The dangers of diet pills

December 2000, Justice French ordered the manufacturer of an appetite suppressant, thereby putting the emphasis on the dangers of such drugs. At the same time, the United States, the Food and Drug Administration went to war against dietary supplements containing ephedrine. Who gets the appetite? Can they be used safely?



On December 22, 2000, the Tribunal de Grande Instance of Nanterre condemned the pharmaceutical manufacturer of appetite Isomeride to pay more than 2.5 million francs in damages to Anna Ferreira. The latter had contracted a disease attributable to the drug, following which she underwent a double lung transplant and cardiac surgery.

Towards the end of appetite?

Since 1985, the Medicines Agency had recommended these treatments for patients with major obesity. They could only be prescribed by hospital doctors or specialists in endocrinology and diabetology. Despite the known risks of pulmonary hypertension, these products continued to be used by people not suffering from obesity, but wishing only to lose a few pounds.

Since September 1999, the marketing of an appetite suppressant is prohibited in France. The risk of hypertension compared with weight loss seemed to finally tip the scales in favor of caution.

Cons of amphetamine appetite!

In the U.S., the Food and Drug Administration recently went to war against weight loss products containing ephedrine, an alkaloid originally amphetamines. Other war-horse, she recently asked pharmaceutical companies to withdraw from the market products containing a chemical substance (of phenylpropanolamine) that increase the risk of bleeding cérébrale2. Overseas, these drugs are given as a nasal decongestant but also as an appetite suppressant ... In very common use in France and the United States, these products are currently undergoing a reassessment of risk by the French Agency safety of health products, according to a press release dated November 14, 2000. But should we therefore call into question all the diet pills?

Effective in treating obesity

Sibutramine, a treatment against obesity marketed in the United States under the name of Meridia and Europe under the name Sibutral ® has proven effective in helping patients lose weight and maintain it. However, the long-term effects of this product are unknown.

Published in the prestigious journal The Lancet3, a study shows the impact of this drug (originally developed as an antidepressant) on volunteers for two years.

Eight European centers recruited 605 obese patients who, for six months, were treated with sibutramine 10 mg daily, combined with an individualized plan of 600 calories per day depending on their need. Result: 80% managed to reduce their body mass more than 5% and participated in the second phase of the program. During the next 18 months, patients were treated either with sibutramine (at 10 mg / day and up to 20 mg / day if weight regain) or placebo. After this period, the results argue in favor of this compound: 43% of the treated group were able to maintain a stable weight against only 16% of the placebo group. In addition, blood tests of those treated show a stabilization of the indicators of this disease: insulin, triglycerides, C-peptide, VLDL cholesterol and uric acid. Finally, HDL cholesterol (good cholesterol) was increasing.

However, some patients had to discontinue treatment because of sibutramine resulted in their increased blood pressure too much. Thus, medical surveillance is still necessary for the long-term treatment of obesity. This is the second clinical trial demonstrating the effectiveness of drug against obesity. The therapeutic arsenal had already Xenical4, which limits the digestion of fats.

This second generation drug, effective and safe, has already helped many obese to reconnect with the pleasures of life. Caution, however, these treatments are in no way adapted to the loss of a few extra pounds.