A case of profound weight loss secondary to use of phentermine

Obesity has become particularly prevalent in both the United States and worldwide. Mississippi continues to lead the nation in prevalence of obesity estimates. The proportion of morbidly obese subjects is increasing at a disproportionately greater rate and the burden of obesity and its complications are more prevalent among ethnic minorities. We present the unique case of a Choctaw lady with morbid obesity who has shown a profound response to pharmacotherapy with phentermine.

The clinical case history of the patient; a 34-year-old Choctaw lady with morbid obesity, hypertension, hyperlipidemia, and type 2 diabetes is presented, followed by discussion of issues relevant to impacting the obesity epidemic in Mississippi.

A 34-year-old Choctaw lady with 1.5 year follow up was noted to have a peak initial body mass index (BMI) of 62.6 kg/m2 and weight of 176 kg. Since commencement of phentermine, initially at 15 mg daily and slowly up-titrated to 37.5 mg daily, she has lost over 23 kg (13% of baseline peak weight) with a current weight of 153 kg and BMI of 54.4 kg/m2. Accompanying the weight reduction has been sustained normal blood pressure and improvement in glycemic control.

Phentermine is a viable and important adjunct in the medical approach to weight management in obese subjects. Its potential utility should be considered even among subjects with morbid obesity. Given its cost it could be a cost effective adjunct in comprehensive weight loss programs for Mississippi that may positively impact the ongoing obesity epidemic. There remains a need for more studies of phentermine to better define its place in obesity management.