These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Phen Fen
Question: I am 49 and in good health. Over the past 10 months, I’ve lost 45 lbs. I started taking Phen Phen in January due to doctor’s suggestion. I’m almost at my goal. I’m afraid that when I go off the drugs, that I will gain back the weight. Is there an easy way to gradually go off Phen Phen? I see many of my friends that have gained back all of the weight.
Answer: Unfortunately, like many forms of weight loss, the weight tends to return after stopping the diet or medications. I know of no way currently to keep the weight off without changing your lifestyle; that is, exercising more and eating less. Tapering will not help much.
Phen-Fen
Question: I am considering beginning a treatment of Phen-Fen. Could you provide
me with information on it?
Answer: Medicine has attempted for many years to find an agent or drug which would aid in weight loss. Unfortunately, the only drugs which had any effect were amphetamines, but they were very addictive and generally only effective for a month at best. About two years ago research was published in several reputable medical journals concerning the use of phentermine resin(Ionamin) and flenfluramine(pondimin) in combination which resulted in sustained weight loss with minimal side effects. Subsequently, a second drug – Redux(dexfenfluramine) has been added to the list . These medications appear to work through a brain chemical called serotonin although the mechanism is not exactly clear. But patient’s hunger was reduced with reduction in serotonin levels. Since the publication of this research, literally millions of patients have been placed on these drugs. In general, I find them very effective with sustained weight loss while taking the pills, but like many weight loss regimens, gain of weight after cessation. Side effects generally are dry mouth, diarrhea, constipation, drowsiness, headaches and fatigue. These drugs should not be taken with other anti-depressants(particularly MAO inhibitors, SRI anti-depressants), and Imitrex(migraine medication). It should not be taken under the age of 18, while breast feeding, or if glaucoma is present or while taking other weight loss drugs. Since the initial publication, there have been reports of an increased incidence of pulmonary hypertension with these drugs. This is an uncommon, but potentially fatal side effect. This has caused many physicians to avoid these drugs unless there is a distinct medical benefit from losing weight – like diabetes, hypertension, etc. The companies only recommend the drug if your body mass index is high. This is calculated by dividing your height in inches into your weight. Levels above 2.8 or 2.9 qualify for the drug. Currently, there is insufficient data to know the true risk of pulmonary hypertension. However, these drugs should not be used casually unless there is a clear medical risk until further research is performed on the true incidence of pulmonary hypertension.
