Place of dexfenfluramine in the management of obesity

The treatment of obesity remains a puzzling challenge because long-term maintenance of weight loss--one of the most suitable goals--is rarely achieved with conventional methods. Among the theoretical measures able to maintain a permanent and bearable constraint to obtain the maintenance of weight loss is long-term (life-long?) pharmacotherapy. Dexfenfluramine is a good candidate for such a use; the demonstration of its long-term efficacy, i.e., maintenance of the initial weight loss with no escape with time, is in progress (ISIS study). Although the correct use of dexfenfluramine in obese patients remains to be more precisely defined, its pharmacological profile leads us to consider that it could be useful for those with normo or hyperphagia and stress induced compulsive feeding behavior, and/or for avoiding relapse in restrained patients. The use of dexfenfluramine must not excuse other types of interventions when needed.