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Fen-phen not for the thin, some doctors warn
December 19, 1996
Web posted at: 10:45 a.m. ESTFrom Correspondent Elizabeth Cohen
This is the third in a series of reports on the diet drug fen-phen.
ATLANTA (CNN) -- The skinny on the diet aid fen-phen is that the drugs should only be used by truly obese people under direct medical supervision, but some people are not hearing the message.
The problem is cultural. Some Americans are convinced that thin is often not thin enough because TV and magazines feature images of lacking an ounce of fat. It is the ultimate peer pressure.
"I didn't feel thin enough," said a fen-phen user named Cindy who is 5'7" and weighed 140 pounds before going on the drugs. "It's America; you have to be skinny."
Now at 124 pounds, Cindy says she is happy with her fen-phen experience.
"I look better now," Cindy said. "And that's all that matters."
The source of Cindy's happiness, the drugs fenfluramine and phentermine being used together as an appetite suppressant, is a source of concern for Dr. George Blackburn of Harvard University's medical school.
"Mainly, what saddens me is that somebody is going to get hurt, disabled, or die (from fen-phen)," Blackburn said.
The director of the UCLA School of Medicine's obesity clinic, Dr. Morton Maxwell, is a little more practical in his assessment of fen-phen use for the less-than-dangerously obese.
"I don't think the risk is worth it for someone who wants to lose 15 pounds for cosmetic reasons," Maxwell said.
Fen-phen's dark side is that its use may lead to amnesia, depression or even the fatal lung-disease primary pulmonary hypertension (PPH).
Yet some doctors are subscribing the fad diet drug combination to their patients without much apparent concern for potential side effects, deadly, or not.
Dr. Pietr Hitzig is one such physician.
Hitzig treats Sunny Griffin, a model who was featured in television exercise programs 15 years ago. But since her TV-show heyday, Griffin has picked up a few pounds. She now weighs in at 138 pounds. At 5 feet, 9 inches tall, she's a lightweight by anyone's definition -- except hers.
Hitzig, with the help of fen-phen, has helped drop Griffin's weight back to the point where she can once again fit into "her Dior and Chanel gowns." Success for Hitzig is defined by the fact that Griffin has "increased her salaries" for modeling since using fen-phen.
Thousands of patients, many obese, many not, rely on Hitzig to supply them with fen-phen.
"Even if it be a small amount of weight in this weight-conscious world that we're in, I say the woman or man should have the right to control their own bodies," Hitzig said.
The hitch in Hitzig's method of prescribing fen-phen is that a great number of his patients never even see him. They are treated over the phone. His brand of "telemedicine," as he calls it, reaches people on four different continents, by his own claim.
UCLA's Maxwell said he is offended professionally by Hitzig's liberal dispersal of the potentially dangerous drug combination.
"I think this demeans the practice of medicine," Maxwell said.
Dr. Marcy Zwelling-Aamot councils her patients before handing out a three-month prescription for fen-phen, and occasionally turns down a fen-phen seeker for being too thin. But, like Hitzig, she thinks the benefit to her patients outweighs the risks. Zwelling-Aamot has few qualms about handing out a prescription for someone seeking to lose only 10 or 15 pounds.
"Weight is a very personal thing," said Zwelling-Aamot. "I don't pass judgment. I don't tell people what they can or can't do."
But it is a doctor's job to pass judgment, Maxwell said. He said doctors should turn down thin patients and follow up with obese patients.
"Someone on fen-phen would see a medical doctor every week if necessary, but at least every other week," Maxwell said.
He also said blood tests for fen-phen users should be done every eight weeks under normal circumstance, more often if abnormalities are apparent in the patient's health.
Maxwell and his obesity-clinic staff treat truly obese people and are always on the lookout for early signs of PPH, memory loss and other problems commonly associated with fen-phen use.
The next installment in CNN's fen-phen series elaborates on health complications commonly associated with this fad weight-loss treatment.
Related stories:
- Fad diet drug may be deadly - December 18, 1996
- Dieters rah-rah over fen-phen - December 17, 1996
- Brain waves interfering with your diet? - December 6, 1996
- Study: Diet pills yet another way to yo-yo - November 26, 1996
- Diet drug combo may cause problems during surgery - November 4, 1996
- Experts: Powerful diet drug can be deadly - October 9, 1996
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