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Diet Drug Works Even If Not Taken Daily

Pounds shed even when Meridia is taken intermittently

WEDNESDAY, Sept. 19, 2001 (HealthDayNews) -- You don't have to take the weight-loss drug Meridia each and every day to drop those extra pounds.

That's what a new study suggests after comparing the treatments of 1,001 obese patients at 108 doctors' offices and three university hospitals throughout Germany. The results appears in today's issue of the Journal of the American Medical Association.

The research confirms what several other studies have found about Meridia, also known as sibutramine: It helps people lose pounds, and it helps people keep those pounds off. But the German study goes one step further, and shows that Meridia can be used intermittently or continuously with the same results.

"With respect to long-term weight loss over 48 weeks, the continuous and intermittent treatments were demonstrated to be equivalent," the study's authors write.

And that's good news for folks who want to lose weight with a minimum of medical intervention, one expert says.

"A lot of people don't like to take medicine to lose weight," says Dr. Donald A. Smith, director of lipids and metabolism at the Cardiovascular Institute at Mount Sinai Medical Center in New York City. "You can actually get some respites from the medicine you start with, and still get some good weight loss."

The researchers stress the drug is not a panacea, and should always be considered as a companion therapy to exercise and dieting.

In the German study, 1,001 obese adults were first put on a four-week regimen of 15 milligrams of Meridia a day, although 214 patients did not complete the study. During that initial period, all the patients lost roughly the same amount of weight: 8.8 pounds. After that, the people were randomly assigned to three groups. One received 15 mg of Meridia every day for 44 weeks. Another group received the 15 mg of Meridia on an intermittent basis, and the third group took a placebo for 44 weeks.

Overall weight loss during the 48-week period was 17.38 pounds for the first group, 17.16 pounds for the second, and 8.36 pounds for the third. More than 60 percent of the patients in the first two groups lost 5 percent or more of their body weight, while only 35 percent of the placebo group was able to do as well.

"As even a moderate weight loss of approximately 5 percent provides unquestionable benefits for obese patients, the number of patients achieving such a weight loss reflects the possible advantage of a treatment with sibutramine," the researchers write.

Although spikes in blood pressure have been observed in other Meridia studies, no changes in blood pressure were found in any of the three groups in the German study. Some patients did experience dry mouth, constipation, sweating and headaches, but researchers note those side effects subsided over time.

Scientists are not sure how Meridia works, but they say it does raise levels of two chemicals in the brain, serotonin and norepinephrine. It may also increase your metabolic rate, the researchers say. The drug is designed for obese patients with a body-mass index over 27 who also have diabetes or high cholesterol, or for people with a body-mass index of 30 or higher who are otherwise healthy.

Knoll Pharmaceuticals, which was recently acquired by Abbott Laboratories, discovered the drug's powers by accident while researching its use as an antidepressant. The company's German arm funded the latest study.

"Basically, the study is another indication of the safety and effectiveness of sibutramine as a medication for weight loss," says Cindy Resman, a spokeswoman for Abbott Labs. She notes the company has other Meridia studies underway, including ones that look at teen usage and the effect of Meridia on the health problems that often accompany obesity. A closer look at intermittent use of the drug and even longer-term studies would also be warranted, she adds. Since the drug first became available in 1998, 4 million prescriptions have been written for Meridia.

"Obesity is not just a cosmetic thing," she says. "It's a medical condition. We need to make sure we look at co-morbidity conditions, and the health benefits of weight loss."

"The problem with obesity is so enormous in this country. The real hope in the whole obesity area is to understand the biochemistry and make drugs that target the problem," says Smith. "As someone who sees people who want to lose weight, it's wonderful to see a safe drug that's efficacious."

What To Do

Go here for more on Meridia.

The National Institutes of Health has set these guidelines for the treatment of obesity.

SOURCES: Interviews with Donald A. Smith, M.D., director, lipids and metabolism, Cardiovascular Institute, Mount Sinai Medical Center, New York, and Cindy Resman, spokeswoman, Abbott Laboratories, Chicago; Sept. 19, 2001 Journal of the American Medical Association
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