Citing serious cardiovascular risks that outweigh expected benefits, pharmaceutical manufacturer Abbott Laboratories voluntarily withdrew the prescription weight loss drug, sibutramine (known by brand names Meridia, Reductil, Reduxada and Ectiva) from the Canadian market this week.
Known History of Adverse Effects and Deaths with Sibutramine
That sibutramine is associated with serious cardiovascular adverse events and deaths is not news. Sibutramine was pulled from the market in Italy in 2002 (yes, that's eight years ago) after more than 50 adverse events, including 2 deaths and many other reports including tachycardia, hypertension and arrhythmias occurred in individuals taking the drug. In fact, hundreds of adverse reactions including 31 deaths associated with sibutramine had already been reported by 2002 from just within the UK, France, the U.S. and Canada (Wooltorton, CMAJ May 14, 2002;16(10)).
Sibutramine: Risks and Benefits
Used in conventional medicine to support weight loss in individuals with a body mass index (BMI) of 30 or higher, sibutramine is a sympathomimetic drug that increases heart rate and blood pressure via inhibition of reuptake of norepinephrine and serotonin in the central nervous system. Studies had demonstrated the drug to support 5%-8% weight loss with 6 months of use compared to 1%-4% with placebo (interesting results from the placebo - we can only speculate how the comparative effect of the drug would have measured up to an actual weight loss program of diet and lifestyle change..hmmm....). Providing 5%-8% weight loss, and only while individuals continued to take the drug, sibutramine offered an unfavourable risk-benefit profile. It was recognized to be a dangerous medication and was indicated as an adjunct to an overall weight loss program, i.e. an addition to a consistent program of diet, exercise and lifestyle modification (Wooltorton 2002).
Adjunctive or Primary Therapy?
Was sibutramine truly used as an adjunct to the counselling- and time-intensive practice of helping patients learn how to lose weight? Or did physicians and patients rely upon it as the ever-sought-after "magic pill" for weight loss while ignoring the role of unhealthy diet and lifestyle choices, hormonal imbalances, and mental-emotional factors contributing to obesity? After a decade of approved use in Canada, Health Canada never got around to protecting Canadians from the risks of taking sibutramine, so we have the manufacturer to thank for relieving doctors and patients of the opportunity to exchange a temporary and relatively small benefit for serious harm or death. Will we continue to risk our lives for the next "magic pill" and believe that we really don't need to take care of ourselves through healthy diets, exercise habits and attending to our mental-emotional needs?
No "Magic Pill" for Weight Loss; the power is within YOU
Achieving a healthy body mass is important to optimizing health and decreasing risks for many forms of disease and premature death. However, naturopathic physicians recognize that there is no "magic pill" for weight loss. Pharmaceutical and natural substances may be available (even Health Canada-approved!) to support weight loss, but should never considered to substitute for long-term healthy lifestyle practices. As a naturopathic physician bound by the oath of "First, do no harm", my view is that any substance, whether natural or pharmaceutical, that is used adjunctively to support weight loss (or any other health goal, in fact) must first and foremost be safe. Naturopathic doctors are experts in teaching the principles of healthy living and using evidence-based natural therapeutics to optimize health. This includes thorough assessment and coaching through safe, permanent weight loss, and education that empowers patients to optimize their health and self-care habits.
You CAN Start Improving Your Health Today
As a naturopathic doctor my goal is to provide comprehensive, minimally-invasive primary health care that is individualized to the unique needs of each person, equips them with the education to make healthful choices, and supports their innate capacity for self-healing. If safe and permanent weight loss is your goal, consult your naturopathic doctor or other primary health care practitioner to discuss your options and start improving your health today.
To find a naturopathic doctor near you, please visit www.oand.org and use the "Find an ND" function.