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Anticonvulsant Might Prevent Recidivism after Weight Loss: Presented at ADA

By Charlene Laino

NEW ORLEANS, LA -- June 17, 2003 -- The anticonvulsant topiramate might help obese people maintain the weight loss they achieve through a low-calorie diet, a new study suggests.

Professor Arne Astrup, director of the research department of Human Nutrition at Royal Veterinary and Agricultural University, in Frederiksberg, Denmark, presented the findings here on June 14^th at the 63^rd Scientific Sessions of the American Diabetes Association.

Professor Astrup said obese patients who lose weight on a low-calorie diet often regain all or most of it within 1 year. A previous study that investigated the role of topiramate in treating peripheral neuropathy unexpectedly found that the drug helped diabetic patients lose weight, he noted.

The study enrolled 300 patients with a body-mass index (BMI) of less than 50 kg/m² or a BMI of 30 to 50 kg/m² plus controlled hypertension and dyslipidemia.

During an 8-week run-in phase, patients were placed on a 800 to 1000 kcal/day diet with behavioral modification and exercise.

The 561 patients who lost 8% of their baseline weight were then randomly assigned to topiramate 96 or 192 mg/day or placebo.

At 44-week follow-up, patients taking topiramate had lost 15% to 16% of their weight, compared with 9% among those on placebo. Also, 72% to 75% of those on topiramate maintained their original weight loss compared with 30% in the placebo arm.

Aaron I. Vinik, MD, PhD, director of the Strelitz Diabetes Research Institutes at Eastern Virginia Medical School, in Norfolk, Virginia, who is studying topiramate in diabetic patients, said he was "very impressed" with the findings.

"This is the first time that anyone has seen a reduction in weight that persists for 16 months to 18 months, and the first time that any drug in addition to a low-calories diet results in long-term weight reduction."

But before topiramate can be considered for use as a weight loss aid, the correct dose must be found, he cautioned.

Johnson & Johnson, which funded the research, stopped the trial prematurely due to drug-related side effects, including parathesia, which occurred in 59% of treated patients, fatigue in 24%, and dizziness in 20%.

Dr. Vinik said his own work provides hints that a lower dose might be effective without these side effects.


[Study title: Effect of Long-Term Topiramate on Body Weight Maintenance after Weight Loss Induced by a Low-Calorie Diet in Obese Subjects. Abstract 1702-P]

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