Many people still remember the wonder-drug Fen-phen. It was the top-selling weight loss medication used widely in the 1980's and early 1990's. The medication was a combination of two drugs: Fenfluramine, a "psycho-active" agent working to provide the sense of fullness, like some antidepressant medications do and Phentermine, an appetite suppressant ,fat-burner and stimulator of metabolism. Although many people battling obesity found the drug to be highly-effective in weight loss, a significant number of people developed an otherwise rare, but potentially fatal, condition known as pulmonary hypertension and heart valve disease. In 1996, a 30-year-old Boston woman developed heart problems after using Fen-Phen for one month. She died in February on 1997 and her story was featured on Page 1 of the Boston Globe. FDA reports of similar stories and studies affirming a relation between Fen-phen and heart valve/ lung disorders led to its withdrawal from the US Market in September on 1997/ Wyeth, the pharmaceutical company, set aside upwards of 20 Billion dollars to settle the 50,000 or more legal claims associated with the use of Fen-Phen. A tragic and expensive lesson was learned.

Despite the tragic story of Fen-Phen, Obesity remains the single, most-modifiable risk factor contributing to disease and mortality in the United States. The need for effective weight loss medications to combat obesity still remains. Fortunately, the science of weight loss continues to evolve, leading to better and safer options for the treatment of obesity. Recently the FDA has reviewed a new option for weight loss, a medication called QNexa, believed to rival the effectiveness of Fen-Phen without the rare complications of pulmonary and heart disease.

QNexa is a once-a-day medication that is the combination of 2 drugs: Phentermine, the same fat burner in Fen-Phen (not implicated in the heart valvedisorder) and Topiramate ( a drug replacing the Fenfluramine (the agent responsible of the heart lung problems). As you may know, Phentermine (aka 'Adipex') was not 'pulled' from the market and continues to be used as a weigh-loss medicine today. Topiramate is the generic name for Topamax, a medicine commonly used in Migraine and seizure treatment. Physicians quite commonly observe their patients reporting a feeling of fullness and satiety and even weight loss while on Topamax. As with Fen-Phen, the combination of the two medications works synergistically to allow large amounts of weight loss in a reasonable period of time.

Clinical Trials show that roughly 60 to 70 % of people taking QNexa once-daily lost at least 5% of their body weight in 6 months. With higher dose of QNexa, the more weight lost. Only 15% of people lost at least 5 % of their body weight with the placebo.

On July 16^th , QNexa underwent initial FDA review for safety and efficacy. The screening panel DID NOT recommend approval, citing insufficient information confirming the safety of Qnexa in terms of risks to the heart. It should be noted that there were no compelling safety issues involving QNexa in the study compared to other FDA approved medications currently on the market, including Phentermine and Topamax. Final consideration of Qnexa by the FDA may come later this year.

Who knows? QNexa may be the Next Fen-Phen.

Dr. Harvey Jenkins is a Harvard-trained Orthopedist & Spine specialist, practicing in South Oklahoma City. He is a Wellness Blogger and is also Owner and Medical Director of BodyTrends, the ElectroSpa in OKC. For more info or questions contact Dr Jenkins at info@bodytrendspa.com