Christine A. Kwong

Chronic treatment with phentermine combined with fenfluramine lowers plasma serotonin

As expected on the basis of published research in both humans and animals, treatment with phentermine/fenfluramine lowers plasma 5-hydroxytryptamine [corrected], whereas treatment with phentermine had no significant effect. In light of these findings, future research should focus on mechanisms other than increased plasma 5-hydroxytryptamine [corrected] to explain how fenfluramine increases the risk of primary pulmonary hypertension and valvular heart disease.

Energy and Macronutrient Intake of Type 2 Diabetics Participating in a Clinical Trial of Pharmacologic Induction of Weight Loss

Abstract Forty-four overweight subjects with type 2 diabetes mellitus were enrolled in a randomized, placebo-controlled, double blind trial of pharmacologic induction of weight loss. All subjects received intensive nutrition counseling, an exercise prescription, instruction on behavioral management, and were randomly assigned to fenfluramine 20mg three times daily and phentermine 37.5mg daily (n=23) or dual placebos (n=21). Drug therapy continued until September 1997 when fenfluramine was withdrawn from the US market. Dietary intake was assessed by administration of a food frequency questionnaire (Block 95) at baseline, 2, 6, and 12 months. Mean ± SEM baseline data for the placebo group and the active drug group, respectively, were: Weight (kg) 106 ± 4, 108 ± 4; kilocalories 2991 ± 445, 3053 ± 482; carbohydrate (%) 36.9 ± 1.5, 40.2 ± 2.5; protein (%) 15.8 ± 1.9, 14.8 ± 1.1; fat (%) 47.8 ± 2.6, 44.7 ± 2.5. Changes from baseline (* placebo vs. active, p * −491±1833.1±1.31.0±0.8−4.2±1.56 MonthsPlacebo (n=13)−2.7±1.4−636±2415.2±1.70.6±0.8−6.2±1.6Active (n=13)−9.6±1.5 * −284±2774.6±2.8−0.3±0.7−4.5±2.612 MonthsPlacebo (n=8)−2.5±2.5−670±3104.2±2.1−0.1±1.4−4.8±2.0Active (n=8)−8.1±1.6−605±277−3.4±5.14.5±3.3−4.6±4.5 Body weight was reduced at all time points for both groups, but was significantly reduced in the drug treatment groups at 2 and 6 months. Although a reduction in reported total energy intake was observed in both groups, no significant difference was detectable between groups. The reported change in intake was accounted for primarily by a reduction in fat intake.

Energy Expenditure and Body Composition of Type 2 Diabetics Participating in a Clinical Trial of Pharmacologic Induction of Weight Loss

Abstract Forty-four overweight subjects with type 2 diabetes mellitus were enrolled in a randomized, placebo-controlled, double blind trial of pharmacologic induction of weight loss. All subjects received intensive nutrition counseling, an exercise prescription, instruction on behavioral management, and were randomly assigned to fenfluramine 20mg three times daily and phentermine 37.5mg daily (n=23) or dual placebos (n=21). Drug therapy continued until September 1997 when fenfluramine was withdrawn from the US market. Body fat composition was assessed by skinfold measurement. Resting energy expenditure was measured with a DeltaTrac metabolic monitor. Physical activity was assessed by questionnaire. Mean ± SEM baseline data for the placebo group and the active drug group, respectively, were: Weight (kg) 106 ± 4, 108 ± 4; BMI (kg/m 2 ) 37.7 ± 1.4, 38.5 ± 2.4; Body Fat (%) 39.1 ± 1.7,40.0 ± 2.3; REE (kcal) 2180 ± 73, 2087 ± 173; and weekly energy expenditure in physical activity (PA, kcal) 1410 ± 613, 1267 ± 367. The changes from baseline were as follows (placebo vs. active, **p 2 )(%)(kcal)(kcal)Placebo (n=18)−1.6±0.5−0.5±0.2−0.5±0.5−13±43344±274Active (n=21)−7.9±1.2**−2.5±0.4**−3.0±0.7**−265±41**938±2896 MonthsPlacebo (n=13)−2.7±1.4−0.8±0.5−0.7±0.7−130±521349±503Active (n=13)−9.6±1.5**−3.2±0.5**−2.5±1.0−262±6260±466*12 MonthsPlacebo (n=8)−2.5±2.5−0.6±0.81.5±1.4−51±491408±546Active (n=8)−8.1±1.6*−2.6±0.7*−1.8±0.9*−139±27650±319 The observed reduction in both body weight and BMI were both statistically significant at 2 and 6 months and approaching significance at 12 months in the active group. As expected, the reduction in body weight was accompanied by a reduction in REE and in percentage of body fat.