FOR RELEASE: Jan. 6, 1997
Contact: Susan Lang
Office: (607) 255-3613
Internet: [email protected]
Compuserve: Larry Bernard 72650,565
http://www.news.cornell.edu
ITHACA, N.Y. -- Don't bother with the hot new diet pill Redux -- the
benefits don't outweigh the risks, according to a Cornell University
nutritionist who has examined the 40 studies on long-term use of the diet
pill. "People do lose weight more easily with Redux (d-fenfluramine) than
with a placebo, but the advantage of taking the medication over a placebo
after a year is less than 5-and-a-half pounds," said David Levitsky,
professor of nutritional sciences and of psychology in the Division of
Nutritional Sciences and Department of Psychology at Cornell and a
nationally known expert on the control of obesity.
That amount of weight lost after one year of taking the drug daily rather
than a placebo is equivalent to a 62-calorie difference a day, roughly the
amount of calories in a medium-sized cookie or apple, or the amount burned
by walking for a half-hour and making other small changes in daily motor
activity. After one year, there is no indication that any further weight
loss can be achieved by the medication alone, Levitsky said.
Until recently patients were prescribed appetite suppressing drugs such as
Redux for no longer than 12 weeks to help them stick to their diets and
lose weight. In the past several years, however, researchers and
clinicians have observed that body weight returns to pretreatment levels
when the medication is discontinued. Consequently, they have largely
agreed that for weight reduction drugs to be effective, people must take
them chronically, perhaps for a lifetime.
To determine just how much weight people could expect to lose if they took
Redux or a similar drug for a long time, Levitsky analyzed the studies from
all the articles published in scientific, peer-reviewed journals in which
patients remained on fenfluramine for more than three months. His
analysis is published in the January/February issue of Healthy Weight
Journal, a publication intended for professional dietitians and clinical
weight loss personnel.
Levitsky concluded that Redux not only produces a relative small weight
loss but also may carry health risks.
"Although conclusive evidence of possible health risks from chronically
taking fenfluramine or any other weight loss medication is not in, there is
some evidence of brain damage in animals and pulmonary hypertension in
animals and humans," he said.
In fact, in one case-controlled 1996 study of 95 patients, patients
suffering from pulmonary hypertension were 23 times more likely to have
taken d-fenfluramine than their matched controls and that the longer they
had been taking the medication, the greater their risk of developing this
serious condition. In an article published in the same issue of the
journal, it is reported that Redux also is associated with sleep problems,
drowsiness, headaches, dizziness, vertigo, nervousness, anxiety, depression
and abnormal dreams and that discontinuing the drug is related to
depression, delusion, hypertension and nausea.
Nevertheless, some researchers argue that even though d-fenfluramine has an
increased health risk associated with it, the risks associated with obesity
are far greater. They argue that these risks can be reduced by weight
loss, perhaps achieved by taking appetite suppressing drugs. Levitsky
disagrees: "There is no evidence that losing weight with the help of
appetite suppressants is as effective at reducing mortality as losing
weight through more conventional techniques such as reducing dietary fat
and increasing exercise."
He emphasized that the burden of proof rests with the advocates of the
weight-reducing medications to show that the benefits of the weight loss
from the medications is equivalent to that of improving diets in reducing
mortality.
"We know that d-fenfluramine is not a completely safe drug, and we know
that simple lifestyle changes such as modest exercise or changing the kinds
of food we eat from having an average of 34 percent of total calories from
fat to an average of 25 percent of calories from fat can easily produce a
deficit equal to or greater than the amount of weight lost by chronically
taking diet pills. We also know these changes in lifestyle will not only
lower body weight but also reduce the risk of cardiovascular disease and
cancer as well.
"Yet, Americans have a love affair with the idea of a 'magic bullet,' and
this is inflamed by the advertising and pharmaceutical industries,"
Levitsky said. "However, enough evidence is in for me to conclude: the
perils of weight loss pills far outweigh the modest weight loss they
achieve, even when taken for years."
-30-
RSS