Tuesday, November 18, 2008

Long-Term Effects of Fen/Phen

I'm sure many of you have heard already that a new study came out, linking Fen/Phen to an increased risk of heart valve damage, even years after its use.

When I first started having children, I joined a lovely email support group for women of size who were moms or were pursuing becoming a mom. As a size-acceptance activist and as a mom, it was a wonderful source of support for me, yet also a source of frustration because it was not a diet-free list.

It was a challenge to try and gently bring some HAES concepts to the list, while also remembering that the mission of the list was not size acceptance and that weight loss talk was not against the rules in this group. This has been very challenging to deal with sometimes, yet it was a group of women I grew to care about, so I wanted to stick around anyhow.

Thus, over the years, I have watched so many of the latest diet fads, drugs, and procedures come and go while on that group. Shortly after I first joined, the Fen/Phen craze was reaching its height, and quite a few of the moms on that list were trying it.

They had only the best reasons at heart: they wanted to improve their health so they would be there long-term for the baby, they wanted to lose weight so they could keep up with an active child, they wanted to set a "good example" for their kids, etc. Many struggled with the popular culture belief that because of their weight, they might not be around to see their children grow up. How sad that moms are so uniquely vulnerable to weight loss scare tactics like this.

So some of them turned to Fen/Phen. I knew it was a disaster in the making, but I couldn't do anything about it.

But now there's proof that there was reason for concern. A new study shows that Fen/Phen actually caused far more harm than benefit, that women were more affected than men, and that damage from the drug may not show up for years after taking it. From the press release:

One of the "fen/phen" drugs once widely prescribed to help fight obesity has been tied to heart valve damage that develops years after a person has stopped taking it, a new study reports.

In the new study, published Nov. 5 in the journal BMC Medicine, researchers looked at 5,743 people who had stopped using fenfluramine more than a decade earlier but had damaged heart valves up to seven years later.

"Valve problems were common in individuals exposed to fenfluramines, more frequent in females, and associated with duration of drug use in all valves assessed," research leader Charles Dahl, from the Central Utah Clinic, said in a news release issued by the journal's publisher.

"We found clear evidence for a strong, graded association between duration of exposure to fenfluramines and prevalence of aortic regurgitation and for mild or greater mitral and tricuspid regurgitation," Dahl said.

"This is probably a conservative estimate, as another study has shown that there exists a 17- to 34-fold excess of clinically apparent (presumably severe), valvular disease in persons who had used fenfluramines for four months or longer," the authors wrote.

I don't know if any of the moms on our list who took Fen/Phen all those years ago sustained damage; many of those moms are no longer on the list. I hope anyone who did take the drug (and especially anyone who took it for more than a month or two) gets their heart function tested periodically because this study shows that the damage may take years to show up.

But this is what is so scary for me in watching all the diet fads, weight loss drugs, and weight loss surgery trends come and go. So often the long-term effects of these interventions aren't clear at first, and so many seem to turn up unexpected complications later on, some even life-threatening.

Now the big trend on the list is weight loss surgery, usually gastric bypass. I understand why these moms choose the surgery, and I understand the kind of miraculous weight loss and health improvements it seems to offer...at first. But over time, the nutritional deficits begin to pile up, the unexpected side effects accumulate, and the quality of life declines.

Weight Loss Surgery (WLS) seems like such a miracle cure on the surface, but I fear the long-term results for many women are going to be far worse than the Fen/Phen fiasco. And like the Fen/Phen thing, it will probably take years to show up and will be difficult to track.

How many women will get exposed to these risks in the meantime before they discover just how risky WLS is in the long run?


Lindsay said...

I wasn't really aware of the fen/phen craze when it really hit mainstream, but my mom's mom was. She was on it for a while. She died of heart problems a few years ago.

This is no small part of my reasoning for absolutely having nothing to do with diet pills. Scary as hell, they are.

Anonymous said...

I have exactly the same concerns you do about WLS. And thank you for bringing up that idea that brings so much pain to so many parents--this concept that they have to lose weight or they won't live to see their kids grow up. This has been so ingrained into the popular consciousness that nobody even questions it. What a terrible belief to have hanging over your head as you raise your kids.

Anonymous said...

Gorgeous entry. Hope you don't mind but I've linked to it (http://devi42.livejournal.com/143791.html).

Anonymous said...

A friend of my family LOVED fen/phen, and kept using it after it was taken off the market.

This whole "better dead than fat" thing makes me so sad. So many wonderful people I know fall for it, and it's terrifying.

Anonymous said...

Wow, this is so sad and I am sorry to hear about your loss Lindsay.

I do remember fen/phen. I am right now learning about HAES and as I am trying to get pregnant I see how so many fat women who want to be mommies are flocking to weight loss surgery because they want to be "normal" sized moms.

I have also thought about it-but after research I know that it is not for me. I have a nurse-for a father who is adamantly against these surgeries because of the sense that in the future there will be numerous problems. When I asked my doctor to give me a referral (for surgery) he expressed a deep reluctance. He encouraged me to simply eat right and exercise.

The problem is that most people are not encountering doctors who look at their health without a fat-phobic lens.