January, 1997

Experts agree that being overweight is a medical problem with a very real physiological basis.

Question: Doesn’t a medical problem require a medical solution?
Answer: Weight No More!

I began my Weight No More program for the medical treatment of obesity in August 1992 while primarily involved with my family practice of 22 years. My treatment of obesity was initially based on the research of Michael Weintraub, M.D., from the University of Rochester School of Medicine. His study – funded by the National Heart, Lung and Blood Institute was published in a series of articles in Clinical Pharmacology and Therapeutics in May 1992.

Obesity is a chronic, metabolic genetic disorder that needs to be treated like other chronic conditions as much as possible with diet, exercise, and behavior modification. But ultimately since obesity represents a chemical imbalance, it needs to be treated by means of drug therapy.

Weintraub’s four-year study concluded that long-term appetite suppressant medication was effective in enabling obese people to lose weight and keep it off. Up until this study, prevailing medical opinion held that medication or other methods short of aggressive surgery to bypass the intestine or staple the stomach could not provide long-term relief from obesity.

There is a genetic predisposition toward obesity similar to other chronic conditions like diabetes and hypertension. You may be aware an obesity gene was discovered within the past three years by a research team from Rockefeller University. This finding gives further evidence supporting the set-point theory for weight control, according to which a portion of the brain knows as the hypothalamus plays a role in determining a person’s body weight and stubbornly defends that level against fluctuations.

As many as 75 percent of people who suffer from obesity do so because their metabolic set point is too high. Between August 1992 and September 15, 1997 we placed our patients, when medically indicated on a combination of two prescription medications: Phentermine, an appetite suppressant that elevated neuropeptides dopamine and norepinephrine, and Fenfluramine which elevated serotonin levels and had antidepressant effects in addition to controlling food cravings.

Thus, the origin of “Phen-Fen,” which had become so popular. I believe many overweight patients have more frequent depression than normal people, not because of their weight per se, but due to the fact that their serotonin levels are too low. As previously mentioned, Fenfluramine elevated those levels. Thus, not only would most people lose weight effectively and consistently but felt good in the process.

Once the desired weight loss was achieved, the dosage of the two medications was titrated to a life-long maintenance regiment when needed. Our patients, as part of a comprehensive weight loss program, also are given recommendations concerning diet, nutrition, and exercise.

The message I hope to relate here is that being overweight, in most cases, in not your fault. Many of you no doubt have heard many times and possible from your personal physicians that what you need to do to lose weight is simply “eat less and exercise more.” That’s false, at least for the majority of you.

We are a medical offices that specialize only in medical weight loss. We are specialists in the field of bariatrics (the diagnosis and treatment of obesity). We have highly qualified staff members who are competent and compassionate.

Obesity has been shown to be a significant risk for cardiovascular disease, hypertension, diabetes, and dysilipidemia (elevated cholesterol and triglycerides). In addition, there often are cosmetic and psychological issues that overweight people must learn to cope with. I believe that weight loss (in an attempt to get as close to ideal body weight as possible) is as important for general health and longevity as quitting smoking is to the prevention of lung cancer. Recently, Time magazine did a cover story on “The Girth of a Nation.” One of the ways to change that story to the “Health of a Nation” would be to inform the more than 50 million overweight people in our country of the availability of pharmacotherapy as an important adjunct for long-term weightloss.

I would like to thank the many patients who, through their success and referrals, have been the highest compliment to our practice. At times, good medical practice requires a challenge to the status quo. I believe that we at Weight No More have been doing just that for the past 6 ½ years.


Individual results may vary with treatment.