Combined Drug Treatment of Obesity

Atkinson, Richard L.; Blank, Roy; Loper, Joyce E.; Schumacher, Donald; Lutes, Richard A.

doi:10.1002/j.1550-8528.1995.tb00218.x

Cited by 44 publications

(33 citation statements)

References 12 publications

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“…Clearly, these findings might have been different if medications had not been adjusted in patients. Further studies using more sophisticated measures of cognitive function are needed to assess complaints of memory loss, which were reported by about 10% of persons treated in a large private practice setting (4). Patients in the present study also reported significant improvements in mood with weight loss, thus, confirming previous findings (33).…”

Section: Discussionsupporting

confidence: 88%

“…Such studies should compare the results of brief, protocol-guided therapy not only with group behavior modification but also with treatment by pharmacotherapy alone, as is likely to be dispensed in busy primary care practices. We, like others (4,19,24,25,26), believe that the best results will be obtained when patients combine medication with their own efforts to modify eating and exercise habits. This belief is supported by the finding in the present study that the more food records patients completed during the first 18 weeks of treatment, the greater their short-and long-term weight losses.…”

Section: Discussionmentioning

confidence: 75%

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Lifestyle Modification in the Pharmacologic Treatment of Obesity: A Pilot Investigation of a Potential Primary Care Approach

et al. 1997

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In addition, half of the women were randomly assigned to traditional group behavior modification, conducted by a nutritionist, which included 32 75-minute sessions during the year. The other half were provided lifestyle modification by a physician during 10 15-20 minute structured visits. All participants received identical treatment manuals and comparable assignments for behavior change. At the end of one year, patients in the physician group achieved the same highly successful weight losses as those treated by group behavior modification (13.9 9.6 kg vs. 15.4 f 7.9 kg, respectively). Treatment was associated with highly significant improvements in lipids and lipoproteins, as well as in mood and several measures of appetite. Weight loss the first four weeks, as well as patient completion of daily food records during the first 18 weeks, correlated positively with weight loss at weeks 18, 26, and 52. Results of this study await replication using larger samples but strongly suggest that effective lifestyle modification can be provided during brief, structured physician visits. The findings are discussed in terms of their implications for the treatment of obesity in primary care practice.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 75%

Lifestyle Modification in the Pharmacologic Treatment of Obesity: A Pilot Investigation of a Potential Primary Care Approach

et al. 1997

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“…As both norepinephrine and serotonin affect food behaviour, and as drugs acting on either norepinephrine or serotonin are available, the temptation was high to combine such compounds (especially phentermine fen¯uramine in the US and amfepramone fen¯uramine in some European countries such as Belgium) in order to improve the ef®cacy on weight loss or to minimize side effects by reducing the dosage of each anorectic agent. 16 The combination of phentermine and fen¯uramine has attracted considerable medical and media attention in the US since the publication of a long-term trial which suggested the ef®cacy and safety of such a combination, 17 and these results were con®rmed in another large study. 16 However, the recent publication pointing out the risk of severe valvular cardiac abnormalities with the combination phentermine ± fen¯uramine, 11 associated with the potential risk of pulmonary hypertension, 10 has recently thrown discredit on such a combined therapy.…”

Section: Serotoninergic Drugsmentioning

confidence: 99%

Pharmacological treatment of obesity: present status

Scheen

Lefèbvre

1999

Int J Obes

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OBJECTIVE: Obesity poses a serious health hazard and its treatment is often disappointing. This review describes the present status of pharmacological treatment of obesity in man. DESIGN: Obesity treatment may include drugs that reduce food intake, drugs that increase energy expenditure and drugs that affect nutrient partitioning or metabolism. The mode of action, ef®cacy and safety of each approach will be brie¯y discussed. RESULTS: All of the pharmacological possibilities have potential activities, but also serious limitations. While current anti-obesity pharmacotherapy essentially uses centrally-acting anorectic drugs, severe side-effects (more particularly pulmonary hypertension and valvular heart disease) have been reported, leading to the withdrawal of licensed fen¯uramine and d-fen¯uramine. New approaches have been recently proposed, such as sibutramine, an amine reuptake inhibitor which decreases food intake, and orlistat, an intestinal lipase inhibitor which decreases fat absorption.Obesity is a chronic disease and should be treated as such with reasonable expectations. Large-scale one-year placebo-controlled studies demonstrated that d-fen¯uramine, sibutramine and orlistat signi®cantly increased body weight loss by an average of 2 ± 4 kg when compared to placebo and, more interestingly, multiplied by 2 ± 3 the number of patients who succeeded in obtaining and maintaining a reduction of more than 10% of initial body weight. Interestingly, some of these compounds may also exert favourable effects on other vascular risk factors, independently of weight loss. CONCLUSIONS: Even if all anti-obesity pharmacological approaches can be helpful, they also have important limitations so that other strategies including either combined therapies or new drugs (peptides) are currently under investigation.

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“…One must be cautioned not to extrapolate the data to longer periods as rates of compliance, pharmacological actions, metabolic benefits and safety remain to be evaluated. As recently stated (20) more research is needed to document long term efficacy of combined drug treatment of obesity, particularly the long-term safety of fluoxetine and dexfenfluramine and other combinations.…”

Section: Discussionmentioning

confidence: 99%

The Addition of Dexfenfluramine to Fluoxetine in the Treatment of Obesity: A Randomized Clinical Trial

et al. 1996

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PEDRINOLA, FILIPPO, CLAUDIA SZTEJNSZNAJD, NICOLAU LIMA, ALFRED0 HALPERN AND GERALD0 MEDEIROS-NETO. The addition of dexfenfluramine to fluoxetine in the treatment of obesity: A randomized clinical trial. Obes Res.Current evidence demonstrates that pharmacologic agents, alone or in combination produce short-term weight-loss and may remain effective for extended periods of time in obese patients. We have evaluated the weight loss of a selective inhibitor of serotonin uptake, fluoxetine, alone as compared with combined therapeutic trial with another serotoninergic drug, dexfenfluramine. Thirty-three patients were randomly assigned in a double-blind randomized clinical trial divided to two groups: Group I [Fluoxetine 40 mg and placebo (n=13) tively minor and no altered clinical vital signs or abnormal laboratory values were observed. We concluded that the combination of fluoxetine (daytime) and dexfenfluramine (at night) may be more effective than fluoxetine alone in weight reduction although the small size of this study does not permit broad generalization.

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Combined Drug Treatment of Obesity

Cited by 44 publications

References 12 publications

Lifestyle Modification in the Pharmacologic Treatment of Obesity: A Pilot Investigation of a Potential Primary Care Approach

Lifestyle Modification in the Pharmacologic Treatment of Obesity: A Pilot Investigation of a Potential Primary Care Approach

Pharmacological treatment of obesity: present status

The Addition of Dexfenfluramine to Fluoxetine in the Treatment of Obesity: A Randomized Clinical Trial

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