While Dr Sheperd’s review of obesity management (“ Effective management of obesity,” 2003; 52(1):34–42) is timely and appropriate, given the significant impact of this problem for both the individual and society, unfortunately his brief review of sibutramine therapy contains an inaccuracy. Although he correctly states that sibutramine is approved by the US Food and Drug Administration (FDA) for long-term obesity management, he is mistaken in his view that “long-term use of sibutramine cannot be recommended, and safety data are unavailable beyond 1 year of use.”
Sibutramine (Meridia), used in combination with diet and lifestyle modification, has been demonstrated to promote weight loss and weight maintenance in obese subjects for up to 2 years,1 and in fact is currently approved by the FDA for 2 years of therapy.2
There can be no doubt that obesity is a worldwide health problem. More than 60% of the adult population in the United States are overweight or obese, and the numbers are growing steadily.3 It is estimated that nearly 300,000 deaths annually in the US may be attributed to obesity.4 Given the enormous challenges faced by physicians and other health care professionals who treat obese patients, we need all the tools that are available to us, and therefore accurate information about safe and effective therapies for the treatment of obesity is essential.
Stephen Brunton, MD, Director of Faculty Development,
Stamford Hospital/Columbia University Family Practice Residency Program,
Stamford, Conn