Patients wonder what happens after Fen-fen



    In the wake of Wieth-Ayerst’s announcement Monday that it would pull its widely-prescribed weight-loss drug, Fenfluramine, off the market for testing, many patients are left asking, “What now?”

    Fenfluramine, which composes half of the controversial drug, Fen-phen, was found in a recent study published in the New England Journal of Medicine to cause valvular heart problems in some patients.

    Dr. Darron Smith, director of the Doctor’s Diet Clinic in Provo, regrets Wieth-Ayerst’s decision to pull the drug off the market. He said, “This is something that has really helped a lot of people.”

    Smith said that critics of fen-phen don’t consider the success stories connected with the drug and said, “This is analogous to the prozac scare in the early 80’s.”

    Still, Smith advises his patients to stop taking the combination drug, but to continue taking the other component of Fen-phen, phentermine. This drug has not been found to have adverse affects.

    Dr. Gregory Nielsen, a Nevada-based family practitioner, has been skeptical of Fen-phen since it’s introduction into the market earlier this year. He suggests a different course of action: “I perform a careful physical exam, paying close attention to their heart.”

    He urges patients on Fen-phen to discontinue use of the drug immediately and to pursue their weight-loss goals in other ways.

    Other physicians in the area, such as Dr. William Dunnaway of Talbert Medical Center in Orem, suggest tapering off the medication over a period of about a week. Dunnaway said, “I have no qualms with them pulling it off the market.”

    Dr. Lawrence Astle supervises weight management at the McDonald Health Center. Referring to BYU students that had Fen-phen prescribed to them, he said, “We’ve called every one of them and encouraged them to come back in to discuss other methods (of weight loss).”

    Patients’ reactions to the announcement Monday to pull Fen-phen have also been varied.

    Dunnaway said, “Patients are more concerned that they can’t get it than the potential side effects.”

    Astle encouraged those who have found success with Fen-phen by saying “This isn’t the only effective way to lose weight. Don’t give up. Continue working.”

    Dunnaway said that other medications are expected to be released to the market in the near future, such as orlistat, a fat cell inhibitor apparently to be prescribed under the name of Zenical.

    Nielsen said, “The cornerstone of any weight-loss program is a moderate diet with moderate exercise. People jumped on the bandwagon and thought that (Fen-phen) would be a quick fix. Our society is conditioned to want a pill for everything, and we don’t have it.’

    Nielsen does not advocate the use of drugs in normal situations to enhance weight loss.

    Cindy Marlin, a medical assistant at Tri-City Medical Clinic in Pleasant Grove, said, “The first choice of the doctors was not the medication. The first line of weight loss was always following a good diet, following a regular exercise program and modifying behavior.”

    Nielsen also said that slow weight loss has been shown to be a healthier approach.

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