staring at me with wild eyes.

“Well, its midnight, so you might want to get back into your tent and get some sleep.”

She looked puzzled, as I continued past her towards the toilet. When I came back, she was gone.

Day 6 – final altitude 4600m (base camp)

Today we walked for only a few hours until we reached our base camp at 4600m.

IMG_0531

We had an early dinner, followed by a debrief about our summit attempt starting at midnight. We headed off to bed around 6:30pm, sleeping in the clothes we’d be wearing as we made the final push to the top of the mountain – some 2 kms higher in elevation. At 11:00 pm, we were woken up by the guides. It was go time! We quickly got dressed, checked our bags, topped up our water supply, and headed off to the mess tent for a cup of tea and a final pep talk from our head guide.

The mood was tense. Some people seemed groggy and tired, while others were running high on adrenaline. It felt like we were going into battle against a formidable foe.

As the clock struck midnight, and our guide gave us some final words of wisdom, our group of 10 set off into the darkness towards the roof of Africa.

TO BE CONTINUED…

Peter

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Happy Unplug and Play Week

unplug

March 23-29 is Unplug and Play Week (hat tip to Dr Jamie Burr for posting to twitter). I’ve gone on and on (and on) about screen time here on the blog, and the damaging effects that it has on everyone, but especially kids.  The current guidelines suggest that kids under 2 get no screen time, that kids 2-4 get less than an hour a day, and that school-aged children get less than 2 hours. But keep in mind that these are upper limits, and that less seems to be better.

I realize that these goals are not necessarily easy, especially when you have been stuck inside for most of the past two weeks due to snowstorm after snowstorm, as we have here in PEI.  But whether or not you can meet the actual guidelines, being conscious of your screen time and cutting back on unnecessary screen time is one of the simplest things you can do for your health, or the health of your kids.

This week, I challenge you to fill out this simple screen time log for each member of your family.  Maybe you’ll be happy with the numbers, or maybe it will give you something to think about.  For ideas on ways to reduce your family’s screen time checkout the ParticipACTION Unplug and Play page.

Travis

Category: News, Sedentary Behaviour | Tagged , | 4 Comments

The latest findings on sedentary behaviour and mortality

Today’s post is a summary of a fascinating new paper published in Annals of Internal Medicine on the relationship between sedentary behaviour and premature mortality (available here).  The paper has garnered a tremendous amount of media attention (see here, here and on Jimmy Kimmel here), and we are fortunate to have a summary of the paper written by lead author Avi Biswas.  You can find more on Avi at the bottom of this post.  This post is also available at the Sedentary Behaviour Research Network.

Background

In a similar vein to other reviews that have examined the association between sedentary time and various health outcomes, our study sought to not only update the sedentary behavior literature but also focus exclusively on studies that adjusted for physical activity in order to assess the independent effects of sedentary time. This differentiated our meta-analysis from two others which had previously reported independent risks (Wilmot et al., 2012 and Schmid and Leitzmann, 2014), as investigating the independent effects of sedentary time (by reporting the effects from studies that at least adjusted for physical activity) was our core focus rather than among a limited subgroup of available studies. Additionally, our study examined the extent to which levels of physical activity may potentially modify the associations between sedentary time and outcomes, which to the best of our knowledge has not been systematically quantified in other reviews.

What we did

We devised a comprehensive, systematic search strategy of studies that assessed sedentary behavior in adults as a predictor variable and correlated to at least one health outcome. We also focused on direct clinical outcomes (death, disease incidence and health service use) rather than indirect surrogate outcomes such as quality of life, insulin sensitivity and weight gain) as we believed the later type would present inconsistent end points and cutoffs. We then collected the statistical effects associated with the longest reported sedentary time (vs. a baseline of the lowest sedentary time) and that adjusted for physical activity. These were used to pool the analysis of the overall effect for each outcome.

When examining whether physical activity modifies the effects associated with sedentary time, we reanalyzed all available studies that met our selection criteria to see if they reported statistical effects of the longest period of sedentary time with the highest duration and intensity of physical activity.

What we found

Our study found that long periods of sedentary time was positively associated with an increased risk for dying (from all-causes, cancer and cardiovascular diseases) and increasing the risk for certain forms of cancer (specifically breast, colon, colorectal, endometrial, and epithelial ovarian cancer), cardiovascular disease and type 2 diabetes. Our meta-analysis found that the largest association was with type 2 diabetes (91% increased risk).

Of the limited studies that reported the joint effects of physical activity and sedentary time (only quantified for dying from all-causes), our pooled analysis found that the risk of dying from all-causes due to long sedentary time was 30% greater in those who spent little to no time in regular physical activity than those who at least met their physical activity recommendations of 30 minutes/day. While the pooled effect corresponding to high levels of physical activity and long sedentary time were found not to be statistically significant, we believe the consistent and strong effects associated across all-cause mortality-assessed studies (and to a lesser degree, cardiovascular disease and mortality) suggests that there is a strong likelihood that physical activity alone does not completely reduce the negative effects from long sitting time. We believe more work needs to be done to tease out whether there is such an association.

Take home message

Our study provides the strongest evidence as so far, to suggest that long periods of sitting is associated with various health outcomes. Furthermore, while regular or high levels of physical activity seems to have protective effects on reducing sedentary time-associated risks, we believe there is sufficient evidence to suggest that a focus on promoting regular exercise AND reducing sitting time to be a better public health message.

Reference:

“Sedentary Time and Its Association with Risk for Disease Incidence, Mortality, and Hospitalization in Adults” paper, Published in the Annals of Internal Medicine (2015: 162:123-132)/.

About the Authors

Aviroop (Avi) Biswas

Aviroop (Avi) Biswas

Avi is a PhD candidate at the Institute of Health Policy, Management and Evaluation, University of Toronto and the Toronto Rehabilitation Institute. Along with this meta-analysis study, his PhD work is focused on understanding the risks of sedentary behaviour among exercise-engaged cardiac rehabilitation patients, in lieu of developing non-sedentary interventions.

 

 

 

 

 

Dr. David Alter

Dr. David Alter

Dr. Alter is a Senior Scientist at the Institute of Clinical Evaluative Sciences and research director of the Toronto Rehabilitation Institute’s Cardiovascular Prevention and Rehabilitation program. Dr. Alter’s research spans across many disciplines including cardiovascular health services and outcomes, clinical epidemiology and social determinants, cardiac rehabilitation and more recently, music and medicine. He has published over 125 scholarly peer reviewed papers in prestigious journals such as the New England Journal of Medicine and the Journal of the American Medical Association. Dr. Alter has also received funding from various agencies including the Heart and Stroke Foundation of Ontario.

 

Category: News, Peer Reviewed Research, Sedentary Behaviour | Tagged | 3 Comments

Standing desks in the classroom

standing desks

Today’s post is an interview with teacher Adam Aldred, a teacher who has incorporated standing workstations into his classroom.  You can find more on Adam below.  Detailed instructions on how he built his standing desks can be found here.

Who are you?

I am a grade 10-12 teacher, in a program called Options and Opportunities (O2) in a small town in rural Nova Scotia. This program is specifically designed to give kids a more experiential, hands-on approach to learning and expose them to a wide variety of post-secondary options, and other learning experiences like service-learning, co-operative education, volunteerism, etc.

I absolutely love the material, which covers everything from citizenship to job interview skills, workplace safety to changing flat tires, I love the way it shapes the kids’, and I love how close our little family becomes over the three years they are with me. On any given day you walk into my classroom you are just as likely to see impact guns or measuring spoons in my kids’ hands as you are to see pencils, and I love the pace and the constant state of change. We have a fantastic curriculum, as well as a healthy budget to support our classes, and these pieces offer a lot of flexibility in how I can teach and reinforce concepts.

 

What started this movement in your classroom to combat sedentary behaviour?

After stumbling onto some initial research on ‘Sitting Disease’, I texted my friend Kerry Copeland who is a youth activity coordinator for Doctor’s Nova Scotia to see if she had heard of it before. She had and directed me to some more research which I happily consumed, and which also left me feeling quite uneasy. Personally, I am a very active individual, but I knew that the same can’t be said for many of my students, and I was quickly learning that even for those who are active too much sitting time can offset any benefits that came from their movement.

 

At what point did you talk to your students about what you had read?

I thought about it for the weekend, and then on Monday I took the research to my grade 10s. And we talked, hypothesized, and complained about a six-hour school day that almost mandates that the kids ‘sit down and listen up’. One of the big things in our class is that complaining isn’t allowed to be the end of any discussion; you have to own it and try to take steps in the right direction. I asked the students if they would be interested in building and trying out some standing workstations.

 

How did the students respond to the offer?

They jumped at the opportunity!

That day just happened to be a double period so while they went to lunch I sketched out a basic plan (what I call our alpha model). Our classroom already had OSB tabletops which we had built to snap down over top of three desks to protect them from things like errant screws or hammer swings. I incorporated those tabletops into our alpha design, and when they returned from lunch we dug the 2x4s out of the shed, got out the tools and went to work. By the end of class we had three different-sized, fairly-unsteady models that we would test for the next few weeks.

 

Did the initial design, the alpha model, stay roughly the same for those few weeks?

Not at all: as we used them we talked about the pros and cons. Over those passing weeks we would take them all apart periodically to modify dimensions in an effort to get an ideal model.  [A detailed description of Adam’s standing desks can be found here]

 

What did you decide for the form of the beta model?

What we came up with in the end was to build a platform underneath one part of the desk so that our shorter students could access the desktop at a height that was more suitable for them. In addition to this, we had learned that while the standing desks were great for listening, reading, and writing, they were far too tall to be used as workbenches, which is an integral part of our class. So in the design of the beta model, the OSB tabletops were left unattached so that they could be easily removed and snapped down over desks, which gives the optimal height for such tasks as sawing, routering, etc.

 

How much of your classroom desk space is dedicated to the standing work stations?

We have three of the standing workstations, each accommodating three or four students, and we still have seating for 12 people in the room so they have the option to sit if they choose. Many of them say they prefer the standing desk, and I think the majority enjoy that they have the option.

 

Any further plans with different models?

Our next task will be an attempt to make a variable-height workstation for me at the front of the class; we are just waiting for the special hinges to arrive. Looking ahead, I will also try to come up with some concrete models of two student desk-concepts that include a) a multi-tiered desk that each student could decide how to use depending on the day, and b) a standing setup with a rail to lean back against, allowing the student a number of ways to support their weight all while standing.

 

How long ago was it that you first began the standing desk project?

We started the standing desk project in November. The beta models have been in use for over two month now.

 

Have you had any interest or concern from other teachers?  Are any thinking of following your lead?

I kind of do my own thing down at the end of a wing of the school that is, right now, only occupied by my classes. This tends to limit the number of other teachers that see my room as there aren’t many random passers-by. From what I can gather the few that have been in seem to think the desks are interesting and a good idea, but I can’t gauge whether they think it is a passing trend/novelty or is actually something that will stick around long-term.

 

Are there any specific tasks that you’ve found work particularly well when standing? 

I find my kids tend to be more open to volunteering help when standing. I am not sure if this is strictly because they’re already up, or that the act of getting out of a chair is labour-intensive, but it seems that when I ask for someone to help out it is almost always a standing student. The standing desks are great for reading/writing/engaging in classroom discussion. They also seem to make the students more likely to engage with their peers in positive social behaviour, and I have wondered if this is because the act of standing naturally positions one’s body in a manner that appears more open and willing to engage. This, however, might be an instance of confounded variables, as those who choose to stand may be a more open, inviting part of the population, or other reasons.

 

Do you find there to be any tasks that really don’t work well when students are sitting in your classroom?

In regards to seated desks, I find them to really hinder active engagement, both physically and mentally.  In the traditional-desked classroom I would often have my students stand up to complete simple 10-second tasks (a dance, a spin, a vocal call back, etc) to get the blood flowing again. It wasn’t until reading the research on sedentary behaviour that I came to fully understanding why this was happening to my students.

 

It sounds like you are in a somewhat unique teaching environment.  Do you think that these solutions would work in a more traditional classroom setting?

I do, but I think the teachers and their students would need to figure out what works in their particular reality.

 

Have you found the desks to have any impact (positive or negative) on classroom management? 

None, whatsoever.

 

Do you have any thoughts or responses for teachers that might be concerned about going down this road? 

I would just say that if your kids are old enough to talk about the research on sedentary behaviour to just throw it out there and see what they think. If the kids are as affected as mine were, they will have all sorts of thoughts and ideas. Also, if you have any questions, or if I can be of help to you please don’t hesitate to email me at Adam.Aldred@tcrsb.ca

 

Do you have anything else you would like to add?

Only that I have fantastic administrators who are very diligent in their attempt to meet our public school mandate of providing a healthier school culture/environment for our students. I would encourage any other educators that are interested in standing workstations for their classroom to get their administration on board as early as possible as they often have a perspective that important and necessary.

 

Thank you, Adam

My pleasure, thank you for having me, Travis.

Category: News | 2 Comments

New obesity medication now available in Canada

saxendaThe very first Obesity Panacea post was written back in November 2008. The topic of that post was the removal from the European market of an obesity medication that had been previously heralded as a potential panacea (but was never approved in US or Canada). That drug was rimonabant (Acomplia), an appetite suppressant that works by blocking the CB-1 receptors of the endocannabinoid system – the same system which induces the “munchies” in response to smoking cannabis. Rimonabant not only suppressed appetite, but was associated with anxiety and depressive mood disorders – the same side-effects which initially prompted the US FDA to refuse approval of rimonabant back in 2007.

Two years later, another appetite-suppressing medication, sibutramine (Accomplia) was also withdrawn from the Canadian and US market due to increased risk of cardiovascular events and strokes.

Thus, over the past five years there was only a single obesity medication available to obese patients in Canada – orlistat (Xenical®). This agent reduces the absorption of ingested fat by about 30%. The 30% that doesn’t get absorbed ends up in the stool, which, as you’d expect, can result in some rather challenging gastrointestinal side effects (e.g. oily discharge).

All of that changed yesterday (Feb. 26), when Health Canada approved a new obesity medication. This new medication, liraglutide 3.0mg (Saxenda®), which is administered via a daily subcutaneous injection has actually been available in Canada but at a lower dose and marketed under a different name (up to 1.8mg, Victoza®) for the treatment of type-2 diabetes. Saxenda is approved for weight loss in addition to diet and exercise for patients with a BMI ≥30kg/m2 or a BMI≥27kg/m2 plus at least one weight-related illness (i.e. hypertension, dyslipidemia, or diabetes). This drug has been studied in a number of large clinical trials which suggest that patients experience an average reduction of 6.3-8.0 kg over and above that achieved with placebo (fake injection) at 1 year of therapy. This of course isn’t the most exciting magnitude of weight reduction, but keep in mind that most experts recommend that obese individuals only aim at 5-10% weight loss to reap health benefits.

More importantly, as we’ve highlighted ad nauseam, positive health behaviours – including a healthy diet and increase physical activity have a tremendous impact on your health regardless of your weight status. And these behaviours form the basis of ANY obesity therapy.

Nevertheless, obese Canadians who only had one option for a medication to help them lose weight (and have oily flatulence), now have another option.

Of course, obese folks in the US have many more pharmacological options – including two combination therapies (Qsymia® and Contrave®) – that remain unavailable in Canada or Europe.

Peter

Category: News | 2 Comments