Weight Loss Drugs for Obesity, Helpful Treatment (cont.)

But researchers have found no side effects like those of fen-phen.

"Any medication carries risk," says Wyatt. "But at this point, I think that [Xenical and Meridia] are as safe as any other medication that we routinely prescribe." In fact, because of the fen-phen debacle, she thinks that weight loss drugs may be held to an even higher level of safety than other types of medicine.

Wyatt also observes that the very small risks of these drugs have to be compared to the real risks of obesity, such as high blood pressure, diabetes, stroke and heart disease. For people who are very obese, another way to frame the choice could be to compare the low risks of weight loss drugs with the higher risks of bariatric surgery, often called stomach stapling.

The Future of Weight Loss Medications

Many doctors and researchers hope the weight loss drugs of the next decade will make Xenical and Meridia look crude. As researchers learn more and more about the complex set of mechanisms that regulate our weight, the drugs we use will become increasingly sophisticated.

A number of medications are now in various stages of development with more specific targets. Many are designed to affect some of the hormones -- such as leptin -- that play a role in appetite and weight regulation.

Wyatt has modest hopes for new weight loss drugs in the immediate future. "I don't see any of the new drugs as obvious blockbusters," she says. She points out that we may need combinations of new drugs to have a substantial effect. The problem is that there are so many different mechanisms that affect our weight that just targeting one may not be enough.

Bray says we'll just have to wait. "Until we get the data from the long-term trials of these drugs," he tells WebMD, "we just won't know how safe or effective they are."

"We're really just in the early stages of using weight loss drugs," says Wyatt. "It's just like when we first began to use drugs for high blood pressure, and they didn't work all that well and caused a lot of side effects. But we'll get better drugs, and as we do, doctors will use them more and more."

So barring some unforeseen breakthrough, weight loss drugs are not going to be "the answer" to obesity any time soon. But along with diet and exercise, they can be an important part of the solution.

Published May 6, 2004

SOURCES: George A. Bray, MD, Boyd Professor at Louisiana State University; professor of medicine at the LSU Medical Center. Holly R. Wyatt, MD, assistant professor of medicine, division of endocrinology, University of Colorado Health Sciences Center, Denver. Wyatt, H. Postgraduate Medicine, January, 2004; vol. 115. National Institute of Diabetes and Digestive and Kidney Diseases. National Center for Biotechnology Information. WebMD Medical News: Xenical May Cut Type 2 Diabetes Risk. WebMD Medical News: New Weight loss drugs Pass First Tests. WebMD Medical News: "FDA Approves Weight Loss Pill for Teens." WebMD Scientific American Medicine, Endocrinology: X. "Obesity." WebMD Medical News: "Next Miracle Weight-Loss Drug?" WebMD Medical News: "Growth Hormone May Be Fat Fighter." WebMD Medical News: "A Hormone That Helps You Feel Full."

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