Well, it’s official. The inmates are now running the asylum. Reversing an earlier decision, the medical experts on FDA’s Drug Panel cleared the way for a new weight-loss drug that is supposed to suppress the appetite. Lorcaserin—to be marketed as Belviq in the United States—was rejected in 2010 for causing tumors in tested animals, plus the drug is also linked to a variety of other side effects ranging from memory lapse to depression. The FDA also says the effect of Belviq on the long-term risk of having, or dying from, a heart attack or stroke has also not been evaluated.
And literally as I wrote and posted this blog, the FDA approved another new weight-loss drug called Qsymia for adults who are obese or overweight and have at least one weight-related condition such as high blood pressure, diabetes or high cholesterol. This drug is actually a combination of two older drugs that have been known to help with weight loss: phentermine and topirimate. Phentermine helps suppress appetite and topiramate is an anticonvulsant, and it helps people feel more satisfied after eating. Although the pill has shown to help with weight loss, there is concern over potential side effects, including increased heart rate, birth defects and a condition called metabolic acidosis, which may lead to hyperventilation, fatigue and anorexia.
The quest for a safe weight loss pill has been filled with bumps along the way. In the 1950s and ’60s, amphetamines were used for weight loss but the pills were highly addictive and dangerously increased blood pressure and heart rate. In the 1990s, a combination drug called fen-phen (fenfluramine) was recalled because one-third of people taking it experienced heart valve damage, resulting in more than a $13 billion settlement of tens and thousands of personal injury lawsuits. Phentermine (which is in the new drug Qsymia) is the “safer” part of the notorious fen-phen combination.
Now this. While patients and doctors are eager for new obesity treatments, the pills are far from magic. When you think of a weight-loss pill, the ultimate fantasy is to be able to pop the pill, eat as much or whatever you want and never have to exercise. The reality? Even when taking a weight-loss pill, you need to change your diet and exercise. And as far as lorcaserin is concerned, the weight-loss results were modest. One clinical trial found that two-thirds of patients on the drug lost 5% of their body weight, while one-third lost at least 10%, after one year of taking the drug as a supplement to diet and exercise. The average weight loss was 17 to 18 pounds. Patients in clinical trials taking Qsymia lost 6.7% of their body weight in one study and 8.9% in another study. On Qsymia, average weight loss was around 23 pounds.
These new drugs, like all the previous attempts, come with certain health risks including heart disease. Are you willing to risk heart disease, stroke, depression and memory lapses just for the potential of a relatively modest, not-so-quick fix? While you may lose more weight on Qsymia, once again is it worth the risk of increased heart rate and birth defects? There is even a warning on the label warning that women of childbearing age should use birth control while taking Qsymia.
Why take the risk of any of these potential side effects when an Atkins way of eating can accomplish the same weight-loss results (if not better) while improving your health at the same time? The ultimate issue isn’t which drug is better or worse; it’s the continuing failure to recognize that drug therapy is inappropriate for any condition that can be improved with lifestyle and dietary changes.