October 15, 2010 | 4:52 pm
Posted by Albert Fuchs, M.D.
… or, So Long Sibutramine
Over two thirds of Americans are overweight. A safe and effective medication that helps people lose weight would be a boon for the health of millions who are struggling to take off the pounds. Unfortunately, this has been an extremely tough nut to crack for the pharmaceutical industry.
The existing medications for weight loss have been only modestly effective, and last week the choices became fewer. Meridia (the brand name of the medicine sibutramine) was voluntarily withdrawn from the market last week after a study in the New England Journal of Medicine last month showed that it increased the risk of heart attacks and strokes.
The study randomized over 9,000 overweight adults to sibutramine or placebo. Though the increase in heart attack and stroke risk was only small, the benefit was even smaller. The patients on sibutramine lost an average of only 5 lb more than the placebo group over more than 3 years of follow up. The FDA decided that the risk was not worth the tiny benefit. The medicine has also been withdrawn from Europe.
That leaves only one prescription weight loss medication on the market, orlistat (sold as Xenical by prescription and Ali over the counter). I wrote about it when I reviewed the available options in July (see link below). It is also only modestly effective and the side effects, while not dangerous, can be annoying and rather icky.
So for now, the best advice for weight loss is to eat less, exercise more and get enough sleep. And for those who are extremely overweight weight loss surgery deserves consideration.
Wall Street Journal Health Blog: Hasta La Vista, Meridia: Another Diet Drug Bites the Dust
New England Journal of Medicine article: Effect of Sibutramine on Cardiovascular Outcomes in Overweight and Obese Subjects
My post in July about lorcaserin (which may not win FDA approval): A New Medication for Weight Loss
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