CAN MEDICATION CURE OBESITY IN CHILDREN? 5
The search for the right long-term medication
has been complicated. Many of the drugs authorized by the Food
and Drug Administration (FDA) in the early 1990s proved to
be a disappointment. Two of the medications—fenfluramine
and dexfenfluramine—were withdrawn from the market
because of severe side effects (Yanovski & Yanovski, 2002,
p. 592), and several others were classified by the Drug
Enforcement Administration as having the “potential for
abuse” (Hoppin & Taveras, 2004, Weight-Loss Drugs section,
para. 6). Currently only two medications have been approved
by the FDA for long-term treatment of obesity: sibutramine
(marketed as Meridia) and orlistat (marketed as Xenical).
This section compares studies on the effectiveness of each.
Sibutramine suppresses appetite by blocking
the reuptake of the neurotransmitters serotonin and
norepinephrine in the brain (Yanovski & Yanovski, 2002,
p. 594). Though the drug won FDA approval in 1998,
experiments to test its effectiveness for younger patients
came considerably later. In 2003, University of Pennsylvania
researchers Berkowitz, Wadden, Tershakovec, and Cronquist released the first double-blind placebo study testing the
effect of sibutramine on adolescents, aged 13-17,
over a 12-month period. Their findings are summarized in Table 1. After 6 months, the group receiving medication had lost
4.6 kg (about 10 pounds) more than the control group.
But during the second half of the study, when both groups
received sibutramine, the results were more ambiguous. In
months 6-12, the group that continued to take sibutramine
gained an average of 0.8 kg, or roughly 2 pounds; the
control group, which switched from placebo to sibutramine,
lost 1.3 kg, or roughly 3 pounds (Berkowitz et al., 2003,