A few weeks ago, a U.S. Food and Drug Administration advisory panel gave the nod to what may be the first new weight loss drug in 13 years. This is despite the fact that Qnexa, manufactured by Vivus Inc., had been rejected by health experts in 2010 because of its potential side effects, including heart attacks and serious heart rhythm abnormalities. The FDA will be deciding on Qnexa’s fate sometime this month.
Like many new drugs, this one isn’t really new. It combines two existing drugs -- the appetite suppressant phentermine and the anti-seizure/migraine medication topiramate (Topamax).
If phentermine sounds ominously familiar, it’s because it was one-half of the drug called fen-phen, which was yanked off the market after it was linked to pulmonary hypertension -- high blood pressure in the lungs -- and heart valve disease. It may have led to as many as 49 deaths and more than 100 adverse reactions, many of them grave, though they were traced to the “fen” (i.e., fenfluramine) part of the combo.
A year ago, studies funded by Vivus found that obese people who took Qnexa lost an average of 22 pounds in a year, which was accompanied by lower blood pressure and cholesterol levels. Data suggests that the drug is best at helping people lose about 10 percent of their weight. That may not help you get into a size 6. But many experts say that 10 percent is the threshold where the health benefits of losing weight, particularly a lower risk of heart disease, start to kick in.
But do we really need a new anti-obesity drug? Don’t we have, well, diet and exercise? That’s a question posed, and answered, by Dr. Mark Hyman -- physician and author of The Blood Sugar Solution -- in a recent blog. “There is a solution to our obesity epidemic. But it’s not at the bottom of a pill bottle. It’s at the end of our forks,” he wrote. “Diet is simply more effective than any medication and works better, faster and cheaper not just as prevention, but also as treatment for what ails us in the 21st century.”
So What’s the Answer?
While Hyman makes it sound easy, he needs to talk to the millions of people who lose weight every year and gain it back, along with some bonus pounds. A 2007 UCLA review of studies on dieters found that one-third to two-thirds regain more weight than they lost. Essentially, the researchers said, the biggest risk factor for weight gain is going on a diet. Read more about the UCLA findings.
Dieting should be the answer, but it may not be the entire solution, says Dr. Melina Jampolis, a physician nutrition specialist in San Francisco and author of several books on weight loss, including The Calendar Diet: A Month By Month Guide to Losing Weight While Living Your Life , which she designed for her patients.
Jampolis’ stock-in-trade is nutrition and dieting, yet she says she welcomes a new weight loss drug. “There are simply too many obesity-promoting factors in our environment for many people to overcome. I believe a medication that could help them reduce 10 percent of their body weight when combined with diet and exercise would be very beneficial.”
So beneficial, says Jampolis, that the pros outweigh the cons for many people. “I’m much more concerned about the side effects of obesity, including heart disease, diabetes, arthritis, cancer and fatty liver. The only concern is carefully screening women who are or may become pregnant -- the drug may cause birth defects -- and certainly monitoring those with heart disease closely.”
What do you think? Would you take a new weight loss drug that could cause serious side effects to eliminate the serious side effects of your weight? (And I’m not just talking muffin top and thunder thighs.)
