Diet Drugs Disaster—A Triple Threat

by Heidi Stevenson

23 October 2009

Always looking for the next blockbuster, Big Pharma has three sorta new drugs in the pipeline to cram down the throats of people desperate to lose weight. As has proven true in the past, these products appear poised to do more harm than good. All of them change brain chemistry in potentially dangerous ways—in some cases, the dangers are already known. None of them focus on the underlying reasons for obesity.

If Big Pharma wants to sell it, then its claims are probably too good to be true. If it sounds too good to be true...

A Brief History of Diet Drugs

Diet pills have a dark history:

• Dinitrophenol (DNP) was discovered by a couple of Stanford doctors in the early '30s. They found that DNP could cause quick weight loss by turning calories to heat, instead of fat. In other words, it produced fever. Unfortunately, there were a few side effects, including death and blindness. On coming into existence, one of the FDA's first acts was to ban DNP.
• Amphetamines: During the 1950s, amphetamines came into use as prescription drugs for weight loss. They function by speeding up the body's metabolism. Amphetamines are now commonly known as speed or meth. Of course, increasing the metabolic rate also increases heart rate, alters mood, and causes ongoing insomnia. The drugs are very addictive. Now they're illegal, but were once pushed heavily by doctors, with predictable results: massive numbers of people, mostly women, became addicted. Many died. Lives were destroyed.
• Fen-Phen, a combination of two other drugs, fenfluramine and phentermine, hit the markets in the mid 90s, in spite of evidence that it caused primary pulmonary hypertension, a potentially deadly disorder, doctors quickly got on the bandwagon to dole these pills out. Within two years, the Mayo Clinic reported that Fen-Phen caused damage to heart valves. The FDA pulled the drug within a month.
• Orlistat (Xenical) is sold over the counter as Alli. It works by blocking fat digestion in the intestines and causing diarrhea. Aside from the obvious unpleasantness, there is also the fact that fats are necessary nutrients, so destroying the ability to digest them cannot be healthy.
• Sibutramine, an SNRI, is a failed antidepressant. The FDA wouldn't approve it for that purpose, but gave the go-ahead for use as a diet drug. It's known to cause amnesia, anaphylaxis, manic disorder, chronic heart failure, suicide, and a host of other life-risking and destructive disorders. It's sold under the name Meridia in Canada, Ectiva in South Africa, and Reductil in Europe.
• Liraglutide, sold as Victorza, was developed as a diabetes treatment. It functions by stimulating insulin production. Its sister drug, Byetta, is known to cause life-threatening pancreatitis. Liraglutide was approved without testing for the likelihood of this effect. Nausea is the most common side effect, but those who suffer nausea lose nearly twice as much weight as those who don't. Sounds like the definition of bulimia.

And now, Big Pharma is at it again.

Diet Drugs in the Pipeline

Two of the three new diet drugs repeat the approach of Fen-Phen; they combine two known drugs. The third is a new variety of selective serotonin reuptake inhibitors.

Qnexa, the diet drug hopeful by Vivus, combines phentermine with topiramate (Topamax). Phentermine is half of the ill-fated Fen-Phen, which caused heart valve damage. It's known to cause psychotic disorders and conduction disorders of the heart, which means it can result in sudden death. Topiramate is an anti-epilepsy drug, with an astounding list of bad effects, including mental impairment, agression, headaches, acidosis—a rapidly deadly effect—and skin disorders that can be deadly.

Contrave is a hopeful from Orexigen. It consists of two drugs. One is bupropion, an atypical antidepressant, neither an SSRI nor an SNRI, categorized by itself because its action is unknown. The other is naltrexone, used to stop the actions of opiates. Its side effects include tacharrhythmia, tinnitus (an indication of brain damage), hallucinations, mental impairment, headaches, dizziness, among many others. As with Qnexa, the manufacturer hopes to foist a drug composed of two others known to be deadly.

Last is Lorcaserin by Arena, which describes it as "a novel single agent that represents the first in a new class of selective serotonin 2C receptor agonists". They state that the serotonin 2C receptor is in the brain, including the hypothalamus. This should be chilling. The hypothalamus, sometimes known as the master gland, is something of a hybrid between brain and gland. It's critical in the body's endocrine (hormonal) balance. Any drug that affects its function carries the potential to do serious harm. It is also part of the brain.

Thus far, trials have documented side effects that include headache, dizziness, and nausea. Headache and dizziness, though, are serious concerns that can indicate harm to the brain. The only potential harm that Arena has focused on is heart valve and pulmonary artery damage—an obvious response to the Fen-Phen tragedy. However, this sounds more like a publicity ploy than a genuine attempt to determine risk. Lorcaserin has little or no connection to the drugs in Fen-Phen, so similar risks would be only coincidental.

The Obesity Epidemic

Louis Aronne is the Director of the Comprehensive Weight Control Center at the New York-Presbyterian Hospital in New York. He has done research on all these drugs. His focus is on treatment, not on why so many people are overweight. Of course, the money's in treatment, not prevention, so it's no wonder he says, "We are going to need many different medications in order to treat obesity effectively in the same way we have many different drugs to treat high blood pressure."

Aside from the fact that his comparison with blood pressure medications virtually proves the futility of his statement, since those drugs are not effective, either, and carry serious risks, Aronne's salary is paid by treating an existing problem.

Donna Ryan is the Associate Executive Director of Pennington Biomedical Research Center in Baton Rouge, Louisiana. She stated, "Losing weight is hard, and we need more tools in our toolbox to help patients." Meaning, of course, drugs.

The enormity of this epidemic will not be resolved with drugs. All pharmaceuticals have ever accomplished is small and brief weight losses, and most importantly, enormous profits for Big Pharma. These profits come at enormous cost, though, to people. After first being victimized by foodstuffs that bear only limited similarity to real nutrition, people are then subject not only to the limitations and bad health obesity causes, they are again victimized by a medical system that focuses on treating symptoms, rather than creating health. After suffering from carrying extra weight, they are again harmed by drugs with only limited effectiveness, but huge risks.