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Post fen-phen: Search is on for new diet drug

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December 31, 1998
Web posted at: 4:10 p.m. EST (2110 GMT)

From Medical Correspondent Rhonda Rowland

ATLANTA (CNN) -- It's been more than a year since dieters were forced to give up the popular drug combination fen-phen because of health concerns. Meanwhile, researchers continue to develop the next generation of diet drugs.

Some scientists are placing their bets on drugs that manipulate levels of the hormone leptin, which controls appetite.

Another possibility are medications that could influence a protein that regulates metabolism. Leading the pack on that front is a drug called Xenical.

"I think people would say Xenical is far down the pipeline -- about ready to come out the spigot," said Dr. Jerry Earll of Georgetown University Hospital. "It should hit the market very, very soon."

Food and Drug Administration approval of the drug has been held up over concerns about breast cancer risk. However, Earll said that based on a review of the data, women should not be worried.

"There is no evidence this medication Xenical increases the risk of breast cancer," he said.

Similar to olestra

Xenical, made by Hoffman LaRoche, is considered a new breed of diet drug. It is similar to the so-called "fake fat" olestra, which blocks fat absorption.

"It's going to come through your bowel -- 30 percent of it -- and not be absorbed in your bloodstream and stored in your waistline," Earll said.

Side effects of Xenical include cramping and diarrhea.

In the past, doctors prescribed diet drugs as a way for patients to jump-start their weight loss programs. But once patients went off the drugs, the weight usually returned. New thinking holds that for a diet drug to work, it must be taken for a long time.

Kathleen Phelps has battled her weight for the last decade; at times, she as been as much as 70 pounds overweight.

"I did use fen-phen about one and a half years ago and had problems on it," she said. "I'm on Meridia and it's just terrific. I've been able to lose 30 pounds since June 23."

But she said she wonders how long she can take Meridia, a drug that has been on the market less that a year.

'Obesity is a chronic disease'

In September 1997, the drugs Redux and Phenfluramine, half of the fen-phen combination, were pulled from the market amid concerns of possible heart problems.

"There's really no place for short-term use of medications to treat obesity," said Dr. Susan Yanovski, head of the obesity program at the National Institutes of Health. "Obesity is a chronic disease just like high blood pressure, just like diabetes."

Health experts say they won't know for sure if new diet drugs will be safe to take long-term until thousands of people start taking them.

However, diet drugs don't have a good track record. Out of 31 diet drugs brought before the FDA for approval in the past 50 years, half were withdrawn or never marketed.

"That's why no one should take the medication who doesn't need it," Earll said.

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