From: dyer@spdcc.com (Steve Dyer)
Newsgroups: sci.med
Subject: Re: Weight Loss with Dexfenfluramine
Date: 10 Nov 92 18:31:18 GMT
Article-I.D.: spdcc.1992Nov10.183118.24619
Organization: S.P. Dyer Computer Consulting, Cambridge MA

In article <1992Nov10.114830.12448@omen.UUCP> caf@omen.UUCP (Chuck Forsberg) writes:
>>>regain.  As the Weintraub study (discussed in Adiposity 101)
>>>showed, most dieters regain weight even when they do not go off
>>>their diets.
>>Hmmm.  I read the study and didn't get that.  Most dieters
>>regain because they can't stay on the diet forever.  The
>>drug allows them to do that.  Also, Weintraub's patients
>>did regain some, just not as much as those without the drug.
>
>I do believe the quote (p. 618) supports my contention more than Gordon's:

My understanding of the study is the same as Gordon's.

>	Overall, the data from the this phase of the long term weight
>	control study reflect what has been commonly known about
>	cessation of weight control interventions in animals and humans;
        ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
I guess you missed this phrase, Chuck, eh?

>	that is, that weight will return toward its baseline level
>	whenever a previously instituted perturbation (such as diet,
>	exercise, modified protein fast, behavior modification, or jaw
>	wiring) has been completed.  In this case, continued diet,
>	exercise, and behavior modification also did not help the
>	subjects to avoid regaining lost weight.  However, it also
>	appears that subjects are able to control their intake and
>	maintain a certain level of increased exercise despite an
>	increase in body weight.

I have the Weintraub study somewhere here, but not in front of me.
Since it is in front of you, why not look for the part which demonstrated
that the subjects' intake was the same as during the early years on the
diet?  You won't find it--it wasn't controlled for this (and this isn't
necessarily a flaw; it's just that you have to be careful not to draw the
wrong conclusions.)  These people were on a "diet" for 3-4 years.  That
doesn't mean that they adhered to it.  The "control mechanisms" which
influence weight almost certainly influence eating behavior; this should
not come as a surprise to anyone.  These people aren't regaining their
weight via photosynthesis, after all.

>Please read the following (p. 581-2) carefully until it sinks in:
>	After completion of the initial study, my colleagues and I
>	undertook further explorations of the value of anorexiant
>	medications as part of a multimodal intervention program.
>	Despite the findings of clinical trials such as these, the
>	public and health professionals remain skeptical about
>	anorexiant medications.  There are many reasons for their
>	negative views of anorexiant medications.  Both the medical
>	profession and society look with disfavor on obese people and
>	obesity in general.  For example, students at a well-known
>	university preferred a number of less savory people to obese
>	individuals as potential marriage partners.  Obese people are
>	treated negatively in cartoons and in literature.  Many believe
>	that obese people need only to "close their mouths" and to be
>	more motivated to lose weight.  Thus use of medications to
>	correct a characterologic defect is, in the opinion of
>	physicians and the public, deemed inappropriate.

Um, so?  Life is unfair, and even scientific medicine isn't immune to
societal bias (especially when it comes to drug use).  This is news?

>	Unfortunately, a lack of understanding of both the natural
>	history of obesity and its diversity adds to the pejorative view
>	of obese people and of anorexiants.  Some health professionals
>	are not aware of data concerning mechanisms present in the human
>	organism that act to countervene perturbations in body weight
>	and that may account for the apparent failure of interventions,
>	including medications.

You seem to have a gift for reading between the lines.  Why not tell us
that you think it says rather than have us try to read your mind?

In fact, Weintraub isn't calling his study a "failure", because it in fact
demonstrated that individuals on the regimen of anorectic drugs weighed less
after 4 years than those who were on placebo.  It in fact flouts the commonly
held perception of the long-term utility of anorectic agents by the medical
community.

-- 
Steve Dyer
dyer@ursa-major.spdcc.com aka {ima,harvard,rayssd,linus,m2c}!spdcc!dyer
Newsgroups: sci.med