Diet drugs: Pills cocktail offered short-cut to weight loss

You could almost hear the rattle and thunk resonating around the neighbourhood. Up and down our cosy streets, men and women were throwing away bottles of pills. They were doing it with a sigh certainly, perhaps a grunt of anger.

This is the great diet pill chuck-out and it is happening in my well- heeled corner of suburban America, just as it surely is all across the land, in the poorest of black ghettoes, in Florida retirement communities, wherever.

If I listened more carefully I may hear the whir of treadmills starting up again.

The disappointment is tangible. In recent years the cocktail of drugs popularly known as fen-phen - one small white pill and a larger capsule - has offered a seemingly miraculous shortcut to weight loss and, for many, the rediscovery of self-respect that had got lost in the fleshy folds.

Hindsight will probably tell users that fen-phen was always too good to be true, even an affront against nature. In a society that is already pill-popping mad, here was a product that told our brain to tell our bodies that we were not hungry, even when we were.

Some will have discarded those bottles months ago when the first scare stories began to emerge. Many more, however, will have clung on to their prescriptions, willing to ride out the warnings of terrifying side-effects up to and including death through pulmonary hypertension.

There was, for example, the story reported in a recent issue of the New England Journal of Medicine, of an otherwise healthy 29-year-old Massachusetts women who developed hypertension 23 days after starting a course of the pills. Eight months later she was dead.

Two months ago there was a wave of negative publicity after the death from a heart attack of the 53-year-old wife of the mayor of North Miami. She had been taking fen-phen for six months in an attempt to lose just 10lb.

Then the news startled to trickle out of cases of heart-valve defects in women on the cocktail. On Monday the government instructed the withdrawal of the pills from sale. And so that, for now, is that.

"For a lot of people this is very upsetting," agrees Jane Aronne, the director of the Comprehensive Weight Control Center at the Cornell Medical Center in New York. "Some of our patients had lost 40 or 50 pounds with these drugs. Now they are going to feel like they are back to square one". But Ms Aronne, whose clinic only treats people with serious obesity, accepts the decision of the Food and Drug Administration, taken last Friday: "It is the safest thing to do", she says.

Not only is the move a giant blow for the pharmaceutical companies marketing the drugs, but also for the thousands of clinics that have sprung up to satisfy the demand for them, sometimes dubbed diet-pill mills or "fen- phen factories".

Richard Bowen, a doctor specialising in dieting, voices sympathy for his newly deprived patients. "There are people who would do anything not to be fat. Look at what people do: They have their jaws wired shut. They have acupuncture in their ears. They have stomach surgery. I don't think the average person understands how terrible it is to be fat in our society".

Among those who stopped taking the pills some months ago is Susan Sorrentino of New York. She shed 187lb over four years on fen-phen.

"I feel glad that I was able to have lost the weight, and I feel sorry for people who are still trying," she commented. "It's sort of like having the rug pulled from under you".

While former fen-phen-aholics will begin the search for alternative therapy - whether it's back to the treadmill or enduring what promises to be a long wait for a new, hopefully safer, generation of drugs - some are turning their minds to another all-American pastime: the filing of lawsuits. The class-action suits have already begun to drop into the court system, and more may well come.