Exercise gives even diet pills a boost

Diet pills do indeed work, new research shows, but the best weight-loss results occur with a change in eating habits and behavior.

One pill, sibutramine, sold as Meridia, helped obese patients lose as much as 40 pounds during a one-year study that had four tracks: those who took only the drug; those who took the drug but kept food diaries and underwent counseling; those who took the drug with brief professional counseling; and a fourth group that only underwent group counseling.

Patients experiencing the greatest weight loss took the drug but also kept food diaries and got the most counseling from their physicians or nurse practitioners. They were on a 1,500-calorie diet. The findings were reported in the Nov. 17 issue of the New England Journal of Medicine.

On average, patients who only took Meridia lost 11 pounds. But those who kept food diaries and changed their eating habits by making note of what they consumed lost an average of 27 pounds. The 40-pound loss was seen in a small group that was especially careful to adhere to guidelines.

“The take-home message is very clear,” said Thomas Wadden, the University of Pennsylvania psychologist who led the study. “When you just take the medication by itself you will lose weight, but you will lose less than half the weight of people who also change their eating habits and modify their behavior. It’s putting the combination together that produces the best results.”

Meridia, a product of Abbott Laboratories, belongs to a class of drugs known as monoamine reuptake inhibitors. They act on brain pathways, producing a sense of satiety. The drug was approved by the Food and Drug Administration in 1998 but came under fire in 2002 from Dr. Sidney Wolfe, director of the consumer watchdog group Public Citizen’s Health Research Group.

Wolfe called for a ban of the drug that year after patients suffered heart problems or died. Health officials in Italy pulled the medication off the market in the wake of two deaths associated with its use.

Wolfe underscored that patients were in their 20s and 30s, and that the drug has the propensity to increase blood pressure.

In August, the FDA announced it would not ban Meridia but would keep a close eye on ongoing European studies.