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Pros and Cons of Weight Loss Drugs continued...

Use of Meridia was associated with slight increases in blood pressure in seven studies.

And Acomplia use was associated with a 3% increase in the likelihood of developing a psychiatric problem such as depression, anxiety, and irritability.

While no serious safety issues emerged during the trials, Padwal says there is little information about the safety of using the drugs for many years.

The analysis is published in the latest online issue of the journal BMJ.

"Anti-obesity drugs can help people achieve modest weight loss, but they have to be taken indefinitely or the weight will come back," Padwal says. "Patients and their practitioners have to make a bit of a leap of faith if they plan to continue on these medications for several years."

Obesity Researcher Targets Alli

Padwal says the drugs have a place in the management of obesity as long as patients have realistic expectations about what they can achieve with them.

But in an editorial accompanying the analysis, obesity researcher Gareth Williams, PhD, argues against the use of weight loss drugs without medical supervision.

Williams says the recent introduction of a lower-dose version of Xenical -- sold over-the-counter as Alli in the United States -- is more about marketing than sound medicine.

"Selling anti-obesity drugs over the counter will perpetuate the myth that obesity can be fixed simply by popping a pill and could further undermine the efforts to promote healthy living, which is the only long-term escape from obesity," he writes.

In an interview with WebMD, Williams charges that the main beneficiary of the new over-the-counter pill will be Alli manufacturer GlaxoSmithKline.

"I'm afraid I regard this as a rather cynical money-making enterprise on their part," he says. Taking a weight loss pill without medical supervision is likely to distract from the message that people have to make significant lifestyle changes to achieve meaningful weight loss."

A spokeswoman for GlaxoSmithKline tells WebMD that Alli is intended for use only by people who are willing to make these lifestyle changes.

"Alli is neither a magic pill nor a quick-fix solution, and we have certainly never marketed it that way," says Malesia Dunn. "The way this product has been marketed from day one has been to educate the consumer about the importance of making lifestyle changes."

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