Millions of us take popular drugs in our efforts to lose weight, but do we really know how they will affect us over the long haul?

That's what researchers say health experts need to find out because the long-term risks aren't fully known, despite two highly popular drugs being approved for use by the U.S. government.

To see if benefits outweigh risks, Dr. Raj Padwal and Dr. Sumit Majumdar, internal-medicine specialists at the University of Alberta, aim their contentions squarely on: 

•  sibutramine (Meridia);

•  orlistat (Xenical);

•  rimonabant (Acomplia).

Cardiovascular problems? 

Any long-term research should find out whether the three popular drugs really do reduce your risk of heart attacks, strokes and diabetes, as well as help you lose weight, the doctors said in The Lancet, a British medical journal.

"These three medications will likely lower weight, modestly, but we need better studies," Padwal said. "The studies that are out there don't provide information on cardiovascular disease and cardiovascular deaths. The other problem is that they are not long-term and have high dropout rates.

"We really need to know what the net benefits of these medications are, and truly know whether we should be using them or not."

To reach their conclusions, Padwal and Majumdar pored over published studies on risks and benefits of the drugs - and found conflicting information on some.

For example, Meridia may improve the risk for heart disease and strokes in some people, but raise another person's blood pressure, which could lead to cardiovascular problems, Padwal noted.

Same results through exercise, healthy eating?

Padwal said he wonders whether the modest weight loss you get from the drugs really benefits your overall health. By contrast, if you begin exercising religiously, then you may not only lose weight but reduce your risk of heart attacks, strokes and diabetes without taking medicine, he added.

At least one noted obesity researcher said medication isn't the answer to the problem of being overweight. Dr. David L. Katz, a public-health expert and director of Yale University's Prevention Research Center, said the history of weight-loss drugs "is not very encouraging."

He noted the two drugs approved by the U.S. Food and Drug Administration - sibutramine and orlistat - could cause "serious side effects" and work only as long as you take them. Last year, the FDA approved an over-the-counter version of orlistat, which is expected to hit pharmacy shelves in late 2007.

As for rimonabant, the new drug blocks appetite, but it may wear off over time. The side effects are unknown, Katz said.

"We are adapted to survive in a world where calories are scarce and physical activity demands high," Katz said. "To use pharmacotherapy to fight obesity, we are, in essence, hoping to redirect the fundamental activities of human metabolism. I don't think we'll ever succeed in doing so, without dire cost in toxicity and side effects."

This article includes information from Health Day.

For more information

•  Weight-loss drugs: Can a prescription help you lose weight?

•  Harvard Health Publications

•  Sibutramine

•  Orlistat

•  Rimonabant

Source: The Lancet

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