Weight-Loss Drugs Are About Health! Really!

Sort of.  Reuters summarized the results of Vivus’ new weight-loss drug study as follows:

Vivus, whose shares shot up nearly 80 percent on the news, combined phentermine with the epilepsy drug topiramate, available generically [and as] Topamax. […]

Phentermine takes an old-fashioned and logical approach to weight loss — it is a stimulant that speeds up the metabolism. Topiramate, an anti-convulsant, has been shown to interfere with binge eating and studies show it can help patients lose weight and lower their blood pressure. […]

Losing just 10 percent of body weight is enough to lower cholesterol, reduce the risk of diabetes and death. […]

Only—-what are the contraindications for phentermine?  Well, per Wikipedia, among those who should not use phentermine are those who have “severe high blood pressure, … heart or blood vessel disease, or severe narrowing of the blood vessels”.  Also, among the “medical conditions that may interact” with phentermine and thus may mean avoiding it are those with “high blood pressure, diabetes, or high cholesterol or lipid levels.”

So this is going to be pushed as a “treatment” for high blood pressure, high cholesterol, or diabetes … but it can’t always be used by those with high blood pressure, high cholesterol, or diabetes …?   How’s that work again?

Oh right.  Many fat people do not have these ills. They can sell it to them!

I also noticed something that is very common:

About 60 percent of U.S. adults are overweight or obese and about 9 million are morbidly obese, with a body mass index above 40.

Notice how they mixed their numbers, going from “60 percent” to “9 million”.  Why not give the percentage for those who are morbidly obese?   The current US population is estimated to be 304 million.  9 / 304=0.0296052632.  Rounding would take it to 3%.   Is 3% not scary enough?

20 thoughts on “Weight-Loss Drugs Are About Health! Really!

  1. Is 3% not scary enough?

    Ummm. . . no?

    But no matter— it’s all fine and good until your internal organs explode like a potato in a microwave . . .or slide right into your underwear. Then the FDA will ride to the rescue!

    Heinlein was right—these are the Crazy Years. . .

  2. Ooooh, topiramate- Topamax- is evil, evil stuff. It’s the ‘drug of the hour’ for migraines and hardly ever works. It is a frontal lobe signal inhibitor.

    I was on it for nearly two months and had to go off. It made me jittery & paranoid; lost all interest or motivation in anything; couldn’t poop even with laxatives; couldn’t sleep for days at a time; couldn’t taste carbonation; couldn’t eat anything b/c i was motion sick all the time (lived on rice and purple gatorade); made the migraines worse; oh, and i was unable to make complete sentences or do simple math (and i am a scientist that writes reports– this is no good!). it was absolutely awful!

    • Argh. I know people who like it, but that’s because they have epilepsy and it keeps them seizure-free.

      Your experience sounds like my 2 weeks on Prozac — it gave me headaches, killed all interest in sex, and made my depression worse.

      • for the people that it works for, it’s wonderful. But the side effects are absolutely horrendous, and they tend to be worse for the people it doesn’t affect their seizures or migraines (as their misfire isn’t in the frontal lobe, so the drug is trying to fix something that isn’t broken, like splinting a leg that isn’t broken, it’s going to reduce it’s function). Topamax on its own has been tested for weight loss since the side effect was first noticed, but until now it was deemed that the other side effects weren’t worth it!

  3. I’ve been taking Topamax for a month and a half now for my migraines, and it’s helped a lot (no more migraines unless I happen to miss a couple of doses, like I did when I had to make a trip to Illinois a couple of weeks ago). I missed my morning dose, took it at noon, and totally spaced on taking my bedtime dose, didn’t get it at all, and had a major migraine the next day, on the way home (and I had to drive from Illinois to Minnesota, not fun).
    But, having taken phentermine and fenfluramine before they were taken off the market (as phen-fen), there is no way I would take phentermine with the Topamax (one set of side effects is more than I want to handle, but I’ll deal with them in order not to have migraines 2 or 3 times a week).

  4. I suppose it was only a matter of time before someone officially recommended “Stupamax” for weight loss. Like you said, L400L, it’s a wonderful drug for certain people who have seizure disorders. But for everyone else, it’s a side-effect-ridden nightmare. And combining it with phentermine? Really? Boy, that’s going to put people in a good mood — for chopping down trees with their teeth. (I take dextroamphetamine and Wellbutrin at low doses to counteract the sleep-til-you-die effects of Remeron, but I don’t think I’d take those two drugs together without being on such a soporific antidepressant. I kind of like my molars.)

    • for chopping down trees with their teeth

      I just went to a logging/forestry center over the weekend, and now I have this vision of hordes of beaver-like fatties hard at work. Who needs saws?

      Seriously—after the fen-phen debacle, they thought it would be a great idea to try a different drug with phentermine? If I remember correctly, fen-phen caused primary pulmonary hypertension in some unfortunate folks; what’s this combo going to do?

      • From Wikipedia:

        Fenfluramine, and later, a related drug, dexfenfluramine, was marketed by American Home Products, now known as Wyeth, but were shown to cause potentially fatal pulmonary hypertension and heart valve problems, which eventually led to their withdrawal and legal damages of over $13 billion. Phentermine was not shown to cause harmful effects.

        That said, Phentermine *is* contraindicated for those with hypertension, high cholesterol or diabetes.

  5. When I saw the prefix -phen, I knew it wasn’t any good. While I’m sure not everyone will develop severe or life-threatening side effects from the drug, I’m not going to take any thing that might screw up my heart. Despite being deathfat, my heart is pretty good right now and I’m taking no chances.

  6. Oh oh, and I saw a mention of this on TV the other night – if I recall correctly The Husband and I both scoffed at the ridiculous results they were claiming as success. Unfortunately I can’t remember what was reported exactly, but let me go look up their study…

    From here
    60% of the full-dose Qnexa patients who completed the study lost at least 10% of their baseline weight;

    And 59% of people on this dose completed the study, which incidentally couples the drug with diet and exercise, although the people on the drugs lost more than those in the placebo group.

    But still… if they had equal numbers in the placebo, low dose and high dose groups, that means about 422 people were on the high dose. If 59% of them completed the study, thats about 249 people from this group. And if 60% of them lost 10% or more of their body weight, then thats only 149 people, which is 35% of the original group.

    Plus, losing 10% of their bodyweight from an average of 256lbs puts them down to 230lbs, which is still going to be obese in pretty much all cases, unless you’re 6’9″.

    Oh, and did I mention this was over the course of A WHOLE YEAR??

    Yeah, I won’t be rushing out to buy this.

  7. There’s a reason that topiramate’s nickname is “Dopamax” — a lot of people have cognitive side effects. Which may be a tolerable compromise if it’s keeping you seizure-free or migraine-free, but for weight loss — absolutely ridiculous. It can also cause kidney stones. I have a friend whose migraines were frequent and debilitating enough that she put up with this drug, but she had some memory problems, especially with word-finding, and got horrific kidney stones.

  8. Living400lbs wrote:
    “So this is going to be pushed as a “treatment” for high blood pressure, high cholesterol, or diabetes … but it can’t always be used by those with high blood pressure, high cholesterol, or diabetes …? How’s that work again?”

    It sounds to me like they are going to peddle it to the “overweight/just over obese” as a preventative medication for diabetes, hypertension, heart disease. Which we all know is SO DAMN SUCCESSFUL!

    *sigh* Another day….another lying sack of shit study twisted to support big pharma’s profit machine. If they TRULY cared about helping people, wouldn’t they do more research on ACTUAL WAYS TO IMPROVE BASIC MEDICAL TREATMENT FOR THE OBESE?!?!?!?

    I’ll be interested to hear what Sandy at Junk Food Science comes up with about this. And I loved the ACTUAL MATH FACTS randomquorum rocked out in comments. Those numbers seem to correlate with the “Rule of Thirds” I learned about in Psychology 101 in college.

  9. !!!!!!

    They’re encouraging people with high cholestrol (well, supposedly, more it’s about fatty fatty fat fats) to take medicine that is SPECIFIED TO HAVE BAD EFFECTS ON SOMEONE WITH HIGH CHOLESTROL?!

    arrrgghhhh.

    Reminds me of that woman who drank tons of red bull, have a heart attack, but she lost weight so it was worth it.

    Weight loss is about everything BUT health.

  10. About the math, I think you misunderstood. They said (who is this “they” anyways?) that 60% of the US population was overweight or obese and then (a seperate) 9 million people were morbidly obese. If the US population is 304 million, then 182.4 million people are overweight or obese (having a BMI of 25 – 34.9) and another 9 million people are morbidly obese (having a BMI of 35+). So in total that would make 191.4 million or 63% of the population who have a BMI of 25 or higher and are classified as overweight, obese, or morbidly obese.

    I think. Now that I look at it, you can’t be morbidly obese without being overweight can you? Hmm.

    • They said (who is this “they” anyways?)

      In this case, Maggie Fox at Reuters. My point was that she used the percentage for the “overweight or obese” number but not for the “morbidly obese” number. I snarkily attributed this to the percentage of people who are morbidly obese being so small – 3% – and therefore not as scary as 9 million.

      Does that make sense? And yeah, those who are morbidly obese would be included in the 60% who are overweight and obese.

  11. Not to mention that the study was not peer-reviewed. This means it was not critically examined by other scientists who try to repeat the results touted in the study.

    Can you say “jumping to conclusions” Vivus?

  12. okay, I ghostwrote (I know, but I did actually work with the doctor) the journal article on the first topiramate Phase III study for weight loss. J&J gave up on pursuing the indication because of the cognitive slowing and numbness/tingling side effects. The side effects generally passed by eight weeks in that study, but that’s a hell of a long time to have cognitive slowing if you’ve got a responsible job. Efficacy? Feh. It was more effective than Xenical/Alli or Meridia, which were the options then on the market. But that was, all told, not terribly effective. I think probably they will end up targeting inbetweenies and neurotic size 8s with disposable income.

    In my business opinion Vivus is pretty much out of its little pharma mind to try to launch this brand. There is a tremendously high regulatory barrier to entry in this category since the fen/phen disaster — by that I mean that the FDA is nearly certain to say hell no to any weight loss drug, particularly if it can’t be marketed to people with diabetes and hypertension — and even if they do manage to get onto the market and generate some excitement, anyone who likes can just “roll their own” cheap Rx out of generic phen and generic topo, rather than pay for a fancy new branded combo pill. So this is a completely idiotic project even just from a business standpoint and I am really surprised they’re bothering unless there’s a side to the story we haven’t seen yet.

  13. Topamax allowed my husband to function after he started getting migraines, but we were both really glad when he was able to stop taking it. He experienced cognitive side effects that were not enjoyable for either of us. The idea of someone taking this stuff and losing mental abilities just to lose weight is really disturbing. On the bright side, at least I know there’s one weight loss drug in existence that my husband won’t be tempted to take.

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