Effective Serotonin-Raising Obesity Drugs May Become Fad Medicine

DRUG USE TRENDS September-October 1994

New research is showing some unexpected results about the nature of and treatment for obesity. Often considered a disease rooted "in failure of will" or "simple overeating," doctors are finding that obesity may be caused by an imbalance of chemicals in the brain (Michael Miller, "Respect for Diet Pills Rises as Studies Shed New Light on Obesity," New York Times, July 20, 1994, p. A1).

Studies in the 1970s by husband-and-wife team Richard and Judith Wurtman found that overeaters may be treating themselves for depression. The key is the chemical serotonin, which is produced in synthesis of starch and regulates mood. Overeaters may be scrambling to boost their serotonin levels, and also their moods.

With new serotonin-regulating drugs, doctors have begun studying their use in treating obesity. One such study by Dr. Michael Weintraub at the University of Rochester found that those taking Pondimin, a diet drug that raises serotonin levels, lost 16% of their weight over eight months, compared to members of the placebo group who lost 5% of their weight. Today, the number of prescriptions for Pondimin is seven times higher than that before the study.

Similarly, other researchers found that a serotonin-raising drug was an effective treatment for depression with the unexpected side-effect of weight loss. That drug, Prozac, has not yet been approved by the FDA for treatment of obesity, although it is a well-known and often-prescribed treatment for depression. Prozac has been approved for use in treating bulimia, an eating disorder.

The Centers for Disease Control (CDC) reports that more than 30% of Americans are now overweight. Critics of serotonin-raising treatment for obesity warn of the possible side-effects of the drugs. Others say that drug treatment will become an excuse for not maintaining a healthy diet and exercise regimen.