Are Weight Loss Drugs Safe?

• Since 1997, 6 weight loss drugs have been
removed from the market:
o Fenfluramine  & dexfenfluramine (heart
valve abnormalities, primary pulmonary HTN);
o phenylpropanolamine (strokes in females);
o phentermine, diethylpropion, & mazindol
 (discontinued by manufacturers;
concerns with abuse and adverse events CNS & CV).
• Sibutramine was temporarily suspended from the
market in Italy, citing tachycardia, hypertension,
arrhythmia & cardiac arrest.  An increase in
BP of 1-3mmHg & heart rate of 4-5 beats/min can
result from sibutramine use; however it is unclear
if any increase in cardiovascular risk is offset by
the reduction in body weight.
• Orlistat is minimally absorbed (<5%); however,
tolerability due to GI adverse events is an issue.
{Discontinuation GI, Lab ~2x  vs placebo 8% vs 4%.}
Absorption of fat soluble vitamins is decreased,
yet remains within range (but a daily multivitamin
is recommended).  The FDA USA is considering
approving a 60mg strength for OTC sale.
• Long term safety has not yet been established.
Adverse reaction reporting is encouraged.