Successful regimens include fenfluramine 20 mg twice daily in
combination with phentermine 15 mg twice daily or with phenylpropanolamine
25 mg three times daily before meals; and phentermine 15 mg twice daily plus
phenylpropanolamine 25 mg three times daily. Weintraub et al. studied the
effects of phentermine 15 mg/day plus fenfluramine 60 mg/day (versus
placebo) in 121 patients 120% to 180% of ideal weight. After 34 weeks of
drug therapy or placebo therapy, along with calorie restriction, behavior
modification, and exercise, patients in the treated group had lost an
average of 15.9% of initial weight, compared with an average loss of 5.9% in
the placebo group. Patients continued in the study for up to 3Ęyears. Weight
loss slowed (and in some cases reversed) after week 20, but drug treatment
helped many patients maintain their weight loss. (Weintraub et al. Clin
Pharmacol Ther. 1992; 51: 586-594; 595-601; 602-607.)

At any given time, up to 40% of women (44% of high school girls) and 24% of
men are trying to lose weight. Many of these people do not need to lose
weight, and of those that do, the majority will fail. But this failure
should not lead medical professionals to abandon their obese patients. According to physician Arthur Frank (George Washington University Obesity
Management Program), obesity is an orphan disease of monumental size: "We
are much better at managing patients even though we are only a little bit
closer to understanding the mystery of how we weigh what we weigh. We should
not leave the mystery to the profiteers and quacks." (Frank A. JAMA. 1993;
269: 2132-2133. NIH Panel. Ann Intern Med. 1993; 119: 764-770. Blackburn GL
et al. Drug Ther. 1993; 23: 17-29. Bray GA. Ann Intern Med. 1993; 19:
707-713.)

Does Aminophylline Cream Really Shrink Thighs?
An obesity researcher reported at a recent scientific meeting that a topical
preparation of aminophylline, applied to the thighs, has an interesting
effect: it shrinks fat cells. Aminophylline, the ethylenediamine salt of
theophylline, has long been used as a bronchodilator for symptomatic relief
of asthma. Frank Greenway (Harbor-UCLA Medical Center in Los Angeles) and
George Bray (Director, Louisiana State University's Pennington Biomedical
Research Center) have been studying the effects of their "patented"
aminophylline cream in topical application to the thighs. At the annual
meeting of the North American Association for the Study of Obesity, Greenway
described results from two studies, each involving 12 women. In the first
study, the women applied 5 mL of aminophylline cream each day to one thigh
and a placebo cream to the other.