Short Communication | Published:

Effect of phentermine on weight reduction in a pediatric weight management clinic

International Journal of Obesity volume 41, pages 9093 (2017) | Download Citation

Abstract

Phentermine is the most widely prescribed obesity medication in adults, yet studies of its use in the pediatric population are limited. We conducted a retrospective chart review of adolescents with obesity treated in a pediatric weight management clinic to examine the weight loss effectiveness of phentermine added to standard of care (SOC) lifestyle modification therapy versus SOC alone. All patients receiving phentermine plus SOC (n=25) were matched with a comparison group receiving only SOC (n=274). Differences at 1, 3 and 6 months were evaluated using generalized estimated equations adjusting for age, sex and baseline body mass index (BMI) and robust variance standard error estimates for confidence intervals and P-values. Phentermine use was associated with a greater percent change in BMI at 1 month (−1.6%; 95% confidence interval (CI): −2.6, −0.6%; P=0.001), 3 months (−2.9%; 95% CI: −4.5, −1.4%; P<0.001) and 6 months (−4.1%; 95% CI: −7.1, −1.0%; P=0.009) compared with SOC alone, with no differences in systolic or diastolic blood pressure between groups. Heart rate was higher at all time-points in the phentermine plus SOC compared with SOC-only group. These data suggest that short-term use of phentermine added to SOC may enhance weight loss in adolescents with obesity in the clinical setting.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1.

    , , , , . Pediatric obesity pharmacotherapy: Current state of the field, review of the literature, and clinical trial considerations. Int J Obes (Lond) 2016; 40: 1043–1050.

  2. 2.

    . Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics 2007; 120: S164–S192.

  3. 3.

    , , . Pharmacotherapy for childhood obesity: present and future prospects. Int J Obes (Lond) 2013; 37: 1–15.

  4. 4.

    , , . How physician obesity specialists use drugs to treat obesity. Obesity (Silver Spring) 2009; 17: 1730–1735.

  5. 5.

    , . National trends in antiobesity medication use. Arch Intern Med 2003; 163: 1046–1050.

  6. 6.

    . Obesity in childhood. A controlled trial of anorectic drugs. Arch Dis Childhood 1966; 41: 309–312.

  7. 7.

    , . Chlorphentermine as an anorexigenic agent in adolescent obesity. Report of its efficacy in a double-blind study of 30 teenagers. Clin Pediatr 1968; 7: 138–140.

  8. 8.

    Team RCR: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, 2015.

  9. 9.

    , , , , . Randomized controlled trial to investigate the effects of a newly developed formulation of phentermine diffuse-controlled release for obesity. Diabetes Obes Metab 2010; 12: 876–882.

  10. 10.

    , , , . Blood pressure and heart rate effects, weight loss and maintenance during long-term phentermine pharmacotherapy for obesity. Obesity (Silver Spring) 2011; 19: 2351–2360.

  11. 11.

    , , , , , et al. The effect of glucagon-like peptide-1 receptor agonist therapy on body mass index in adolescents with severe obesity: a randomized, placebo-controlled, clinical trial. JAMA Pediatr 2013; 167: 355–360.

  12. 12.

    , , , , , et al. Exenatide as a weight-loss therapy in extreme pediatric obesity: a randomized, controlled pilot study. Obesity (Silver Spring) 2012; 20: 364–370.

  13. 13.

    , , , , , et al. Effects of metformin on body weight and body composition in obese insulin-resistant children: a randomized clinical trial. Diabetes 2011; 60: 477–485.

  14. 14.

    , , , , . Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA 2005; 293: 2873–2883.

  15. 15.

    , , , , , et al. Metformin extended release treatment of adolescent obesity: a 48-week randomized, double-blind, placebo-controlled trial with 48-week follow-up. Arch Pediatr Adolesc Med 2010; 164: 116–123.

  16. 16.

    , , , , , . Influence of age, gender, body mass index, and functional capacity on heart rate variability in a cohort of subjects without heart disease. Am J Cardiol 2004; 93: 381–385.

  17. 17.

    , , , , , et al. Addiction potential of phentermine prescribed during long-term treatment of obesity. Int J Obes (Lond) 2014; 38: 292–298.

Download references

Acknowledgements

Dr Ryder is supported by an individual training grant from NIH/NHLBI (F32-HL127851). Dr Rudser and Kaizer are supported, in part, by the National Center for Advancing Translational Sciences/NIH (UL1TR000114). The other authors received no funding for this project.

Author information

Affiliations

  1. Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA

    • J R Ryder
    • , A Gross
    • , A S Kelly
    •  & C K Fox
  2. Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA

    • A Kaizer
    •  & K D Rudser
  3. Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA

    • A S Kelly

Authors

  1. Search for J R Ryder in:

  2. Search for A Kaizer in:

  3. Search for K D Rudser in:

  4. Search for A Gross in:

  5. Search for A S Kelly in:

  6. Search for C K Fox in:

Competing interests

Dr Kelly serves as a consultant for Novo Nordisk Pharmaceuticals, but does not receive personal or professional income for these activities. Dr Kelly receives research support in the form of drug/placebo from Astra Zeneca Pharmaceuticals. Dr Fox serves as a site principal investigator for a clinical trial sponsored by Novo Nordisk Pharmaceuticals. The other authors declare no conflict of interest. No honorarium, grant or other form of payment was given to anyone to produce the manuscript.

Corresponding author

Correspondence to J R Ryder.

Supplementary information

About this article

Publication history

Received

Revised

Accepted

Published

DOI

https://doi.org/10.1038/ijo.2016.185

Supplementary Information accompanies this paper on International Journal of Obesity website (http://www.nature.com/ijo)