Medication for weight loss? A drug for sleep disorders might help with weight loss by reducing impulsivity. Bradley Cooper is a fan.
Medication for Weight Loss
If you’ve taken the trouble to read beyond the title, there are multiple reactions possible to this article.
Perhaps as you read, you hear a choir singing “Hallelujah!!” in your ear. You’ve been struggling to control your weight and a magical weight loss pill sounds like music to your ears. In fact, you’ve reserved an entire cupboard for this pill and all its failed predecessors. Your mantra is “I’d rather lose weight with what I put in my mouth than with what I don’t put in my mouth.”
Or perhaps you’re someone with a healthy weight who has worked hard for it. Chances are, you’re thinking, “Weight loss comes from willpower and discipline. Balls to the wall! No excuses, no pain, no gain,” or some other cliché fitness quote. If you’ve struggled up a mountain, you might quickly get annoyed when you reach the top and see there was a ski lift on the other side.
Personally, I find it easier to identify with the sentiment of the second group. Sacrifice, discipline, and perseverance to achieve your goals.
In the first group, I have to put myself in their shoes to understand them better. It turns out that the brains of people with what we commonly call self-control work differently than the brains of those who struggle with it (in various areas). Yet, for me, medication to control oneself, particularly regarding food, feels a bit like the dark side. Is that fair?
This article (or the research that prompted it) is not a paean to a miracle cure that you can buy here for only $9.95 including a CD from Nick and Simon. It’s more of an opening to start a fun discussion at parties about the pros and cons of medication for weight loss.
Impulsivity and Obesity
About those differences in the brain. One example is impulsivity. Researchers from Imperial College London suggest, based on their research, that the drug Modafinil could help with obesity by reducing impulsivity[1]. To reach this conclusion, they make some connections:
- Impulsivity contributes to addiction
- Obesity is a form of addiction, addiction to food
- The drug Modafinil works against impulsivity
Whether Modafinil helps with obesity was not proven in this study. That wasn’t the intention. Previous research from 2004 already showed that people who used Modafinil had less desire to eat. The researchers compared the effects of Modafinil and amphetamines on body weight. Both led to lower weight. However, with Modafinil, this was not accompanied by an increased heart rate as with amphetamines [2]. Also, in a later study from 2006 on the effect of Modafinil as an antidepressant, the subjects also lost weight due to the use of Modafinil [3]. The link between impulsivity and addictions, such as drug addiction and alcoholism, has also been demonstrated in previous research [4]. More specifically, the link between impulsivity and obesity was demonstrated in 2013 in research from Texas A&M University [5].
The researchers from Imperial College were mainly interested in the specific role of impulsivity in the weight loss caused by Modafinil. Impulsivity was indeed found to be reduced with the use of Modafinil. When we talk about “impulsivity” in this context, think of the inability to resist emotional, unplanned needs.
Limitless
In the movie “Limitless,” Bradley Cooper possesses superior cognitive abilities thanks to a drug supposedly based on Modafinil. Hence, the ‘Panorama header’ of this article is explained. While you probably won’t immediately dominate the stock markets and become a multimillionaire, Modafinil appears to be a sought-after smart drug among various demographics. Among students, for example, it’s used to enhance focus. This focus could be one of the causes of weight loss by Modafinil. One student, for example, recounts how he lived on one banana all day because he only thought about eating in the evening due to his focus on studying. Not exactly advisable, but it illustrates the effects of Modafinil.
The US military has studied Modafinil as a way to keep soldiers awake and alert. In terms of side effects, it caused fewer complaints than a (less effective but large dose of 600mg) caffeine [6]. In a previous article, I wrote about the use of amphetamines as so-called “go-pills” for US pilots to keep them awake. This use became controversial when pilots pointed to the use of amphetamines as the cause of certain errors in action. Amphetamines are therefore prohibited as “go-pills” in the US military, a role now fulfilled by Modafinil and Dexedrine [7,8].
But it’s not just the US military that uses Modafinil to keep troops alert. It’s used by various armies, from the French Foreign Legion to the Indian Air Force [9-11].
Hacking the System
Naturally, there are side effects, but they seem to be fairly mild [kim d]. Mainly, issues like headaches and nausea are reported by a relatively small number of users. However, there are also some scarier side effects reported, albeit in rare cases related to an allergy. Think of very unpleasant skin diseases to life-threatening organ inflammations. Additionally, the immune system could be disrupted because more stress hormones could be released due to Modafinil (which could be one of the causes of the extra focus) [12].
As with all medication, the question is to what extent it benefits and to what extent it harms. When it comes to weight loss, you’re quickly inclined to judge that there are healthier ways to achieve your goal. “Just eat less and move more.”
However, science is discovering more and more about the differences in the brain that influence your weight. Why is that important? Because it emphasizes that we don’t all have the same PC in our heads and only differ by the decisions we make there. Different software leads to different decisions. The only “natural” way to overwrite that software is by behaving “against the code” for a long time. In this case, consuming different food than the software dictates.
As a personal trainer, nutritionist, coach, etc., your main goal will be to bring about behavior change in your client. A change that lasts long enough to overwrite the old software. Medication like Modafinil is akin to changing the code by hacking into the system and rewriting it directly. Instantly more motivation and focus. Sounds great. However, you always fear bugs and crashes.
Just as more is known about how that software works, more is also known about “tools for hacking more safely.” As the ratio between the effectiveness and safety of a drug tilts towards the good side, the threshold for using and prescribing these agents will become smaller. However logical that may be, personally, it doesn’t feel right to me. But hey, my software is just written differently.
References
- Myutan Kulendran, Laura R. Wingfield, Colin Sugden, Ara Darzi, Ivo Vlaev. Pharmacological manipulation of impulsivity: A randomized controlled trial. Personality and Individual Differences, 2016; 90: 321 DOI: 10.1016/j.paid.2015.11.025
- Makris AP, Rush CR, Frederich RC, Kelly TH. Wake-promoting agents with
different mechanisms of action: comparison of effects of modafinil and
amphetamine on food intake and cardiovascular activity. Appetite. 2004
Apr;42(2):185-95. PubMed PMID: 15010183. - Vaishnavi S, Gadde K, Alamy S, Zhang W, Connor K, Davidson JR. Modafinil for
atypical depression: effects of open-label and double-blind discontinuation
treatment. J Clin Psychopharmacol. 2006 Aug;26(4):373-8. Erratum in: J Clin
Psychopharmacol. 2006 Oct;26(5):523. PubMed PMID: 16855454. - Crews FT, Boettiger CA. Impulsivity, Frontal Lobes and Risk for Addiction. Pharmacology, biochemistry, and behavior. 2009;93(3):237-247. doi:10.1016/j.pbb.2009.04.018.
- Fields SA, Sabet M, Reynolds B. Dimensions of impulsive behavior in obese,
overweight, and healthy-weight adolescents. Appetite. 2013 Nov;70:60-6. doi:
10.1016/j.appet.2013.06.089. PubMed PMID: 23831015. - Adenosine receptors: development of selective agonists and antagonists.Daly JW, Jacobson KA, Ukena D
Prog Clin Biol Res. 1987; 230():41-63 - Taylor GP, Jr; Keys RE (December 1, 2003). “Modafinil and management of aircrew fatigue” (PDF). United States Department of the Air Force. Retrieved September 18, 2009.
- Air Force Special Operations Command Instruction 48–101 (sects. 1.7.4), U.S. Air Force Special Operations Command, November 30, 2012.
- Wheeler B (October 26, 2006). “BBC report on MoD research into modafinil”. BBC News. Retrieved July 4, 2012.
- “MoD’s secret pep pill to keep forces awake”. The Scotsman. February 27, 2005. Retrieved December 31, 2013.
- Pilot pill project”. News – City. PuneMirror. February 16, 2011. Retrieved July 4, 2012.
- Kim D. Practical Use and Risk of Modafinil, a Novel Waking Drug. Environmental Health and Toxicology. 2012;27:e2012007. doi:10.5620/eht.2012.27.e2012007.
- Review Corticotropin-releasing hormone (CRH) as a regulator of waking.Chang FC, Opp MR
Neurosci Biobehav Rev. 2001 Jul; 25(5):445-53.
