March 24, 2000 (Lake Worth, Fla.) — People have been looking for a safe and
effective diet pill ever since two highly effective but potentially dangerous
drugs — fenfluramine (part of the Fen-Phen combination) and Redux –were taken
off the market. Meridia (sibutramine) is looking to take their place in the
land of weight loss promises, but does it really cut the fat?
A new study from Mexico shows that Meridia is effective, with participants
who took the drugs meeting their goal of a 5% loss of total body weight over
six months. But a significant number of study participants who took a placebo,
or sugar pill, met that goal as well.
The Mexican study, which involved 109 obese patients, is reported in the
February issue of the International Journal of Obesity. All the patients
were advised to eat a low-calorie, high-carbohydrate, and low-fat diet; half
took Meridia and half took the placebo. Researchers looked at the participants’
body mass indexes (BMI) and hip-to-waist ratios as well as their weight.
Of those taking Meridia, 85% met their 5% weight loss goal, but 48% of those
on the placebo met this goal as well. Still, even those patients remained
significantly overweight. They went from an average BMI of 36 to about 32.5.
Anyone with a BMI above 27 is considered overweight, and those with BMIs over
30 are classified as obese.
Meridia is an appetite suppressant that helps to curb food cravings. It
works through the serotonin system, much as antidepressants do. The study’s
authors note that the main side effect of Meridia is a dry mouth, although some
patients experienced constipation, elevated blood pressure, and a rapid
pulse.
“Sibutramine induces significant loss of body weight, BMI and waist
[circumference], but does not significantly affect cardiovascular
function,” the authors write.
This statement concerns Richard Dickey, MD, president of the American
Academy of Clinical Endocrinologists. “There have been patients who have
had clinically significant rises in blood pressure and pulse with
sibutramine,” says Dickey, who reviewed the study for WebMD. “Just
because these people did a study with 109 patients doesn’t mean it doesn’t do
that.”
Patients who take Meridia should have their blood pressure and pulse
monitored to see if they have any ill effects from the drug, Dickey says.
Overall, he says, it’s a safe and effective diet aid that must be used in
conjunction with a low-calorie diet, exercise, and behavioral modification.
Mike Myers, MD, who also reviewed the study for WebMD, agrees with Dickey’s
take on the study. “Sibutramine is not a wonder drug, [but] it does have
its place and it can assist with weight loss,” he says. “Assist” is
the operative word, as diet and exercise are still very important to any weight
loss program, both physicians say. Myers is a primary practice physician in Los
Alamitos, Calif. A member of the North American Association for the Study of
Obesity, he specializes in weight management and eating disorders.

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