Abstract
The efficacy of anti-obesity drugs usually does not consider the high degree of interindividual variability in responses to the drug which could affect the decision to withdraw the drug early due to ineffectiveness or to continue therapy according to specific expectations of success. The aim of this study was to analyze body weight loss in kilograms during the first month (1 mo-BWLkg) of treatment with 30 mg phentermine and development of tolerance to phentermine, on its 6-month efficacy. One hundred sixty-six subjects with obesity were individually or jointly analyzed in the study. Subjects with 1 mo-BWLkg of <1 kg, 1–3 kg, 3–5 kg, and ≥5 kg reached 6-month mean percentage body weight reductions (BWR%) of approximately 3%, 5%, 10%, and 15%, respectively. Development of late tolerance (4–6 months) to phentermine had a lower impact than early tolerance (2–3 months). Subjects with 1 mo-BWLkg < 3 kg who developed early tolerance did not achieve relevant BWR% (≥5%) at month 6, while the rest of the subgroups achieved increasing and progressive BWR%, according to their 1 mo-BWLkg range and time of onset of tolerance. The 1 mo-BWLkg and development of tolerance to phentermine could be useful to predict the expected 6-month efficacy trends in obese patients treated with 30 mg phentermine.
Highlights
Obesity is a complex, multifactorial, and highly prevalent disease that should be treated [1]
Total cholesterol, low-density lipoprotein-cholesterol (LDL-C), and high-density lipoproteincholesterol (HDL-C) were within normal reference values, mean fasting glycaemia and triglycerides were slightly above reference values (Table 1)
We found that daily oral administration of phentermine over a 6-month period led to weight reductions in a time-dependent manner, with a magnitude of 7.5 kg (8.3%) and 10 kg (11.2%), at months 3 and 6, respectively, high interindividual variability was observed
Summary
Multifactorial, and highly prevalent disease that should be treated [1]. Drug therapy is frequently used to treat this disease [2,3]. The efficacy of anti-obesity drugs has been generally evaluated and reported based on average weight reductions (kilograms), average percentage weight loss, or other anthropometric measures. Even when obesity treatment guidelines by expert committees consider weight losses between 5% and 10% to be sufficient to translate into health benefits [5], efficacy expectations of anti-obesity therapies may vary depending on the magnitude of the weight reduction being considered. The decision to initiate drug therapy for obesity could be guided by the intention to improve chronic diseases or reduce the risk of developing comorbidities such as diabetes mellitus, hypertension, hyperlipidemia, among others, which may be associated with the magnitude of percentage body weight loss [6]. Preoperative weight loss is recommended before bariatric surgery and other procedures like orthopedic hip or knee replacement, for which certain levels of body weight reduction in a specific period of time are required [7]
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