Dear Alice,

I only caught half of a TV segment that highlighted possible health effects of the fenfluramine and phentermine combination of drug therapy used to assist in weight loss. I have been on the regimen for two months, with a 20 pound loss, and would like to continue another month to see if I can shave off another five to ten pounds. I believe that they referred to pulmonary hypertension, but I don't know what circumstance (prior conditions, dosage errors, etc.) causes this to be a concern. The fen-phen pages I have been able to access on the Internet thus far have no information on this and the one doctor I tried to ask about this gave a contrite answer advising me that if my doctor knows the right doses to give, I shouldn't worry about it. Any information you have will be much appreciated!

Dear Reader,

Fen-Phen? No-No. The fenfluramine-phentermine (fen-phen) drug combination was discontinued in the late 1990s due to health risks. It may be a helpful lesson, though, to understand how fen-phen worked and why it is no longer in use.

Obesity, which is linked to a number a health problems, is a growing health concern in the U.S., and indeed, much of the world. As with other health problems, finding a pharmacological solution to obesity prompted the development of weight loss treatments since the mid 20th century. Fenfluramine (tradename Pondimin) had been available in the U.S. since the 1970s as a weight loss drug. It worked by releasing extra serotonin into the body, resulting in feelings of satiety, or fullness. This extra serotonin may have led to side effects such as drowsiness and altered moods.

When, in the 1980s, the stimulant phentermine (aka "phen") was found to offset the negative side effects of fenfluramine when the two were taken together, fen-phen shot to stardom in the 1990s, though it had never been approved by the U.S. Food and Drug Administration (FDA). Furthermore, in the mid-1990s, dexfenfluramine (tradename Redux), a pharmacological relative of fenfluramine, was introduced to treat long-term obesity. While these drugs did seem to help people lose weight, they were linked to some unsavory side effects.

In 1997, the FDA received reports of heart-valve disease in individuals who were taking fen-phen. As a result, fenfluramine (Pondimin) and the short-lived dexfenfluramine (Redux) were taken off the market and the fen-phen drug combo has not been available since September 15, 1997. If you are interested in learning more about fen-phen and its eventual termination, you may want to read Dispensing with the Truth by Alice Mundy. A diet drug that is currently available, Meridia (sibutramine), also has its share of controversy, as it may be linked with increased heart rates and high blood pressure.

If you are considering losing weight, you may want to consider having a chat with a health care provider, who may be able to make recommendations, i.e., diet and exercise, based on your individual circumstances. If you are a student at Columbia, you can make an appointment with a nutritionist at Primary Care Medical Services by calling x4-2284 or by logging into Open Communicator.

Individuals may have different reasons for wanting to lose weight, owing to a combination of personal and external factors. Whatever they may be, weighing the health risks and benefits of any weight loss regimen with a health care provider may help you reach your weight loss goal, as safely as possible.


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