Long-term weight control study: Conclusions

Weintraub, Michael

doi:10.1038/clpt.1992.76

Cited by 154 publications

(67 citation statements)

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“…The combination of phentermine resin and dlfenfluramine was demonstrated to produce sustained weight reduction over a 3-year period while subjects continued with the study medication (17). However, there has been no study which investigated combination therapy in the binge eating subgroup of the obese population.…”

Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Pharmacotherapy on Weight Loss, Depressive Symptoms, and Eating Patterns in Obese Binge Eaters and Non‐Binge Eaters

et al. 1999

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ALGER, SHARON A . , MARGARET MALONE, JENNIFER CERULLI, STEVEN FEIN, LYN HOWARD. Beneficial effects of pharmacotherapy on weight loss, depressive symptoms, and eating patterns in obese binge eaters and non-binge eaters. Obes Res. 1999;7:469-476. Objective: The purpose of this study was to compare the impact of drug therapy on weight loss, Beck Depression Inventory (BDI) scores, and binge eating patterns (BES) between obese binge eaters and non-binge eaters. Research Methods and Procedures: 22 severe binge eaters, 17 moderate binge eaters, and 16 non-binge eaters received phentermine resin 1 5mg/day and dl-fenfluramine 20mg three times daily over a 6 month period for weight loss. All data are reported as meankS. Results: The percent weight loss compared to baseline within the 3 groups ranged from 8.9% to 11.3% at 3 months and 10.6% to 14.9% at 6 months. After 6 months, 73% of the severe binge eaters, 59% of moderate binge eaters and 69% of non-binge eaters had experienced more than 10% weight loss. BDI scores were significantly higher in the severe group at baseline when compared to non-binge eaters (p<0.006). After 3 and 6 months BDI scores improved in all groups but remained significantly different between the severe and non-binge eaters until the 6-month assessment. BES scores declined in all groups over the 6-month period. Echocardiograms were performed in 35 of 55 subjects following reports of a possible association between fenflur- amine and valvular changes. Fifteen (43%) of subjects had no abnormal findings and 20 (57%) had evidence of valvular insufficiency occurring in one or more valves. Seven patients (20%) had significant valve damage according to the DHHS and FDA criteria. Conclusion: After 24 weeks of treatment severe binge eaters improved their eating pattern, depression scores, and achieved weight loss similar to non-binge eaters. These data suggest that pharmacologic intervention for weight loss and subsequent weight maintenance can be as successful in binge eaters as non-binge eaters. A relationship was seen between duration of drug treatment and valvular insufficiency in subjects treated for an average of 52 weeks. These findings validate the FDA requirement for studies of at least 1 year duration to evaluate both the safety and efficacy of pharmacologic treatment for obesity.

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Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Pharmacotherapy on Weight Loss, Depressive Symptoms, and Eating Patterns in Obese Binge Eaters and Non‐Binge Eaters

et al. 1999

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“…In 1984, Weintraub et al published a wellcontrolled study [9] demonstrating the efficacy of combining phentermine and fenfluramine in patients with mild obesity. In a 4-year study, they combined these drugs with a program of diet, exercise, and behavior modification to effect significant weight loss with little morbidity [10,11]. The drug combination, popularly called Phen-Fen, gained widespread acceptance and use, often being prescribed without behavior-modification therapy.…”

Section: Second-line Therapy: Pharmacotherapymentioning

confidence: 99%

Medical and surgical options in the treatment of severe obesity

Fisher

Schauer

2002

The American Journal of Surgery

275

156

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Weight loss programs, diets, and drug therapy have not shown long-term effectiveness in treating morbid obesity. A 1992 statement from the National Institutes of Health Consensus Development Conference affirmed the superiority of surgical over nonsurgical approaches to this condition. Bariatric surgical procedures work in 1 of 2 ways: by restricting a patient's ability to eat (restrictive procedures) or by interfering with ingested nutrient absorption (malabsorptive procedures). Many of these procedures can be performed by a laparoscopic approach, which has been shown to reduce operative morbidity. In the United States, the primary operative choice for morbidly obese patients has recently shifted from vertical banded gastroplasty (VBG) to the Roux-en-Y gastric bypass (RYGBP). VBG, a purely restrictive procedure, has fallen into disfavor because of inadequate long-term weight loss. RYGBP combines restriction and malabsorption principles, and has been shown to induce greater weight loss than VBG. Other procedures currently being offered include laparoscopic adjustable gastric banding; biliopancreatic diversion (BPD), including the duodenal switch (BPD-DS) variation; and distal gastric bypass (DGBP). The problem of obesity has reached epidemic proportions in the United States. More than 50% of adults are obese or overweight, and 5% are severely obese (body mass index [BMI] of Ն35) [1]. Numerous studies have demonstrated a strong relation between BMI and the development of lifeimpairing comorbidities, such as hypertension, diabetes (type 2), atherosclerosis, sleep apnea, and osteoarthritis. Obesity is associated with a higher risk of cancer (breast, colon, uterine) and premature death. Patients with severe or morbid obesity (BMI Ͼ35), the focus of this review, are consequently most severely affected by the disease, have a poor quality of life, and thus have the greatest need for weight loss therapy. Numerous medical and surgical treatments for severe obesity have come and gone over the years, underscoring the challenge and complexity of obesity management. The intent of this review is to summarize the current status of medical and surgical options for the treatment of severe obesity. Management of obesity

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“…Sibutramine raises hypothalamic serotonin and noradrenaline concentrations by inhibiting their reuptake; this decreases food intake [72]. There have been three candidate gene studies that explored the association with weight loss outcome in response to sibutramine ( Figure 2).…”

Section: Obesitymentioning

confidence: 99%

Pharmacogenetics: potential role in the treatment of diabetes and obesity

Vella

Camilleri

2008

Expert Opinion on Pharmacotherapy

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Background-Common genetic variation is associated with increased risk of common metabolic diseases such as type 1 and type 2 diabetes, and obesity. Increasing experience with genetic association studies has led to an understanding of the large sample sizes required to detect a weak to moderate genetic predisposition to disease, the need to reproduce such associations in independent cohorts, and the statistical criteria required to detect a true association. This approach has been used successfully to identify disease-associated gene variation usually in representative populations of large numbers.Objective-To review the current understanding of how common genetic variation influences predisposition to, and treatment of, metabolic disease. Methodology-Review of scientific literature.Results-While there has been progress in understanding how genetic variation predisposes to diabetes and obesity, and how candidate genes may alter drug response, several caveats limit the interpretation and significance of pharmacogenetic studies published to date: those caveats typically include relatively small numbers of participants and choice of endpoints in determining gene-associated differences in response, which may not be clinically significant or relevant as a biomarker or predictor of a desired clinical effect. The genetic variants studied at a given locus are often limited in number and may not represent a comprehensive map of the region under study.Conclusions-The pharmacogenetic associations in diabetes and obesity that have been reported to date have had limited impact on the choice of individual treatments. We perceive, however, that this field is in its infancy in these multifactorial metabolic diseases, and with further advances and future drug intervention trials designed in a way that allows a more clear interpretation of the impact of genetic variation on differences in drug response in obesity and diabetes, it is anticipated that pharmacogenetics will have a significant impact on individualizing medical care.

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Long-term weight control study: Conclusions

Abstract: Clinical Pharmacology and Therapeutics (1992) 51, 642–646; doi:

Cited by 154 publications

References 0 publications

Beneficial Effects of Pharmacotherapy on Weight Loss, Depressive Symptoms, and Eating Patterns in Obese Binge Eaters and Non‐Binge Eaters

Beneficial Effects of Pharmacotherapy on Weight Loss, Depressive Symptoms, and Eating Patterns in Obese Binge Eaters and Non‐Binge Eaters

Medical and surgical options in the treatment of severe obesity

Pharmacogenetics: potential role in the treatment of diabetes and obesity

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