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SANDY BANKS / Life As We Live It : Chasing the Beauty Dream, No Matter the Risks Involved

September 19, 1997|SANDY BANKS

Even if you could have ignored those newspaper ads--promising "safe, proven, no hunger" weight loss--it was hard to avoid the personal accounts.

Your neighbor's hairdresser lost the 30 pounds she'd been carrying since her last baby. A co-worker bought a bikini this summer for the first time in 15 years. The fat guy in your husband's carpool shrunk before your eyes, shedding 50 pounds without missing a meal.

What Prozac is to depression, fen-phen became to the battle of the bulge--a magic bullet, a quick fix, a way to defy time and biology.

Until this week, that is, when our fen-phen-fueled fantasies crashed into a wall of hard medical realities, and the drugs disappeared amid a haze of stories about heart failure and untimely death.

It is a hallmark of our culture, this preoccupation with body size and shape, this fanaticism that has led teenage girls to starve themselves and grown women to accept heart damage as an acceptable risk, if the payoff resembles Elle McPherson.

"In our society, women will do anything to get thin, men will do anything to get muscular," says Dr. David Heber, a UCLA professor of medicine who studies obesity and nutrition.

"The driving force is the same--to be attractive to the opposite sex. That's why men take anabolic steroids and women use fen-phen. It's the body image they're after."

Forget the health risks and get out of our way; we're chasing a dream.

*

They were black market drugs, arriving in plain brown boxes from France for years before doctors here could legally prescribe them. Magic pills with the power to melt pounds away without making you hungry or grumpy or sick.

Their price tag ran into the thousands and only doctors with the right connections could get them, putting them out of reach for many women. But their legend grew nonetheless, as we swapped stories in gyms, beauty shops and office bathrooms about how they'd transformed our friends' bodies--and, therefore, their lives.

By the time the drug combo was approved by the FDA last year--to treat obesity in patients 20% over their optimum weight--the market was already booming. Weight loss centers began sprouting on every corner, handing out prescriptions to anyone with a few pounds to lose at the low, low price of $59 a month.

It was the death of one of those people that helped spark this week's drug recall.

Patricia Ann Mishcon, the 53-year-old wife of the mayor of North Miami Beach, Fla., had been taking the pills for six months when she died this summer of a heart attack that doctors linked to damage caused by diet drugs. She had gotten her fen-phen from an ophthalmologist who was running a weight loss clinic on the side. She was trying to lose 10 pounds.

"What happened with fen-phen was the tragedy of our times," says Heber, who runs UCLA's nationally known weight loss program.

"It had benefits to patients when used in a medical setting, but it was never meant to be used for cosmetic obesity. And now, the result is a valuable tool for weight management for seriously obese patients--for whom nothing else has worked--has been taken away."

Heber has seen people whose "whole lives have been turned around" by fen-phen--the secretary who lost 100 pounds and can now walk up a flight of stairs without gasping for breath, the man who can finally take an airplane ride or fit in a seat at a movie theater.

More than 4 million prescriptions have been written for the fen-phen combination in the past 15 months, and only a handful of medical problems has surfaced. But those are so serious--potentially lethal heart problems--that their manufacturer withdrew the drugs Monday rather than risk a public health disaster.

Since then, weight loss clinics have been flooded with calls from patients who are not worried that they may have damaged their hearts but angry that their pills have been taken away.

"It's like telling somebody that they can't get their nose made smaller or their breasts made larger," said Dr. Don S. Jensen, whose 18 Manhattan Weight Control centers have dispensed fen-phen to most of the 15,000 patients who have come through their doors.

Most of them, he said, were middle-aged women who were 40 to 60 pounds overweight. "Those are the main people who are going to miss fen-phen," he said.

Not to mention the operators of weight loss clinics--many of them "doctors whose incomes have fallen so tremendously [due to managed care], they decided to do a little fen-phen on the side."

*

In our weight-obsessed culture, we've bet on Jenny Craig and Nutri-System, Slim-Fast and Dexatrim, Weight Watchers and Overeaters Anonymous. And in the absence of fen-phen, we'll continue to search for that magic bullet.

Already doctors are experimenting with new ways to package the available weight loss drugs and counter all this bad publicity--touting concoctions like "herbal fen-phen" and fen/Pro (you guessed it: Prozac combined with an appetite suppressant).

And there are promising new drugs on the horizon, though they probably won't be introduced until the furor over fen-phen dies down. And like fen-phen, they will soon make their way out of legitimate obesity clinics and into the hands of quacks promoting better body image through chemistry.

"There will be abuses for any drug that comes along for weight loss," predicts Yale psychology professor Kelly Brownell, who runs Yale's Center for Eating and Weight Disorders. "It's part of our deep-seated need to look good, to have the perfect body.

"There's this assumption today that if you don't have the perfect body . . . you're not trying hard enough; that you can shape your body at will and the only thing that lies between you and perfection is effort."

And the right combination of drugs.

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