Adapted from an article by David Katz, MD
There are currently three new weight loss drugs in the front of the queue for FDA consideration — Qnexa, Contrave and lorcaserin — and all of them made news this week.
Perhaps the lead news item is that an advisory panel to the FDA recommended against approval for Qnexa, a drug that combines phentermine (an amphetamine) and topiramate (an anti-convulsant). The drug produces weight loss, but at a cost in brain function — impaired concentration and memory loss — the advisory committee deemed too high. (I am tempted to consider that people taking the drug simply don’t remember to eat, but that may take things too far.) The FDA is likely to follow the advice of its expert panel on this one.
Contrave is in the news at the moment only by association. This drug, a combination of the antidepressant bupropion and naltrexone, a drug used for treating addiction, comes up for its own FDA review later in the year. It appears to be slightly less effective than Qnexa, and perhaps slightly less encumbered by side effects, although nausea appears to be common enough to be rate-limiting.
The third drug, lorcaserin, which influences brain serotonin levels, was featured in a clinical trial just published in the New England Journal of Medicine. Most news reports seem to be putting a positive spin on the trial, which found the drug produced a 5 percent or greater weight loss when combined with a lifestyle intervention more often than the lifestyle intervention alone. But half of the study participants dropped out, and the rather modest weight loss achieved in those who remained lasted reliably only as long as they kept taking the drug. Half who stopped the drug gained back the weight, despite the lifestyle intervention. The drug company that sponsored the trial waxed optimistic, but honestly, I am much underwhelmed.
Anyone surprised by this most recent and potentially discouraging installment is either a perennial optimist, or hasn’t been paying much attention. Because the history of weight loss drugs is a litany of disappointments, large and small. From the infamous demise of Fen-Phen, a combination antidepressant and stimulant that caused heart valve damage (due, most now concur, to the ‘Fen,’ or fenfluramine, not the ‘Phen,’or phentermine which has reappeared in Qnexa), to the 2007 decision by the FDA to deny approval for rimonabant, the most promising weight loss drug to come down the pike in some time. FDA almost certainly got it right, however. The European Union approved rimonabant, then withdrew it from the market after noting a marked rise in the rate of depression and suicide among those taking it.
Dr. Jonny comments: This excellent summary by Dr. David Katz hits the nail on the head. The history of prescription drugs for weight loss is littered with false promises, bad side effects and FDA recalls. And the real kicker is that none of them work all that well to begin with, despite enormous hype and advertising.
Before going the drug route, why not really see what eating and living differently can achieve. Lifestyle changes — and I’m talking deep, profound changes, not quick-fix diets — may not be all that sexy, and certainly don’t produce instant gratification.
But they do produce real change.
And the only “side effects” are good ones.
You can read the full text of Dr. Katz’s article here
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Thank you Dr Johnny, for this most Informative information, and i do believe the Public do need to become more Aware of what is Actually in the Drugs they are taking and being offered to them, and the Plosssible Side affects, and Long term affects this can have on their Health, We are living in a very Unnatural, Drug orientated Society, and people have come to “learn” to accept these Drugs as a Way of Life, without Questioning the What. Why and if’s about the Matter, where as people should be thinking More for themselves, and Start taking SOME Responsibility for their Own Health, Regards, m.c.
FDA should be strict in approving these kinds of drugs. The drugs help loss weight but it may also cause brain damage.
(I am tempted to consider that people taking the drug simply don
I’ve lost about 100 pounds using CLA, and 800 to 1000 mcg chromum picolinate. Some brands worked much better than others. The effect is not immediately noticed, but gradually over a couple weeks the craving for sugar and salty carbs diminishes. It’s hard to believe, but snack chips actually sat around past their use by date. Chocolates went bad, and were pitched. Before, it was the slad stuff that rotted.
The tiny pills are better than the large pills sold by Costco.
I found that the first step in permanent weight loss is the “water work out” One works up to drinking one ounce of water for every pound you weigh. At 389 that’s a LOT of water. I had to learn to take gulps not tiny sips, then to drink more gulps at a time. I went from 1/2 cup serving of H2O to chugging 20 oz. I haveepisodes of low blood pressure, and found that drinking a large water 32oz would eliminate the weakness and exhaustion
My alleged exercise never exceeded 5 minutes at a time and I never broke a sweat.
I’m working on a diet for the very obese who are not canidates for any of the operations. I found a way to shrink the stomach without these.
I used to eat 2 plates of “salad” rolls, soups, two or three plates of entree then a couple desserts at the local Golden Corral. Now a small bowl of salad, soup, then I’m too full for more than a few bites of entee and a taste of dessert. The change is astounding.
I tried Hoodia but found it unreliable from one bottle to the next, even within a brand. If you know of some that produces consistant hunger control i’d like to know about it,
I visualized going from dress size 34 to 24, but now am having difficulty visualizing myself closer to my ideal size and weight.
I need to believe I can be fit and healthy under 140#. Unfortunately I developed severe SOB after having my teeth extracted under a general anesthesia. I could walk less than 20 feet without gasping for air. Before I could walk for an hour. I think this was due to an anesthesia reaction. Now I’m on oxygen and in much worse health than I was before the weight loss. How can I think correctly tolose more when the first half has me in worse health? I know I have to change my thinking before I can change my pant size.
I still don’t understand how some of these prescription drugs pass FDA standards when they have so many side effects. I’m going to try some of these weight loss drugs you’ve listed and see if I have any better luck with these.
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