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Three New Weight Loss Drugs: What's the Scoop?
Posted on Aug 16th 2010 11:00AM by Jonny BowdenFiled Under: Diet & Weight Loss, Nutrition & Supplements
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By now, you might have heard some buzz about three new weight loss drugs that are being considered by the FDA: Qnexa, Contrave and lorcaserin. Don't worry if you can't pronounce their names. What's important is what they do. Or don't do.
The drugs aren't on the market yet; but some preliminary info is leaking out, and my colleague at the Huffington Post, Dr. David Katz, recently spilled the beans.
The first thing to know is that the FDA typically asks a blue-ribbon advisory panel to make recommendations on a drug, which is exactly what it did here. Regarding Qnexa, the panel voted a big thumbs-down. Qnexa combines two drugs: phentermine (remember fen-phen?), which is an amphetamine (upper), and an anticonvulsant called topiramate. Apparently one of the known side effects is loss of memory and the ability to concentrate. According to Katz, the FDA is likely to take the advice of the panel and nix this one.
Oh, well. One down, two to go. We haven't gotten much news on Contrave. Like Qnexa, it combines two other drugs: an antidepressant (bupropion) and a drug used for addiction treatment (naltrexone). Naltrexone is an opioid antagonist, which means it blocks the feel-good effects of opiates in the brain. According to Katz, preliminary data indicates Contrave is a little less effective than Qnexa. There seems to be somewhat fewer side effects; but one of them is nausea, and it's not uncommon. Good luck with that one.
Finally, there's lorcaserin. Lorcaserin is a selective serotonin receptor agonist (as opposed to a selective serotonin reuptake inhibitor, the class of antidepressant drugs that includes Prozac, Zoloft and Lexapro). SSRIs work by preventing serotonin from being vacuumed back into the cells, thus keeping more of it around in the brain. Serotonin agonists like lorcaserin work by acting as serotonin turbochargers.
There's a lot of buzz about lorcaserin, since there's actually a published study on it that came out recently in the New England Journal of Medicine. In the study, 3,182 obese or overweight adults were randomized to receive either 10 mg of the drug or a placebo twice daily for one year. (The subjects also had counseling on both diet and exercise.) At the end of the first year, everyone was also weighed, and weight loss was noted.
Over the next year, the placebo group continued to receive placebos (inert substances), but the lorcaserin group were randomly divided in two sections, with half continuing on the drug and the other half taking a placebo. At the end of year two, the researchers again weighed the subjects to see how much of their first year's weight loss was maintained.
Over the next year, the placebo group continued to receive placebos (inert substances), but the lorcaserin group were randomly divided in two sections, with half continuing on the drug and the other half taking a placebo. At the end of year two, the researchers again weighed the subjects to see how much of their first year's weight loss was maintained.
Keep in mind that there were a heck of a lot of dropouts, which is never a good sign. Only slightly more than half the participants remained in the trial after the first year, though most of those stayed through year two. Of those in the lorcaserin group, 47.5 lost 5 percent or more of their body weight in the first year compared to 20.3 percent in the placebo group, and those who stayed on lorcaserin were more likely to maintain their loss.
However, this is just one study, and the weight loss did not come without a cost. "Among the most frequent adverse events reported with lorcaserin were headaches, dizziness and nausea," reported the researchers.
For what it's worth, I've never seen a weight loss drug that accomplished all that much, and certainly I've never seen a single one that didn't have an awful lot of side effects. The history of prescription drugs for weight loss is littered with false promises, bad side effects and FDA recalls. And the real kicker is that none of them work all that well to begin with, despite enormous hype and advertising.
Before going the drug route, why not really see what eating and living differently can achieve. Lifestyle changes -- and I'm talking deep, profound changes, not quick-fix diets -- may not be all that sexy and certainly don't produce instant gratification.
But they do produce real change.
Jonny Bowden, author, nutritionist and weight loss coach, cuts through all the misconceptions about diet and fitness to help you transform your body, your health and your life. Visit his website to learn more.
Jonny Bowden, author, nutritionist and weight loss coach, cuts through all the misconceptions about diet and fitness to help you transform your body, your health and your life. Visit his website to learn more.
