Study: Drug Helps Keep Weight Off

LONDON (AP) â€” As every seasoned dieter knows, the real struggle isn't so much losing weight, but keeping it off. <br><br>Now, new research suggests a long-term weight-maintenance pill could be at

Friday, December 22nd 2000, 12:00 am

By: News On 6

LONDON (AP) â€” As every seasoned dieter knows, the real struggle isn't so much losing weight, but keeping it off.

Now, new research suggests a long-term weight-maintenance pill could be at hand. A study published this week in The Lancet medical journal found that sibutramine, marketed as Meridia in the United States, tripled the chances of obese people keeping off 80 percent of the weight they had shed for at least two years.

``It's extremely well tolerated and the success rate is remarkable,'' said Dr. Mike Lean, an obesity expert at the University of Glasgow who was not connected with the study. ``It's clearly got evidence of long-term prevention of weight gain.''

But it's no miracle pill, said the study's lead researcher, Dr. Philip James, a professor at the Rowett Research Institute in Aberdeen, Scotland, and chairman of the International Obesity Task Force, an independent worldwide scientific organization.

Better diet and exercise habits are still crucial, experts say, but the drug seems to help people make those necessary changes by making them feel full on less food.

``People who simply advise diet and exercise for individuals are helping only a small proportion of people,'' James said. ``Only about 10 percent to 15 percent manage to keep it off.''

``In this study, 43 percent of those on sibutramine kept the weight off. That's phenomenally impressive,'' James said. ``This drug trebles the number of people who can cope on a long-term basis.''

The pill did raise blood pressure in some people and slightly increased the heart rate, side effects experts say need more study. Also, it is too soon to tell whether the drug will keep working over the long term.

Researchers have found no evidence the pill damages heart valves â€” a concern that led to the withdrawal in 1997 of fenfluramine, part of the popular anti-obesity cocktail fenfluramine-phentermine, or fen-phen.

While fen-phen acts by making the brain produce more of the chemicals seratonin and noradrenaline, the new drug doesn't influence the amount released but inhibits the brain from mopping the chemicals back up, prolonging the time they are available.

The drug is made by the Knoll Pharmaceutical unit of Germany's BASF Pharma, which partly funded the study. About 4 million people worldwide take the drug.

About 20 percent of the adult population in the United States is obese, according to the U.S. Centers for Disease Control and Prevention. In Europe, experts estimate about 15 percent of men and 20 percent of women are obese. Reliable estimates for the rest of the world are not available, but researchers say the problem is escalating across the globe.

Another long-term drug option could be Orlistat, trade-named Xenical. Orlistat works by blocking absorption of about one-third of fat that people eat, but experts say it can cause loose stools.

In the study, 605 obese people took sibutramine for six months. They were put on a diet that cut 600 calories from their previous daily intake and took a brisk walk every day that lasted between 30 and 45 minutes.

They had an average weight of 220 pounds and a body mass index of at least 30, the threshold between being overweight and obese. After six months, those who had lost more than 5 percent of their body weight â€” 77 percent of the original group â€” were randomly assigned to continue taking the drug or a fake pill for a further year and a half at an individually tailored dose.

Two years after the study began, 43 percent of those taking the pill all along kept 80 percent of their weight off, compared with 16 percent of those taking the dummy pill.

Obesity expert Dr. Xavier Pi-Sunyer, chief of endocrinology at St. Luke's Roosevelt Hospital in New York, said the findings look encouraging for a long-term drug, but that the blood pressure and heart-rate increases â€” four beats per minute â€” noted with the drug need to be monitored carefully.

Lean said the blood pressure increase appears to affect few people, can be spotted easily and the drug can simply be discontinued.

Blood pressure hikes led 18 patients to drop out of the study, but people who already had high blood pressure when they started improved while taking the pill, the study found.

â€”â€”â€”

On the Net:

International Obesity Task Force, http://www.iotf.org

The Lancet, http://www.thelancet.com