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Pharmacotherapy in the Management of Obesity

Michael Steelman, MD
JAMA. 1997;277(15):1201-1202. doi:10.1001/jama.1997.03540390031025.
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Although the article1 on pharmacotherapy for obesity was an excellent review, 2 statements in that article deserve additional comment.

First, the authors indicate, "The use of these medications was widespread and often indiscriminate." This statement is typical of disparaging comments offered in review articles on obesity treatment. Without statistical or numerical validation, such pronouncements are difficult to interpret. What, specifically, do the terms "widespread" and "indiscriminate" mean?

The authors use as a reference for this statement an article2 that stated, "Amphetamine, however, suffers from the serious disadvantage of having a substantial abuse potential" (emphasis added). There is a considerable difference between the phrases "substantial abuse potential" and "widespread and indiscriminate use." As opposed to class II amphetamines, are there data to indicate that abuse of the class III and IV anorexigenics is or has been widespread or indiscriminate?

Second, the authors state, "Until more data are available, pharmacotherapy cannot


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