[Tolerance and acceptability of dexfenfluramine in the long-term treatment of obesity in private practice. ESIM Group].
OBJECTIVE
The value of a one year prescription of dexfenfluramine (dF) was demonstrated by a large multicentric study performed in centres specialised in the treatment of obesity (Guy-Grand 1989). We tried to evaluate the safety and acceptability of this treatment prescribed in routine practice.


METHODS
27 internal physicians or general practitioners recruited 58 overweight patients who received 15 mg of dF twice a day in association with a balanced hypocaloric diet and were followed for one year with two-monthly visits, plus a visit after the first month of treatment. At each visit, the patients were weighed and completed a questionnaire concerning hunger sensations, appetite, preference for sweet foods and the number of meals per day.


RESULTS
32 of the 58 patients (55%) followed the proposed treatment for 12 months. The dietary survey showed a significant reduction until the sixth month, then a maintenance until the twelfth month for the number of meals per day, the urge to eat, as well as the desire for foods prohibited by the diet. The course of the desire to eat sweet foods was similar but non-significant as compliance with diet deteriorated regularly with time from the second month of treatment onwards. Drug consumption, evaluated by the doctor, was regular for 79% of patients after 6 months and for 77% of patients at the end of the study. Acceptability was considered to be good or very good for 92% of patients after 6 months and for 97% after 12 months. The mean weight loss for the 32 patients who complied with treatment for twelve months was 8.8 kg, close to 10% of their initial weight.


CONCLUSIONS
The long-term addition of dF to a moderate low calorie diet was well tolerated and perceived as an aid by the majority of patients. The weight loss achieved by general practice management, as well as the proportion of patients who completed 12 months of treatment, was close to that observed by Guy-Grand and should encourage general practitioners to undertake the outpatient treatment of obesity.
Héraïef
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Centre hospitalier universitaire vaudois, Lausanne.
D000328:Adult; D001067:Appetite Depressants / Q000009:adverse effects / Q000627:therapeutic use*; D004038:Diet, Reducing; D005260:Female; D005277:Fenfluramine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000188:drug therapy*; D010349:Patient Compliance
D001067:Appetite Depressants; D005277:Fenfluramine
Tolérance et acceptabilité de la dexfenfluramine dans le traitement à long terme de l'obésité en pratique privée. Groupe ESIM.