–January 5, 2007
Prescription weight-loss drugs are currently being used by millions of Americans, but recent research is raising questions about the long-term effects of these drugs.
Two Canadian researchers recently reviewed existing data on anti-obesity drugs like Meridia (sibutramine), Xenical (orlistat), and Acomplia (rimonabant) to determine whether their benefits ultimately outweigh the risks.
Better Studies Needed
Drs. Raj Padwal and Sumit Majumdar published their commentary in the medical journal The Lancet , stating that the only way to determine the overall risk-benefit ratio is to conduct longer, more thorough studies.
These three medications will likely lower weight, modestly, but we need better studies. The studies that are out there don’t provide information on cardiovascular disease and cardiovascular deaths, said Padwal.
The other problem, he added, is that [the studies] are not long-term and have high dropout rates. We really need to know what the net benefits of these medications are, and truly know whether we should be using them or not.
A Benefit To Overall Health?
According to Padwal, the most important question is the extent to which the small amount of weight loss associated with these medications really benefits an individual’s overall health.
Padwal cites people who only lose a modest amount of weight through exercise but who also significantly reduce their risk of serious health problems, including heart attack, stroke, and diabetes.
Until you have a study that show that these medications lower the incidence of heart attack, the incidence of stroke, cardiovascular mortality, overall mortality, you don’t know what the overall net benefit of these medications are, he said.
The Risks
Meridia and Xenical are both FDA approved, and Acomplia is currently under review. However, none of the drugs is without side effects. Meridia has been linked to increased heart rated and high blood pressure, Xenical to gastrointestinal side effects, and Acomplia to an greater risk of mood disorders.
Dr. David L. Katz, associate professor of public health at Yale University School of Medicine, expressed concern over the use of drugs to address the obesity epidemic.
To date, the history of weight-loss drugs in not very encouraging. The two FDA-approved weight-loss drugs now available, sibutramine and orlistat, have some serious potential side effects, limited efficacy, and work only as long as they are taken, he said.
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