This approach appears to be less and less common. Instead, the concept of pharmacologically assisted weight loss is slowly being replaced by the concept of pharmacologically dependent weight loss. Without continued administration of such agents, the failure of most previously obese patients to maintain weight loss seems quite probable. Generally, rates of return are no different with pharmacology than with other forms of weight reduction, and are perhaps not even as satisfactory as behavioral modification. We now recognize that obesity is a lifelong chronic illness requiring continuing lifelong attention and commitment of a rather substantial degree to reverse obesity and maintain reasonably normal body weight.
Physicians are, in many ways, no better than their patients.
The frustrations of multiple failed weight-loss attempts are as difficult for physicians to bear as they are for patients. Both have a clear need for long-term therapies that make weight reduction easier than it is with currently available techniques. Long-term use of anorectic agents seems out of the question in light of recent revelations regarding their toxicity. Because of inadequate safety data and the high rate of reported adverse reactions, this agent may never be made available for widespread clinical use. Reductase inhibitors for hypercholesterolemia have passed such rigorous scrutiny.