Calocurb® is a plant-based supplement containing Amarasate®, a bitter extract of hop flowers that increases endogenous production of three gut hormones that promote satiety and slow stomach emptying glycogen-like peptide1 (GLP-1), cholecystokinin (CCK) and peptide YY (PYY). Its mode of action is via the stimulation of bitter taste receptors on enteroendocrine cells present throughout the gut, which release these gut hormones in response. Backed by $30M of New Zealand government funding, and with over 15 years of clinical research behind it, Calocurb has proven its efficacy in reducing hunger and energy intake.
Taken an hour before ad libitum meals, it increased baseline GLP-1 production by 6.4-fold, CCK by 6-fold and PYY by 4-fold, resulting in an 18% reduction in calories consumed at the subsequent meal.1 In addition, fasting 14-hour water-only fasts in both men and women demonstrated a 25% and 30% reduction in overall hunger in men and women respectively, and a 40% reduction in the women’s overall cravings.2,3 The women consumed 14% fewer calories at their post-fasting meal, despite having had the Calocurb 4 hours previously.3
Calocurb Use Scenarios
Calocurb has multiple use scenarios. The standard one is to help reduce portion size by its effect on satiety centrally and stomach emptying peripherally. Ongoing anecdotal and case reports reflect its success in helping users lose weight, and a clinical study is almost complete in which weight loss over 6 months is assessed after either Calocurb or placebo. In addition, Calocurb can be used intermittently at specific times (e.g., to reduce increased hunger and cravings associated with premenstrual syndrome, or as an adjunct to time-restricted eating or 5:2 intermittent fasting).
As with any weight loss tool, using Calocurb is most successful when it’s part of a weight management program over at least three-to-six months that incorporates other factors too. In addition to dietary, nutritional and exercise advice, those factors may include telehealth check-ins or onsite visits, virtual or in-person counselling (including group sessions), or the use of medications, especially GLP-1 receptor agonists (GLP-1 RAs) like semaglutide or tirzepatide.
Calocurb and GLP-1 RAs
Even before they start using them, patients may have anxiety about what they will do if/when they have to stop them. Not only has rebound weight gain been clinically proven after discontinuing GLP-1 RAs, but it’s commonly discussed on websites, online forums, in the lay press, and on TV. Such conversations are hardly surprising: not only does someone stopping a GLP-1 RA experience loss of the highly active suppressor of hunger, but they’ve likely also suppressed their natural GLP-1 hormone activity while on the prescription medication. Kim et al showed that after only 14 weeks’ treatment with liraglutide, the normal postprandial rise in endogenous GLP-1 was completely supressed.4 Stopping a GLP-1 RA therefore delivers a “double whammy”: no more GLP-1 receptor activation and reduced natural hormone response. Calocurb can thus be particularly helpful in the context of GLP-1 RA prescribing for a number of reasons.
As a Psychological Aid When Starting a GLP-1 RA
Calocurb lets you provide patients with the psychological boost that there is a plan in place if they have to stop the medication (for whatever reason).
A small study investigated the psychological impact on patients about to start or already using GLP-1 RAs whose health insurance suddenly refused coverage.5 In addition to feelings of anger around stigmatizing obesity and the unfairness of not covering GLP-1 RAs when other conditions of perceived lack of willpower are (such as drug addiction or smoking), respondents expressed their anxiety at how they would manage their weight going forward, and depression at having a successful treatment that had finally given them hope being taken away—"feelings of hope replaced by hopelessness.” Letting patients know before they even start a GLP-1 RA that there is a plan in place to continue their weight management using Calocurb after stopping the injections is an important step.
Concurrent Use With GLP-1 RAs
As Kim et al proved, production of endogenous GLP-1 hormones is soon down-regulated with GLP-1 RAs. Using Calocurb alongside the prescription medication aims to provide two benefits:
- Maintenance of endogenous GLP-1 activity
- Allow dose reduction of the GLP-1 RA. Patients can use lower doses of semaglutide or tirzepatide without losing efficacy (which may help reduce adverse events).
As an Off-Ramp or Exit Strategy When Stopping GLP-1 RAs
By starting Calocurb the week or two of their last medication injections patients can “kick start” their endogenous GLP-1 activity. Continuing with Calocurb over the subsequent weeks and months provides them with an ongoing tool to help maintain their weight loss program, rather than just “leaving them in the lurch”.
Calocurb’s slow and steady effect also allows them time to learn to make better nutritional and dietary choices, in contrast to the precipitous change in eating behavior without the need for lifestyle changes that the medications cause. Consequently, a minimum three-to-six-month post-injectable treatment program is advised, to allow patients to be guided through such changes while they benefit from continued psychological and physical support.
Conclusion
Calocurb is an effective and price-friendly adjunct to patients using GLP-1 RAs, whether they have started these prescription drugs, are currently using them, are about to stop them, or have tried them in the past. As part of an ongoing weight management program, Calocurb is an invaluable aid in the toolbox of medications, lifestyle changes and support programs.
References
- Walker EG, Lo KR, Pahl MC, et al. An extract of hops (Humulus lupulus L.) modulates gut peptide hormone secretion and reduces energy intake in healthy-weight men: a randomized, crossover clinical trial. Am J Clin Nutr. 2022;115(3):925-940. doi:10.1093/ajcn/nqab418
- Walker E, Lo K, Tham S, et al. New Zealand bitter hops extract reduces hunger during a 24 h water only fast. Nutrients. 2019;11(11):2754. doi:https://doi.org/10.3390/nu11112754
- Walker E, Lo K, Gopal P. Gastrointestinal delivery of bitter hop extract reduces appetite and food cravings in healthy adult women undergoing acute fasting. Obes Pillars. 2024;11:100117. Published 2024 Jun 20. doi:10.1016/j.obpill.2024.100117
- Kim SH, Abbasi F, Nachmanoff C, et al. Effect of the glucagon-like peptide-1 analogue liraglutide versus placebo treatment on circulating proglucagon-derived peptides that mediate improvements in body weight, insulin secretion and action: a randomized controlled trial. Diabetes Obes Metab. 2021;23(2):489-498. doi:10.1111/dom.14242
- Haggerty T, Dekeseredy P, Bailey J, Cowher A, Baus A, Davisson L. Navigating coverage: a qualitative study exploring the perceived impact of an insurance company policy to discontinue coverage of antiobesity medication. Obes Pillars. 2024;11:100120. Published 2024 Jul 22. doi:10.1016/j.obpill.2024.100120
