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Obese Children Suffer Like Cancer Kids

Behavior Therapy/Weight-Loss Drug may Help Some Teens

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Berkowitz concludes that adding drug therapy to behavior therapy makes a powerful combination. The reason? Obese children face toxic environments both inside and outside their bodies.

"Behavior therapy helps kids deal with this toxic outside environment. You get all this junk food coming at you, this television, this sedentary culture, and you teach families to manage that," he says. "The drug targets the kids' internal environment -- the biology of obesity."

Meridia is not by any means a totally safe drug. It's now approved only for adult use -- and many adults who take the drug have dangerous increases in blood pressure and pulse rate. Citing at least 32 patient deaths, the consumer group Public Citizen has called for a ban on Meridia. About 40% of the teens in the Berkowitz study had to have their Meridia dose reduced because of high blood pressure and/or high pulse rate. Doctors have to keep a close watch on patients taking the drug.

"When we did that -- closely monitor the kids -- we could keep blood pressure under control," Berkowitz says. "Their pulse rate did go up. But we saw a doubling in reductions in hunger compared to the placebo group. The drug is working the way we think it is working. ... My own belief is when you follow these guidelines, Meridia is a relatively safe medication. ... Although we had some adverse events, we could put most teens on the right dose and they were quite successful."

Berkowitz has already begun a larger study. Schwimmer agrees with Berkowitz's view that there's a need for more and better treatments for childhood obesity.

"I think we need multiple tools including drug treatment," he says. "There are so many obese children. People are desperate to be able to offer them care. Many doctors will use medications, and it is going to be essential to have trials like the one Berkowitz has done to understand which are effective -- and for whom. It will be one important strategy. It is very important that they used the drug only in combination with behavior therapy."

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