THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Friday, May 10, 1996 TAG: 9605100490
SECTION: LOCAL PAGE: B1 EDITION: FINAL
SOURCE: BY PAT DOOLEY, STAFF WRITER
LENGTH: Long : 106 lines
A Chesapeake weight-loss clinic was inundated with telephone calls Thursday after a national television report on the benefits and potential dangers of ``fen-phen,'' a combination of two drugs that is increasingly prescribed to treat obesity.
The Chase Wellness Center, in the city's Greenbrier section, fielded more than 150 calls by midday Thursday, mostly from people who wanted to use the drugs for weight loss, the center's staff said.
The calls began shortly after ABC's ``Primetime Live'' aired a segment Wednesday night that focused mainly on the drugs' potential dangers.
One condition, primary pulmonary hypertension, causes increased pulmonary artery pressure and shortness of breath, and can lead to heart or lung failure. Lab studies with rats given large doses of the drugs have indicated potential problems with damaged brain cells, and some patients have reported short-term memory loss.
In its 11 p.m. local newscast, Channel 13 followed up on the national news report and featured the Chesapeake center, which focuses on weight control often with the help of fen-phen. It is one of few weight-loss centers in the area to prescribe the drug combination.
The soaring popularity of the drugs and concern that they are prescribed without proper medical supervision has prompted the Virginia Board of Medicine to consider specifying how long patients can safely use fen-phen. It will hold a public hearing this month on changing its regulations.
The public is clearly interested in the drug. Minutes after the televised reports, the phone started ringing at the Chesapeake center and it didn't stop all day Thursday, says Ronda Wright, a licensed practical nurse who works there.
For about two years, the center has prescribed fen-phen - the drugs fenfluramine and phentermine in tandem - for some significantly overweight patients, says Dr. Lisa Harris, clinic physician and a specialist in weight loss and nutrition.
She and some other experts say the drugs are safe when used short-term and with other weight-loss strategies, such as improved nutrition and regular exercise.
``They aren't meant to be used casually by someone who is 10 pounds overweight,'' she says.
The center won't prescribe the drugs unless a patient is at least 25 percent over ideal weight.
The drugs are not for overweight children, Harris says, nor for anyone with heart or lung problems, or a history of brain tumor, hypertension or drug dependency. The center requires a physical examination and medical history. And patients must be committed to a lifestyle change, not in search of a miracle tablet. ``A lot of people are looking for a quick fix,'' Harris says.
The drugs may be prescribed separately, or in combination.
Phentermine affects the level of the brain chemical dopamine and stems appetite, Harris says. Fenfluramine affects the brain chemical serotonin, which is associated with feelings of calm and well-being. The drugs have been used separately for several years, but the discovery that the combination is more successful at helping people lose weight has fueled interest, even among people who aren't obese. Initial side effects can include dryness of mouth, diarrhea, nervousness and loss of sleep. These diminish, Harris says. Patients begin on small doses and are monitored weekly, then biweekly, to prevent problems.
The center also limits prescriptions to 90 days at a time. Harris says the drugs cost about $3 to $9 a week, depending on the person.
Most of the dangers are associated with long-term use, say Harris and Dr. Warren Koontz, executive director of the Virginia Board of Medicine. The board licenses Virginia's physicians, and establishes regulations for its members.
Koontz says the drugs are considered safe when used carefully. But the board believes there have been instances where the drugs were given ``willy-nilly,'' he says, and patients weren't closely monitored.
Because fen-phen is becoming more popular, Koontz says, the board wants to change its regulations to clarify short-term use. It recommends that ``short-term'' be defined as 90 days, resulting in a minimum weight loss of 12 pounds. If that goal were met, a physician would be required to re-evaluate a patient before prescribing more fen-phen, Koontz says.
The board will hold a public hearing on May 24 in Richmond. Approval for a change probably will not come before the end of the year, Koontz says.
The drugs appear to be successful for some overweight people, but one problem with traditional diets is that people often gain back the weight, Koontz says. The long-term results with fen-phen are not clear. ILLUSTRATION: THE FUSS OVER FEN-PHEN
``Fen-phen'' is the nickname for a combination of the diet drugs
fenfluramine and phentermine, which appear to safely diminish
appetite and help obese people lose weight. It is rapidly growing in
popularity and was featured Wednesday night on ABC's news magazine,
``Primetime Live.''
How does it work? Fenfluaramine affects the brain's level of the
chemical dopamine, and causes satiety. Phentermine affects the
brain's level of the chemical serotonin, which produces a feeling of
calm or well-being.
Proponents say that when used with a responsible weight-loss
program, including exercise and proper nutrition, the drugs can help
severely overweight people shed pounds.
Critics say the drugs can cause short-term memory loss and
degeneration of brain cells or lead to primary pulmonary
hypertension, which can cause heart or lung failure.
It is estimated that about 30 percent of the U.S. population is
significantly overweight.
KEYWORDS: DIET PILLS by CNB