From: yazz@locus.com (Bob Yazz)
Subject: Re: Weight Loss with Dexfenfluramine
Date: Wed, 11 Nov 1992 06:05:27 GMT

Chuck F. wrote:

| >I do believe the quote (p. 618) supports my contention more than Gordon's:

dyer@spdcc.com (Steve Dyer) writes:

| 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?

Duh.

You stop the intervention and the weight comes back.  "Commonly
known" says it well.

"Duh" says it even better.

The relevant sentence -- I suppose we should congratulate you for
not pulling a Rosemary Woods and omitting it from your post -- is
highlighted below:

| >	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.

So, not only was weight regained when the diet + exercise + behavior mod
stopped (duh), weight was also regained when these were continued.

You know, some people might actually take a piece of data like that and
conclude that diet + exercise + behavior mod -- gasp gasp -- didn't
really work very well!

| 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.

OK, so both the dual-drug and placebo groups got diet + exercise + behavior
mod, both groups regained some of their initially-lost weight, but the
placebo group regained more.  How much did they regain after 4 years?
30%?  95%?  115%?

Since so few diet studies actually last this long, this one can speak
to how well the "conservative" d+e+bm regimen works -- quite apart from
the positive light it sheds on the whole long-term pharmacological
intervention question.

| [ Weintraub's study ] in fact flouts the commonly
| held perception of the long-term utility of anorectic agents by the medical
| community.

Depending on just how much regain the "conservative"-only treatment group
experienced, it might also fly in the face of the commonly held perception
of the long-term utility of diet + exercise + behavior mod by the
medical community as well.

Wouldn't it be ironic if the numbers actually lent support to both
Steve's and Chuck's positions?

Could someone with the study handy give us those numbers?

Best Wishes

== Bob Yazz ==
-- 

Welcome to Sci.med -- where-school-of-thought bashing is as old as
sickness itself.