Pharmacotherapy for obesity - do the benefits outweigh the risks?

Article Abstract:

The benefits of fenfluramine and its derivatives probably outweigh their side effects. One side effect recently discovered was pulmonary hypertension, a condition characterized by high blood pressure in the lungs. Researchers found that almost one-third of 95 people with pulmonary hypertension had been taking fenfluramine. This translates to a risk 23 times greater than in people who don't use the diet pill. However, obesity has serious health consequences and drug therapy would save an estimated 280 lives for every 1 million persons treated. Fenfluramine would cause an estimated 14 deaths for every 1 million persons treated.

Editorial, Pulmonary hypertension

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The prevalence of cardiac valvular insufficiency assessed by transthoracic echocardiography in obese patients treated with appetite-suppressant drugs

Article Abstract:

The diet pills fenfluramine, dexfenfluramine and/or phentermine may increase the risk of heart valve insufficiency. This occurs when the valves do not close properly. Researchers analyzed the rate of heart valve insufficiency in 233 obese patients who had taken one or a combination of these pills and in 233 people who had not. Compared to those who did not take the pills, the risk of heart valve insufficiency was 12 times higher in obese people who took dexfenfluramine, 24 times higher in those who took dexfenfluramine and phentermine and 26 times higher in those who took fenfluramine and phentermine.

Phentermine

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A population-based study of appetite-suppressant drugs and the risk of cardiac-valve regurgitation

Article Abstract:

The diet pills fenfluramine and dexfenfluramine appear to increase the risk of heart valve insufficiency. This condition occurs when the valves do not close properly. Researchers analyzed the rate of heart valve insufficiency over a five-year period in approximately 20,000 obese people, half of whom were taking one of these two drugs or another diet pill called phentermine. Within five years, there were 11 cases of heart valve insufficiency in the people taking diet pills, but none in those who were not. The aortic valve was most often affected.

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