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Combination Weight Loss Drugs Appear Effective for Obesity

Naltrexone and bupropion plus modified diet and exercise help individuals lose 5 percent of weight

FRIDAY, July 30 (HealthDay News) -- Treatment with two obesity drugs, naltrexone and bupropion, plus lifestyle modification appears effective in helping people lose 5 percent or more of their excess body weight, according to research published online July 30 in The Lancet.

Frank L. Greenway, M.D., of the Louisiana State University System in Baton Rouge, and colleagues randomized 1,742 men and women aged 18 to 65, with a body mass index (BMI) of 30 to 45 kg/m² and uncomplicated obesity or BMI of 27 to 45 kg/m² with comorbidities, to a mild hypocaloric diet and exercise and either: sustained-release (SR) naltrexone 32 mg daily plus SR bupropion 360 mg daily, SR naltrexone 16 mg daily plus SR bupropion 360 mg daily, or placebo.

Of the 1,453 participants included in the final analysis, 48 percent taking naltrexone 32 mg plus bupropion, 39 percent taking naltrexone 16 mg plus bupropion, and 16 percent of those on placebo lost 5 percent or more of their body weight. Those receiving the combination therapies were more likely than the placebo group to experience headache, constipation, dizziness, vomiting, and dry mouth; nausea was experienced by 29.8 percent of participants in the naltrexone 32-mg group, 27.2 percent in the naltrexone 16-mg group, and 5.3 percent in the placebo group. The combination treatment groups also experienced a transient increase of about 1.5 mm Hg mean systolic/diastolic blood pressure, and then a drop of about 1 mm Hg below baseline.

"A sustained-release combination of naltrexone plus bupropion could be a useful therapeutic option for treatment of obesity," the authors write.

Eight authors disclosed financial and other ties to pharmaceutical and/or medical device companies, including Orexigen Therapeutics which provided funding for the study. One author holds three patents related to obesity treatment.

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