Fen-Phen Gone, but Other
Diet Drugs Still Popular
Excerpt By Eric Sabo, Reuters Health

Despite growing safety concerns at the time, the use of a weight loss drug combo known as "fen-phen" continued to soar until the Food and Drug Administration removed two of the medications in 1997, an analysis of prescription records shows.

The report, published Tuesday in the Archives of Internal Medicine, suggests that the fallout has hardly put a dent in America's robust appetite for weight loss treatments.

In fact, anti-obesity drugs are as popular now as when fen-phen first took off in the early 1990s, with both old and new medications competing in their place.

"Fen-phen hit when obesity was starting to be seen as a medical problem, rather than a personal responsibility issue," said the study's lead author, Dr. Randall S. Stafford, a disease prevention expert at Stanford University. "Patients and doctors were ready to accept a change."

While such quick public health responses can be beneficial in some cases, Stafford said that fen-phen offers the opposite lesson.

"Clearly the enthusiasm got of hand here," Stafford told Reuters Health.

Fen-phen became the diet craze of the 90s after published research found a positive slimming effect from combining two old appetite suppressants, fenfluramine and phentermine. With the approval of a newer fenfluramine agent, called dexfenfluramine, prescriptions for these medications skyrocketed in 1996 alone.

But reports from the Mayo clinic and others began linking the "fen" part of the combo to potentially harmful heart valve defects. By the fall of 1997, the FDA removed both fenfluramine agents from the market, citing concerns that their off-label use with phentermine was putting people at too high a risk.

If it wasn't for the FDA stepping in, Stafford said, fen-phen would probably be a popular weight-loss aid today.

"Even though there was little evidence that it could work, the use of fen-phen just took off," Stafford said. "These drugs tapped into something we hadn't seen before."

The rise and fall of fen-phen also corresponded with a yo-yo effect in obesity statistics. For instance, the total number of obese patients who saw a doctor for a weight problem nearly doubled from 1995 to 1996. These rates have since dropped to four million a year, roughly the same as they were before fen-phen hit its peak.

The number of overweight people seeking treatment solely to lose weight increased as well, jumping from 59 percent in 1991 to 71 percent in 1996.

This is not what anti-obesity drugs were intended for, according to Stafford.

"Many patients receiving these drugs aren't the ones who have obesity-related medical problems, like hypertension," said Stafford, adding that those who are just trying to shed a few pounds with drugs potentially stand to do more harm than good.

European drug agencies have banned phentermine in addition to the fenfluramines, based on the chance that phentermine might also cause heart valve defects and other side effects. This appetite suppressant, sold under brand names such as Fastin, is still available in the U.S.

The FDA recently approved two other anti-obesity treatments, Meridia and Xenical. These drugs may turn out to be helpful, said Stafford, but it's important that people not rush to take the latest diet pill without understanding the potential downsides.

"There is no quick and easy approach for losing weight," Stafford pointed out. Before embracing the newest fad, he said, "we need to apply a great deal more scrutiny."

Reference Source 89

For more information on how to prevent other diseases, use
PreventDisease.com's "Quick Prevention Resources".