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    Unrealistic expectations for diet drugs says review


    Posted by .(JavaScript must be enabled to view this email address)
    Thursday, September 28, 2006 7:17 am Email this article
    There are unrealistic expectations regarding diet pills according a review paper published in the Annual Review of Pharmacology and Toxicology. Incorrect Assumptions

    When weight loss stops, it does not mean the diet drug has stopped working

    “A frequently encountered misconception in the treatment of obesity is the assumption that a drug has lost its efficacy when body weight is stabilizing at a lower level during treatment,” the paper notes.

    “In pharmacological terms, this means that a new steady state has been achieved and the drug effects are counterbalanced by compensatory mechanisms.”

     

    Weight Gain When Diet Drugs Stopped

    When weight loss stops, it does not mean the diet drug has stopped working

    “This becomes evident when treatment is terminated and body weight rises again toward the initial values.”

     

    Accepted With Other Drugs, But Not Diet Drugs

    Durgs only work for as long as you take them

    “Although such phenomena are generally accepted for established drugs in other chronic indications, antiobesity agents still meet unjustified criticism because it is expected that body weight should continue to fall during chronic treatment and remain reduced after drug treatment has been stopped.”

    Comments: OK to use diet drugs on an “As Needed” basis

    Comment: Some doctors have their patients take diet drugs until they lose the desired weight, and then allow them to stop taking the medication as long as they keep their weight within 5 pounds or so of their target weight.

    If a patient ever gains more than 5 pounds, they are instructed to go back on the medication immediately to lose the weight that they have gained.

    Some doctors will also give their patients a prescription for phentermine, or whatever drug they happen to be using, to keep on hand when a patient feels extra hungry.

    I think both of these methods, especially the second method, is an excellent idea.

    Studies in hospital have found that when patients on morphine (for pain) are allowed to control when and how much pain morphine they get, they use less of the drug than when they have to ask a nurse to give them an injection.

    I imagine the same thing happens when patients are allowed to determine when and how often to use a diet pill.

     

    Comments

    Comments: FDA claims most diet drugs only approved for short-term use because of safety concerns

    In the summer of 1997 when the Mayo Clinic found that fenfluramine was associated with heart valve problems, and the FDA removed fenfluramine from the market, the FDA claimed that this was why these drugs were only approved for short-term use—because the FDA thought they might be dangerous if used long-term.

    Comments: The FDA is trying to rewrite history

    Nonsense. The FDA is trying to rewrite history when they say this, but this is not true.

    I’ve read the studies from the 1950’s and 60’s and that is not the reason why the FDA approved drugs like phentermine, fenfluramine and phendimetrazine for short-term use only.

    They did it because the drugs tended to cause weight loss for the first few months, and then people tended to stop losing weight.

    It should also be noted that diet drug studies were done differently back then.

    Comments: Diet drug studies in the 50’s and 60’s did not use diet and exercise

    They used to give subjects diet drugs but would not put them on a diet or exercise program. They would just give the drug and see how much weight they lost.

    Comments: Today diet drug studies all use diet and exercise

    Today, virtually all diet drugs studies include diet plus exercise plus behavior modification (sometimes) plus the diet drug. This is more realistic to the way that diet drugs are used in the real world.

    Comments: FDA approved drugs like phentermine for short-term use because they thought they stopped working

    Back in the 1950’s and 60’s, the FDA concluded that diet drugs only work for the first few months and then stop working, and that is why they only approved them for short-term use.
    REFERENCE

    Hofbauer K, Nicholson J, Boss O. The obesity epidemic: Current and future pharmacological treatments. Annu Rev Pharmacol Toxicol. 2006 Sep 26.

    AUTHOR’S CORRESPONDENCE

    Karl Hofbauer
    Applied Pharmacology
    Biozentrum/Pharmazentrum
    University of Basel
    CH 4056 Basel, Switzerland
    .(JavaScript must be enabled to view this email address)

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