Traditionally doctors have approached obesity by starting with a program of diet and exercise which, if unsuccessful on its own, is then supplemented with drug treatment. However, it would seem that a drug commonly used in adults may not work when prescribed for obesity in teenagers.
As with adults the first line of attack for obesity in teenagers is normally a carefully controlled program of diet and exercise. In many cases however this does not do the trick and so many doctors will move on to supplement this treatment with drugs, commonly choosing a drug which has been used with limited success in adults.
Sibutramine, which is sold within the United States under the trade name of Meridia®, is an appetite suppressant which affects appetite control centers within the brain to decrease appetite and which has been shown to have some affect in assisting with weight loss in adults when taken in combination with a low calorie diet. However, a recent study suggests that it does not produce the same results when used in teenagers.
In adult patients sibutramine increases both the metabolic rate and the feeling of fullness so that fewer calories are consumed and more of those calories are burned off but, in a trial involving twenty four teenagers who were given either sibutramine or a placebo the same affects were not forthcoming.
At the end of a twelve week trial the weight loss of patients in both groups was virtually identical although, interestingly enough, weight in the group given sibutramine stabilized following the trial but actually continued in the placebo group.
In both groups body composition and metabolic rates were measured using underwater weighing techniques and x-ray imaging and no significant differences were found between the two groups.
In addition, resting metabolic rates were measured for both groups and, while the rate decreased at first in the placebo group and remained constant in the sibutramine group, it later increased in the placebo group and decreased in the sibutramine group.
Overall it would seem that for some reason, which is as yet not understood, not only does sibutramine not assist obese teenagers in losing weight, but it might actually slow the rate of weight loss in the longer term.
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