2 New Weight-Loss Drugs Won’t Reverse U.S. Obesity Crisis

THURSDAY, July 19 (HealthDay News) — The U.S. Food and Drug
Administration’s approval of two new weight-loss drugs within the past
month — the first such medications in 13 years — won’t be a panacea for
America’s obesity epidemic, health professionals say.

And as the FDA‘s drug regulators reiterated when approving the two
drugs, Qysmia and Belviq, no weight-loss medication should be used without
also making lifestyle changes to facilitate weight loss.

“The bottom line is there’s no such thing as a magic pill and I hope
that individuals do not think by taking this pill that it will ensure
long-term weight loss,” said Keri Gans, a registered dietitian in New York
City. “We need to be reminded that diet and exercise are still
critical.”

Qysmia, formerly called Qnexa, was approved on Tuesday and is a
combination of the weight-loss drug phentermine (brand name Adipex-P,
among others) and the anti-seizure medication Topamax (topiramate).

It is only approved for people who are obese (a body mass index, or
BMI, of 30 or above) or overweight people (BMI of 27 or higher) and who
also suffer from conditions such as high blood pressure, type 2 diabetes
or high cholesterol.

Phentermine once was prescribed widely as the “phen” part of the
fen-phen weight-loss drug, which was withdrawn from the market in 1997
after it was linked to both high blood pressure in the lungs and heart
valve disease. The problems appeared to be related to the “fen,” or
fenfluramine, part of the combination, not the phentermine.

Qsymia was initially denied FDA approval in 2010 because of potential
side effects, including heart palpitations and birth defects — such as
cleft lip in babies — if taken by pregnant women.

Phentermine is believed to work by controlling appetite and Topamax by
speeding up metabolism.

But Topamax also has side effects, including, possibly, numbness in the
arms and legs, said Dr. Michael Aziz, an internist at Lenox Hill Hospital,
in New York City, who added that having two drugs together could compound
the side effects.

The U.S. Food and Drug Administration is stressing that Qsymia not be
used by pregnant women. Nor should it be taken by people who have had a
recent stroke or unstable heart disease as it can speed up heart rate.
Neither should it be taken by people with glaucoma or hyperthyroidism.

And the drug can only be sold via specially certified drug stores.

“The concern is with it being overprescribed,” Gans said. “There’s the
concern that too many people may have access to it when they simply need
to make diet modifications and not look for some magic solutions.”

The second drug approved in the last month was Belviq (lorcaserin),
also for obese adults who have high blood pressure, high cholesterol or
type 2 diabetes.

Belviq seems to work by controlling appetite, Aziz said, but in trials
it produced limited weight loss.

Belviq may cause serious side effects, including “serotonin syndrome,”
particularly when taken with certain medicines that increase serotonin
levels or activate serotonin receptors, such as drugs used to treat
depression and migraine. The drug may also cause problems with attention
or memory, the FDA said.

Other common side effects of Belviq in non-diabetic patients include
headache, dizziness, fatigue, nausea, dry mouth, and constipation. In
patients with diabetes, side effects can include low blood sugar,
headache, back pain, cough and fatigue, the FDA said.

The cost of the drug is relatively modest, at least compared to other
medications on the market, and may range between $100 and $200 for a
month’s supply, Aziz said.

But neither drug, despite the splash they’ve made in the news, is
likely to make a significant dent in America’s obesity crisis, with
two-thirds of the population either overweight or obese.

“The problem that all the drug companies are overlooking is the fact
that obesity is really multi-factorial,” Aziz said. “It’s not only related
to diet and exercise but also to hormonal imbalances, stress and lack of
sleep.”

More information

For more on obesity, visit the U.S.
National Library of Medicine
.

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