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Weight-Loss Drugs

The Holy Grail

Dr. Marc Zerey
Dr. Marc Zerey is a board certified physician specializing in bariatric weight loss and advanced laproscopic surgical techniques. Dr. Zerey has published extensively including journal articles in American Surgeon, American Journal of Surgery, American Journal of Surgical Research and is an ASMBS Bariatric Surgery Center of Excellence designee. The Bariatric Surgery Center can be reached at (805) 898-3472.

by Marc Zerey, MD, CM, MSC, FRCSC, FACS 

Obesity has reached epidemic proportions worldwide in all segments of the population. According to the Centers for Disease Control and Prevention, more than one-third of U.S. adults are obese (35.7%) and 17% of children and adolescents aged 2-19 years are obese. Obesity raises the risks of diabetes, heart attacks, and stroke and costs the U.S. economy an estimated $147 billion per year in healthcare and lost productivity.

These statistics are well known to the pharmaceutical industry: in the past few decades, there have been dozens of medications for weight loss that have come and gone either due to harmful side effects or poor effectiveness.

Beginning in the 1950s, amphetamines were prescribed to raise metabolism and decrease appetite to help individuals lose weight. The weight lost was modest and often temporary. Due to their dangerous side effects including high potential for addiction, elevated blood pressure and rapid heart rate, they are rarely prescribed today.

In the 1990s, the combination of appetite suppressants Phentermine and Fenfluramine ("PhenFen") was heavily marketed as a weight-loss drug. Soon after Food and Drug Administration (FDA) approval, reports began surfacing about life-threatening complications including pulmonary hypertension and valvular heart disease. These were found to be linked to the Fenfluramine portion. The drug was eventually withdrawn from the market.

Since then, the FDA has been very cautious about approving other weightloss drugs. The last medication to be approved, Orlistat (Alli), was approved in 1999 and remains the only FDA-approved drug for weight loss. Orlistat acts by blocking a digestive enzyme that breaks down fat. It has a very good safety profile since it is not absorbed in the bloodstream. Patients can expect to lose between 5-10% of their excess weight. The problem with Alli relates to the fat which is not absorbed; side effects include gas with oily spotting, diarrhea, and more frequent bowel movements.

A diet pill that actually helps people lose weight without exposing them to harmful side effects is like the Holy Grail to drug manufacturers. Sales of this drug could mean billions for these companies and their investors and provide yet another glimmer of hope to a customer base hungry for a quick fix.

 

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