This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (152)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

National Task Force on the Prevention and Treatment of Obesity

JAMA. 1996;276(23):1907-1915.

Abstract
Objectives.
—To examine the rationale for long-term use of medications in the management of obesity, to provide an overview of published scientific information on their safety and efficacy, and to provide guidance to patients and practitioners regarding risks and benefits of treatment.

Data Sources.
—Original reports and reviews obtained through electronic database searches on anorexiant drugs supplemented by a manual search of bibliographies.

Study Selection.
—English-language articles that discussed the role of medications in the treatment of human obesity, and studies that evaluated their safety and efficacy for a minimum of 24 weeks.

Data Extraction.
—Studies were reviewed by experts in the fields of nutrition, obesity, and eating disorders to evaluate study design and the validity of authors' conclusions.

Data Synthesis.
—The long-term use of medications in the management of obesity is consistent with the current consensus that obesity responds poorly to short-term interventions. Net weight loss attributable to medication is modest, ranging from 2 to 10 kg, but patients taking active drug are more likely to lose 10% or more of initial body weight. Weight loss tends to reach a plateau by 6 months. Weight remains below baseline throughout treatment, although some studies show partial weight regain despite continued drug therapy. Most adverse effects are mild and self-limited, but rare serious outcomes have been reported.

Conclusions.
—Pharmacotherapy for obesity, when combined with appropriate behavioral approaches to change diet and physical activity, helps some obese patients lose weight and maintain weight loss for at least 1 year. There is little justification for the short-term use of anorexiant medications, but few studies have evaluated their safety and efficacy for more than 1 year. Until more data are available, pharmacotherapy cannot be recommended for routine use in obese individuals, although it may be helpful in carefully selected patients.

Footnotes
A complete list of members of the National Task Force on the Prevention and Treatment of Obesity and their financial disclosures appear at the end of this article.

Reprints: Susan Zelitch Yanovski, MD, Weight-Control Information Network, 1 WIN WAY, Bethesda, MD 20892-3665.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial
Aude et al.
Arch Intern Med 2004;164:2141-2146.
ABSTRACT | FULL TEXT  

Efficacy of Pharmacotherapy for Weight Loss in Adults With Type 2 Diabetes Mellitus: A Meta-analysis
Norris et al.
Arch Intern Med 2004;164:1395-1404.
ABSTRACT | FULL TEXT  

Screening and Interventions for Obesity in Adults: Summary of the Evidence for the U.S. Preventive Services Task Force
McTigue et al.
ANN INTERN MED 2003;139:933-949.
ABSTRACT | FULL TEXT  

Are There Benefits From Long-term Pharmacotherapy of Obesity?
Kearns
Arch Intern Med 2002;162:1070-1070.
FULL TEXT  

Obesity
Yanovski and Yanovski
NEJM 2002;346:591-602.
FULL TEXT  

Extracts from ""Clinical Evidence"": Obesity
Arterburn and Noel
BMJ 2001;322:1406-1409.
FULL TEXT  

Benefits of Lifestyle Modification in the Pharmacologic Treatment of Obesity: A Randomized Trial
Wadden et al.
Arch Intern Med 2001;161:218-227.
ABSTRACT | FULL TEXT  

Criteria for definition of overweight in transition: background and recommendations for the United States
Kuczmarski and Flegal
Am. J. Clin. Nutr. 2000;72:1074-1081.
ABSTRACT | FULL TEXT  

Dieting and the Development of Eating Disorders in Overweight and Obese Adults
National Task Force on the Prevention and Treatmen
Arch Intern Med 2000;160:2581-2589.
ABSTRACT | FULL TEXT  

Efficacy and Safety of Sibutramine in Obese White and African American Patients With Hypertension: A 1-Year, Double-blind, Placebo-Controlled, Multicenter Trial
McMahon et al.
Arch Intern Med 2000;160:2185-2191.
ABSTRACT | FULL TEXT  

Current and Potential Drugs for Treatment of Obesity
Bray and Greenway
Endocr. Rev. 1999;20:805-875.
ABSTRACT | FULL TEXT  

The war against obesity: attacking a new front
Klein
Am. J. Clin. Nutr. 1999;69:1061-1063.
FULL TEXT  

Weight, Health, and Culture: Shifting the Paradigm for Alternative Health Care
Robison
Complementary Health Practice Review 1999;5:45-69.
ABSTRACT  

Report of a National Institutes of Health–Centers for Disease Control and Prevention workshop on the feasibility of conducting a randomized clinical trial to estimate the long-term health effects of intentional weight loss in obese persons
Yanovski et al.
Am. J. Clin. Nutr. 1999;69:366-372.
ABSTRACT | FULL TEXT  

Treating the Obese Patient: Suggestions for Primary Care Practice
Anderson and Wadden
Arch Fam Med 1999;8:156-167.
ABSTRACT | FULL TEXT  

Weight Control and Risk Factor Reduction in Obese Subjects Treated for 2 Years With Orlistat: A Randomized Controlled Trial
Davidson et al.
JAMA 1999;281:235-242.
ABSTRACT | FULL TEXT  

Garcinia cambogia (Hydroxycitric Acid) as a Potential Antiobesity Agent: A Randomized Controlled Trial
Heymsfield et al.
JAMA 1998;280:1596-1600.
ABSTRACT | FULL TEXT  

Antiobesity Drugs: Should They Be Used in the Treatment of Obesity?
Apovian
Nutr Clin Pract 1998;13:251-256.
 

Evidence based case report: Helping an obese patient make informed choices
Mulrow
BMJ 1998;317:266-267.
FULL TEXT  

Hip Fracture Risk in Older White Men Is Associated With Change in Body Weight From Age 50 Years to Old Age
Langlois et al.
Arch Intern Med 1998;158:990-996.
ABSTRACT | FULL TEXT  

Obesity and Heart Disease : A Statement for Healthcare Professionals From the Nutrition Committee, American Heart Association
Eckel
Circulation 1997;96:3248-3250.
FULL TEXT  

Brain Serotonin Neurotoxicity and Primary Pulmonary Hypertension From Fenfluramine and Dexfenfluramine: A Systematic Review of the Evidence
McCann et al.
JAMA 1997;278:666-672.
ABSTRACT  

Obesity
Rosenbaum et al.
NEJM 1997;337:396-407.
FULL TEXT  

Pharmacotherapy in the Management of Obesity
Tiedt
JAMA 1997;277:1201-1201.
ABSTRACT  

Pharmacotherapy in the Management of Obesity
Steelman
JAMA 1997;277:1201-1202.
ABSTRACT  

The Treatment of Obesity: A Call for Prudence and Professionalism
Kushner
Arch Intern Med 1997;157:602-604.
ABSTRACT