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Two New Drugs May Help In Fight Against Obesity

Filed by KOSU News in Health.
September 24, 2012

The Food and Drug Administration approved two new medications this year to help obese and overweight individuals lose weight. Both drugs have been around in different forms for a while, but now researchers hope one of the two might help actually make a dent in the obesity epidemic.

Both the drugs — Belviq and Qsymia — were approved in July. Belviq works in a similar way to the fen-phen appetite-suppression drug combination that was pulled from the market in 1997 because of a link to fatal heart valve problems. The new drug, at a lower dose, has been shown to be safe.

“Belviq was developed specifically to avoid the receptor on the heart valve which had been associated with heart damage, and there’s no evidence in our research that heart valve problems will develop,” says Dr. Donna Ryan a researcher and obesity specialist at the Pennington Biomedical Research Center, which conducted studies of the two medications for the drug makers.

Qsymia is a time-released combination of two older medications: topiramate, an anti-seizure medicine, and phentermine, a stimulant. It is more powerful than Belviq, but works in a similar way to stave off the body’s “starvation response” to weight loss. Most of us who have tried to lose weight are familiar with that: hormones are released to stimulate appetite, and metabolism slows down in order to conserve energy, adding up to an unfortunate recipe for regaining weight.

Dr. Judith Korner, an obesity specialist at New York’s Columbia University Medical Center, says her patients know this well.

“I have one patient who came in and said he’s lost the weight of a Volkswagen during his lifetime,” she says. “It’s like 2,000 pounds; he’s lost 100 pounds and gained it back; lost and re-gained.”

Ryan says the drugs work to make you feel satisfied with less food — and not as hungry between meals.

“The medications are working through biology to reduce appetite, diminish hunger, improve satiety,” she says, adding people still have to diet.

The drugs don’t work magic in the body. They simply help people eat less.

“Patients must intentionally go on diet, reduce food intake, and increase physical activity,” Ryan says.

Side-Effects

The new medications don’t do anything to boost metabolism. Only exercise helps with that. There are side-effects from the medications, including dry mouth, constipation and a slight tingling in fingers and toes.

But Qsymia can also have serious side-effects. It can increase heart rate, and it can cause birth defects. So, women who want to become pregnant should stay away from the drug. Both drugs must be prescribed by a doctor. Women taking Qsymia will be required to take a monthly pregnancy test.

Belviq may interfere with treatments for migraine headache or depression. Patients should consult with their doctor to see if either drug is right for them. Neither is right for people “who want to lose weight for wedding or get into their bikini for summer,” Ryan says. They were approved to treat people who are obese (body mass index over 30) or who are overweight (body mass index over 27) and who suffer from at least one weight-related problem such as high blood pressure, cholesterol or blood sugar.

Decreasing blood sugar, in particular, says Ryan, is the drug’s biggest benefit.

“We know if we can get that modest weight loss, we can prevent the development of type 2 diabetes; chronic disease reaching epidemic proportions in U.S. and really need to get a jump on that,” she says.

In studies, patients lost between 4 and 8 percent of their original body weight, and diabetes risk was reduced.

Korner says the new medications are a welcome option for her patients, most of whom do not want to have surgery to reduce the size of their stomach.

“We’re slowly starting to come around to treat obesity as we treat other chronic diseases just like we do for controlling blood pressure, cholesterol and a multitude of other diseases,” she says.

But Cindy Pearson, with the National Women’s Health Network, cautions those benefits may not be enough to justify potential risks.

“Both of these drugs have met a very modest test of around 5 percent weight loss, and there’s hope that over the long term, if you can maintain 5 percent weight loss that you can get health benefits, but we actually don’t know if its true,” she says.

Pearson says long-term studies are needed to ensure both drugs’ safety.

“We really think women and all consumers deserve better information before these drugs are marketed widely,” she says.

Qsymia is expected to be available this month; Belviq around the beginning of next year. [Copyright 2012 National Public Radio]

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