THE VIRGINIAN-PILOT
Copyright (c) 1997, Landmark Communications, Inc.
DATE: Saturday, February 8, 1997 TAG: 9702070100
SECTION: DAILY BREAK PAGE: E3 EDITION: FINAL
SOURCE: BY PAT DOOLEY, STAFF WRITER
LENGTH: 76 lines
BEING FAT is nothing to be ashamed of. It isn't a result of laziness, poor character or a lack of willpower.
Obesity is a chronic medical condition that should be treated as any other - with medication, says Dr. Steven Lamm, a New York City internist and author of ``Thinner at Last'' (Fireside, 1997).
Lamm, who's treated hundreds of patients in the last five years with the newly popular weight-loss drugs - such as fen-phen, phentermine and dexfenfluramine - will discuss obesity at 2 p.m. Sunday at Founders Inn in Virginia Beach.
``Obesity needs to be viewed as a medical issue, not a character issue,'' Lamm said in a recent telephone interview. He estimates up to a third of people in the United States are obese, or about 20 percent over ideal weight.
Many have dieted repeatedly - only to regain the pounds, and then some, Lamm said.
They suffer physical ills, such as high-blood pressure and fatigue, and a litany of emotions, ranging from anxiety and frustration to despair, Lamm wrote in his book.
But researchers are beginning to understand the physiology of what we eat and why, offering new hope to the overweight masses, he said.
It is believed that weight is regulated by hormonal activity in the brain, Lamm said. The newly prescribed weight-loss medications work with brain chemicals to stem hunger.
In his book, Lamm emphasizes the popular combination of fenfluramine and phentermine, also known as fen-phen. But other newly prescribed medications, such as Redux (dexfenfluramine), work similarly, he said.
The drugs help 75 to 80 percent of patients, the typical loss being about 50 pounds, Lamm said. Up to 20 percent of patients ``lose a little,'' while up to 15 percent don't lose, he said.
Another 10 percent don't tolerate the side effects, which can include dry mouth, jitters and diarrhea but often are minimal, Lamm said.
Some patients experience ``minor memory loss'' with fenfluramine and must stop taking the medication, he wrote. ``The loss is reversible once the drugs are discontinued.''
Redux and fenfluramine have been associated with pulmonary hypertension, a potentially fatal lung condition, and have been the subject of television news reports. Lamm said the condition is rare - about ``40 cases in the world.''
Unlike amphetamines - appetite suppressants commonly used in the 1950s and '60s - the newly prescribed drugs are less stimulating and non-addictive, Lamm said.
But they are not a quick fix. Lamm advises exercise and proper nutrition, along with medication. And because obesity is chronic, he suggests life-long vigilance. That doesn't mean a patient must stay on medication for life. But she may be off and on it - what Lamm calls ``pulsing.''
Critics say the long-term effects of the drugs are not known, but Lamm said short-term studies show they are safe.
It is unlikely a patient would use one medication for a lifetime, he added, because newer, improved treatments are on the horizon.
One, a medication called Xenical, helps block the body's absorption of fat. Researchers also are looking at ways to alter metabolism, or to harness nerves in the digestive tract, Lamm wrote.
One thing is certain, Lamm said: Calorie restriction does not work.
When we ``diet,'' our brains sabotage our efforts by secreting more hunger signals, Lamm said. Metabolism slows.
``It's almost a built-in system,'' he said.
It's estimated that 50 percent of Americans diet at a given time. Studies suggest 95 percent of them will regain the pounds within a year. ILLUSTRATION: WANT TO GO?
Who: Dr. Steven Lamm, internist and author of ``Thinner at Last''
What: Will talk about obesity as a chronic medical condition.
Sponsored by Chase Wellness Clinic, a weight-loss center in
Chesapeake and Virginia Beach, it is open to the public
When: 2 p.m. Sunday
Where: Founders Inn, Virginia Beach
Tickets: $6 in advance, or $7 at the door. Copies of Lamm's book
also will be available. For tickets or information, call the clinic
at 382-9904 (Chesapeake) or 460-4300 (Virginia Beach)