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PATIENTS on weight-loss drugs may lose little more than their money, a recent study claims, and they risk unpleasant side effects too.
An article in the British Medical Journal on Thursday said close to 20,000 fat patients, weighing an average of 100kg, lost less than 5kg each from taking these drugs.
They had been on one of three weight-loss medicines for one to four years. Two of the drugs, Xenical and Reductil, are the main weight-loss medications used here. The third, Accomplia, is sold in Europe, but not in the United States or Singapore.
Associate Professor Tan Huay Cheem, head of the National University Hospital's cardiac department, said: 'The mere taking of these anti-obesity medicines to reduce weight frequently fails miserably.'
Though he does prescribe Xenical to patients, he said exercise and dieting must be part of the treatment.
However, private diabetes specialist Tan Chee Eng said the loss of barely discernible kilograms makes a significant difference for people suffering from diabetes.
Obese people who lose 4kg cut their risk of getting diabetes by a hefty 30 to 40 per cent, he said.
For those who suffer from diabetes, this amount of weight loss 'significantly' cuts their blood sugar levels and their risk of getting heart disease.
But he agreed that people who take the drugs just to look good may not see much benefit.
As one of the paper's authors, Dr Raj Padwal, an assistant professor at the University of Alberta in Canada, put it: 'Drugs are not the magic cure, and are not for everybody. But in specific patients, they have great benefits.'
The meta-analysis, which looked at data from 30 clinical trials, found that up to 30 per cent of Xenical users had unpleasant digestive and intestinal side effects, such as incontinence. Users lost an average of 3kg.
Patients on Reductil lost 4kg and had improved cholesterol levels. But up to 20 per cent suffered from raised blood pressure and pulse rates, insomnia and nausea.
Patients on Accomplia lost the most weight - 5kg on average. Their blood pressure and cholesterol levels also improved. But the risk of mood disorders increased in 6 per cent of patients.
Another study released yesterday by a different medical journal, The Lancet, found that patients on Accomplia were far more likely to suffer from depression, anxiety and, in severe cases, suicidal tendencies.
These drugs are meant for severely obese people who have, or are at high risk of, heart disease or diabetes. Worldwide sales of the three drugs amounts to US$1.2 billion (S$1.73 billion) a year.
The side effects mentioned in the study are known and listed by the drug manufacturers, and taken into account by doctors using them to treat patients.
A Health Sciences Authority spokesman said it has received reports of 'non-serious reactions such as rashes, nausea and vomiting'.
She added that the medicines 'should not be used solely on their own for the treatment of obesity'.
Dr Tan Chee Eng prescribes mainly Reductil to medically obese patients who have lost weight from better diets and exercise, but need help maintaining their weight.
Reductil, which costs more than $4 a pill, acts by making patients feel full with less food. They take it for six months to a year until used to their new dietary regimes.
Xenical, at less than $2, does not need to be prescribed. It prevents the digestion of oil from food but is less popular as patients risk 'oily leakage' from their bottoms, which can stain the clothes and be embarrassing.
salma@sph.com.sg
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