Monday, August 16, 1999
Dieters still want fen-phen
Some believe benefits beat health risks
BY SUSAN VELA
The Cincinnati Enquirer
Dr. Fortune Williams holds a bottle of phentermine, one of the two ingredients of the diet drug fen-phen.
(Patrick Reddy photos)
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Roselle Schroot remembers the days of fen-phen, when friends would look at her newly diminished form and say: “Don't stand sideways, I can't see you.”
After battling with her weight for so long, the Sayler Park resident didn't mind the dry mouth she experienced from using the popular diet drug.
Despite other users' charges of much more serious side effects, Mrs. Schroot would like to see fenfluramine - one of two drugs in the diet-drug combination known as fen-phen - back on the market.
The FDA banned the sale of fenfluramine, along with its chemical cousin dexfenfluramine, in September 1997 be cause of potentially life-threatening complications.
On Aug. 6, a Texas jury awarded $23 million to a 36-year-old woman who said that her three-month use of fen-phen caused damage to two of her heart valves, in addition to making her tired and short of breath. The Texas woman is among more than 3,100 people nationwide who have sued American Home Products and subsidiary Wyeth-Ayerst Laboratories over health problems they say were caused by fen- phen.
Yet Mrs. Schroot and some other Tristate dieters and diet doctors contend that fenfluramine's ability to help overweight and obese people lose weight is worth any potential health risks, which they believe are minimal.
“I'd like to see it come back just for the obese people who cannot lose weight on their own. They need help. It was the only thing that worked with me,” said Mrs. Schroot, who in her 60s now weighs about 180 pounds. On fen-phen, her weight plummeted from about 200 pounds to 140.
AHP's drug division, Wyeth-Ayerst Laboratories, manufactured fenfluramine and dexfenfluramine. Spokesperson Audrey Ashby said late last week that there are no plans to bring the drugs back to the market. She refused to comment further.
Dr. Rick Grover, a cardiologist with Health Alliance of Greater Cincinnati, is shocked but not surprised at the public clamoring for fen-phen's return. America has an obesity problem, he said, and that's why so many will take what seems like a cure-all, despite the health risks.
“The drugs worked and that's why they were so popular,” Dr. Grover said. “It's easier than exercising and changing diet habits that have been there for a lifetime. Dieting's tough.”
And heart valve damage is very serious, he said. It can hamper blood flow, causing the heart to work harder. The damage is irreparable and makes the valves more susceptible to later problems.
Fen-phen became a dieting option in the late 1980s. The moniker came from the ingredients of the diet-drug combinations of fenfluramine, an appetite suppressant that caused drowsiness, and phentermine, an amphetamine-like drug that acts like a stimulant to counter the sleepy feeling. The 1997 ban did not affect phentermine, the second half of fen-phen, which is still prescribed by diet doctors.
Fen-phen “was the hottest thing that ever came down,” said Dr. Jerry Sutkamp of Fort Thomas. “I'd go back to it right away, in a heartbeat. If the benefits far outweigh the risks, then it's valid medicine. And it's good medicine. I never saw any signifi cance in the studies.”
Dr. Sutkamp said he thinks the fen-phen users who suffered health problems already had heart valve problems before they began ingesting fenfluramine and dexfenfluramine. He also believes that health problems were caused by patients taking more than the recommended daily dosage.
Rick Pearl, an owner of Riverfront Diet Clinic, and Dr. Fortune Williams, the resident doctor at the clinic, also say that they would like to see the return of fenfluramine. For now, they're placing most of their clients on a newly available drug, Xenical, along with either phentermine or Meridia.
But the alternatives have not shown the benefits of fen-phen.
Riverfront Diet Clinic was opened in Covington about four years ago with the purpose of dispensing the popular drug. Mr. Pearl said he wanted to capitalize on the fact that Kentucky was drawing people eager to get it from surrounding states.
At the time, Tennessee had banned its use, Ohio allowed prescriptions for only 12 weeks and Indiana had a 30-day restriction.
Mr. Pearl stressed that health exams were always given before offering fen-phen prescriptions. Clinic clients generally paid about $750 for six months of clinic visits, exams and prescriptions.
He acknowledges that the clinic has not been as profitable since the fen-phen ban. Meanwhile, the clinic is one of several defendants in a federal lawsuit filed by a former patient alleging that her fen-phen use resulted in health problems.
A 52-year-old Union woman who is a former fen-phen user does not put much stock in the litigation. She now weighs about 210 pounds. While using fen-phen for about a year, she was able to get down to 136.
The weight gain, she said, has caused joint problems. She's still taking phentermine but said she's now more apt to give in to cravings.
“I'd give my left arm for the other,” said the woman, who didn't want to be identified, for fear her relatives would worry. “It calmed the monster in my body. Who do I sue to get it back on the market? I'm suffering without it.”
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