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| Obesity | |||
| Prevalence (home) | |||
| Definition | |||
| Causes | |||
| Why Be Worried? | |||
| Psycho-Social Factors | |||
| Medical Complications | |||
| Medical Treatments | |||
| Disastrous Therapies | |||
| "Phen/fen" | |||
| Dexfenfluramine | |||
| Diuretics/Thyroid/etc. | |||
| Current Obesity Meds | |||
| Comprehensive Treatment | |||
| Surgical Options | |||
| Future Options | |||
| Gimmicks & Low Carbs | |||
| FAQ's | |||
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| Weight Management Programs | |||
| For Patients | |||
| For Injured Workers | |||
| For Case Managers | |||
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| Eating Disorders | |||
| Compulsive Overeating | Diagnostic Criteria | ||
| Eating Behaviors & Moods | |||
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| Resources | |||
| Patient Education | |||
| Obesity Education Programs (first airing June, 2004) | Consulting & Med-legal Asst | ||
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| Cigna Hall of Shame | |||
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| Accessibility/Section 508 | |||
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| Office Location/Appts. | |||
| Michael D. Myers, M.D.,Inc. | |||
| 10601 Walker Street, Suite 250 | |||
| Cypress, CA (U.S.) 90630 | |||
| Voice: (562) 493-2266 | |||
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Phentermine combined with fenfluramine ("Phen/Fen Diet"): How well does this combination work? (written in 1995)
IMPORTANT NOTICE:
The information below was written before fenfluramine was withdrawn from the market because of its association with valvular heart disease. This information is provided to give some perspective on the use of this combination and what went wrong.
Most people have heard of combining phentermine with fenfluramine ("phen/fen diet") in an attempt to control weight. Michael Weintraub, et al in a series of studies (Long-term weight control Study I , II, III, IV, V, VI, & VII in Clin Pharmacol Ther; May 1992) studied these medications in individuals over a period of 210 weeks. Both medications are anorexics (appetite suppressants) that help diminish appetite by different mechanisms of action. Phentermine is a stimulant acting through noradrenergic and dopaminergic pathways resulting in decreased appetite and less frequent eating. Fenfluramine acts through serotonergic mechanisms resulting in a feeling of increased satiety. Phentermine may produce "mild" side effects such as nervousness, irritability, insomnia, agitation, dizziness, dry mouth, constipation, elevated blood pressure, and rapid or irregular heartbeats.
Fenfluramine may produce somewhat opposite effects with drowsiness, sedation, diarrhea, and depression. Both medications can lead to serious side effects, with fenfluramine being associated with primary pulmonary hypertension, a life-threatening complication. Furthermore, in July 1997, a new complication (valvular heart disease) was found to be associated with the use of "phen/fen". The thinking was that by combining these two medications, one could take advantage of their different pharmacologic actions and get, in essence, better effectiveness while (hopefully) minimizing the "mild" side effects. The results of the studies are summarized below.
Patient participation
Patients were 18 to 60 years of age and weighed between 130% and 180% of their ideal body weights according to the 1983 Metropolitan Life Insurance Tables. The patients were in good health, not taking any long-term medications, and did not have hypertension (high blood pressure), diabetes, or other chronic diseases.Medication
Phentermine resin (15 mg) combined with Fenfluramine (60 mg).Behavior therapy
Active and ongoing behavior therapy with professionals trained in behavior modification techniques was an integral part of the study.Caloric restriction
All individuals received individualized dietary counseling by dieticians to help limit calorie consumption to between 1500-1800 kcal per day for men and between 1000-1200 kcal per day for women.Exercise
The participants in the study were started on graded exercise programs to expend at least an extra 300 kcal three times per week over their usual daily activities.Medical monitoring
All participants were seen by physicians at regular intervals during the study, with periodic laboratory and electrocardiographic monitoring.Page 1 of 7 | Next page
The above information is for general purposes only and should not be construed as definitive or binding medical advice. Because each person is medically different, individuals should consult their own personal physicians for specific information and/or treatment recommendations.