People like athletes, sportsmen, hard working labor population and all others doing regular exercise involving regular body movements are well placed to maintain their BMI without much concern. Those affected by disorders like diabetes and others suffering from physical immobilization are constrained to restrict body movements to a minimum. They tend to put on weight unless severe food intake restrictions are imposed which is not possible in many cases. While supervised exercises can maintain the tone of muscles and joints, weight gain is a real danger in such cases. Hospitals and nursing homes are concerned with this situation and the crisis is now affecting ordinary house holds where the proportion of old age populations continue to rise with the responsibility for ensuring a good quality life to them rests on the younger generation with government pitching in for orphaned elders as a part of the societal commitment.
Sach Institute in San Diego CA, in USA takes its name from the famous scientist who discovered polio vaccine, has a way to deal with this problem, found suitable, at least in animal testing. Of course finding some thing exciting in animals need not transfer into reality for human beings but at least it offers hope. The rationale for the excitement is the finding of the effectiveness of a drug discovered in 1994 called Aicar used to treat other ailments but without any connection to weight control. The observation that in athletes the muscle fibers (Type I) contain more mitochondria which are resistant to fatigue as compared to Type II present in others have less mitochondria, more vulnerable to fatigue, led the scientists to explore ways and means to spur the fat burning by manipulation at the gene level. Aicar activates the PPAD-delta protein which signals to the cell that it has burned off more energy and needs to generate more energy. The
drug pushes the genome towards a more enhanced genetic tone that impacts metabolism and muscle function. In other words the drug moves the genetics to a more activated metabolic state. This is similar to mimicking the effect of exercise without actually moving the limbs.
Diet and exercise are still the pillars of any ameliorative regime to control weight and prevent obesity and by no stretch of imagination one can even think of substituting it with a pill like Aicar. If at all these findings are validated in human beings, the medical world will have a tool to deal with severely affected obesity cases and patients not able to move much due to various reasons. From an ethical angle, use of such drugs for regular weight control purposes, in place of well proven exercise protocol for normal people is fraught with many uncontrolled consequences to the society.