The Treatment of Obesity in Patients with Cardiovascular Disease

Bernstein, Arthur; Simon, Franklin

doi:10.1177/000331976101200107

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…The main concerns with dexamphetamine relate to toxicity, abuse potential, and concern that the small increase in blood pressure could exacerbate ischemic heart disease ( 16 ). However, amphetamines have been previously studied for the treatment of obesity ( 16 – 19 ) [including in individuals with cardiovascular disease ( 16 )] and also for their psychotropic properties ( 20 ). Griffith et al showed that psychosis can be induced in individuals with no known predisposition within 5 days through dexamphetamine doses of 5–15 mg hourly ( 20 ).…”

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confidence: 99%

Piloting a New Approach to the Treatment of Obesity Using Dexamphetamine

et al. 2015

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Background and aims: There is a clear need for a new approach to the treatment of obesity, which is inexpensive and is effective for establishing lifestyle change. We conducted a pilot study to evaluate whether dexamphetamine can be used safely, combined with diet and exercise, for treating obesity. Our ultimate aim is to develop a 6-month treatment program for establishing the lifestyle changes necessary for weight control, utilizing dexamphetamine for its psychotropic effect on motivation. We viewed the anorexigenic effect as an additional advantage for promoting initial weight loss.Methods: Obese adults were treated with dexamphetamine for 6 months (maximum of 30 mg twice daily), diet, and exercise. Weight, electrocardiogram, echocardiogram, and blood pressure were monitored.Results: Twelve out of 14 completed 6 months treatment. Weight loss by intention to treat was 10.6 kg (95% CI 5.8–15.5, p < 0.001). The mean weight gain in the 6 months after ceasing dexamphetamine was 4.5 kg (95% CI 1.9–7.2, p = 0.003), leaving a mean weight loss at 12 months from baseline of 7.0 kg (95% CI −13.4 to −0.6, p = 0.03). All reported favorable increases in energy and alertness. Dose-limiting symptoms were mood changes (2) and insomnia (2). None had drug craving on ceasing dexamphetamine, and there were no cardiac complications. Among the seven women, there was a significant correlation for those who lost most weight on treatment to have the least regain in the following 6 months (r = 0.88, p = 0.009).Conclusion: Our treatment with dexamphetamine, diet, and exercise was well tolerated and effective for initial weight loss. Future research will focus on identifying baseline predictive variables associated with long-term weight control.

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Section: Introductionmentioning

confidence: 99%

Piloting a New Approach to the Treatment of Obesity Using Dexamphetamine

et al. 2015

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Comparison of Weight Losses With Three Reducing Regimens—diet Therapy, Phenmetrazine, and an Amphetamine Combination (Obetrol)

Berman¹,

Anderson²

1966

J American Geriatrics Society

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The pattern of compulsive eating is strikingly similar to that of dipsomania. The majority of patients who lose weight will regain it within a year, and 40 per cent will attain or exceed their previous weight in spite of good intentions and ordinary therapy (1). For this reason i t is desirable to conduct a follow-up study of any reducing regimen, to determine the long-term as well as the immediate results.I n the present investigation the procedure included intensive treatment for a period of ten weeks with follow-up for six months, nine months or one year. The purpose was to determine to what extent the new dietary habits begun during the ten-week period had succeeded in re-educating the patient regarding his weight-control problem. REGIMENS-DIET THERAPY, PHENMETRAZINE, AND AN DIETRigid menus and calorie tables impose a serious hardship and inconvenience which often result in complete abandonment of the reducing program. Therefore we have instituted a program of nutritional counseling designed to provide a high-protein, low-carbohydrate type of diet in a form that will be satisfactory to the individual patient.First, the subject is asked to record her actual diet for one week. This diet is then reviewed and modified in order to reduce the excessive amounts of carbohydrates and replace them with as much protein as possible. I n addition, fresh fruits and vegetables are substituted for high caloried food of poorer nutritional value (2).The generally accepted dietary plan for control of obesity provides a liberal allowance of protein because of its high satiety value, specific dynamic action, and importance in protecting tissue and building muscles. The fat intake should be minimal, restricted primarily to the eggs and meat necessarily included in the increased protein ratio. The carbohydrates should be limited chiefly to the low-carbohydrate bulky fruits and vegetables (3).Storage of fat in the body cannot take place unless glucose is being metabolized. There is a close relationship between the metabolism of carbohydrate (glucose) and the synthesis of both fatty acids and triglyceride or neutral fat. This link is mediated through 3 main channels as follows:1. Glycolysis, which is the main source of pyruvic acid and acetyl CoA, from which fatty acids are synthesized.2. Oxidation of glucose by the pentose pathway or the hexose monophosphate shunt; this generates the cofactor-reduced triphosphopyridine nucleo-623

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The Treatment of Obesity in Patients with Cardiovascular Disease

Cited by 2 publications

References 7 publications

Piloting a New Approach to the Treatment of Obesity Using Dexamphetamine

Piloting a New Approach to the Treatment of Obesity Using Dexamphetamine

Comparison of Weight Losses With Three Reducing Regimens—diet Therapy, Phenmetrazine, and an Amphetamine Combination (Obetrol)

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