Anabolic Therapies- Involuntary weight loss is the result of many chronic progressive diseases, often leading to diminished lean body mass, frailty, susceptibility to illness, and increased mortality. Various anabolic agents have been used to combat weight loss with mixed results. Similar to the frustration experienced by advocates of weight loss in the obese, none of the pharmacological appetite stimulants available at the current time have been uniformly successful in combating involuntary weight loss in the elderly population. Some of these agents have been U.S. Food and Drug Administration (FDA) approved to combat weight loss, and others are used off-label for this purpose.
via newspsychology.com
Androgens
Serum testosterone levels decline with advancing age; however, the benefits of increasing serum levels by androgen supplementation are controversial. Testosterone has been shown to increase muscle mass in older men, but adverse effects on the prostate are greater and hematocrit levels are higher than in younger individuals. Oxandrolone is a chemical derivative of testosterone that increases muscle mass but has decreased toxicity. In the elderly, oxandrolone administered daily for 3-month intervals over a year resulted in improved appetite and mental improvement. More recently, the metabolic effects of oxandrolone were thoroughly evaluated in healthy, overweight elderly men.
Highly significant reductions in abdominal fat were noted, and insulin sensitivity was improved. Positive effects were most pronounced in men with low testosterone levels, and the benefits were sustained for at least 12 weeks after discontinuation of therapy. Taken together, these preliminary studies suggest that oxandrolone significantly increases lean body mass and reduces body fat in healthy elderly men.
Dronabinol (Tetrahydrocannabinol)
Dronabinol, the active ingredient in marijuana, has been used as an antiemetic and appetite stimulant primarily in cancer and AIDS patients with mixed results. Little is known about the use of dronabinol in the elderly. Dronabinol, megestrol acetate (MA), and a combination of the two were compared in a randomized study of 469 cancer patients with a mean age of approximately 65 years. MA was superior to dronabinol in terms of appetite (75% vs. 49%) and in the number of participants who gained more than 10% of their body weight (11% vs. 3%).
You must look : Anti-Aging: The Practitioner's View
Combination therapy showed no advantage over MA alone. However, in one intriguing study of 15 Alzheimer's disease patients hospitalized on a dementia study unit, dronabinol increased body weight and improved resident behavior. No serious adverse reactions were noted. Taken together, these studies indicate that dronabinol is a weak orexigenic (appetitestimulating) agent and is less potent than MA. There may be a role for its use in treating patients with dementia, but convincing evidence is lacking at the current time.
EmoticonEmoticon