Drug Medical Information

OBESITY PROBLEMS: PEELING THE POUNDS AWAY

Dr. Kirschner says only 10 percent of patients on calorie-controlled diets lost weight and kept it off Very low-calorie diets-400 calories a day-do somewhat better under strict medical supervision. Dr. Kirschner's patients who followed a liquid diet regime that is available only through a doctor's prescription had 32 percent success in losing weight and keeping it off.

During the weight loss, blood pressure drops, the cholesterol system returns to a healthy state, arthritis is relieved (especially in the weight-bearing joints), and many diabetics no longer need injections of insulin.

Dr. Blackburn says that some patients who lost only 10 to 15 percent of their excess weight had, within 3 to 6 months, reversed the life-threatening symptoms of high levels of blood pressure, LDL cholesterol, uric acid, and high insulin.

Researchers, trying to find chemicals that will cancel the drive to eat excessively, have found some drugs that help. One being tested in Europe is dexfenfluramine. Scientists showed that, with the drug, patients lost an average of 10 percent of their body weight in 6 months and kept it off for a year. Without the drug, the patients lost 8 percent of their weight in the same period. Only 55 percent stayed on the diet without the drug, compared to 63 percent with it.

In this country, Hoffmann-LaRoche, the pharmaceutical company, is testing a drug that inhibits a key enzyme required for fat absorption, preventing some of the ingested fat from being absorbed.

In sum, discoveries about apples and pears, the genetic basis of obesity and the distribution of fat, as well as new drugs to cut the storage of fat, have opened a new route to the control of disease in obese men and women.

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