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BMJ 2011; 342 doi: (Published 20 April 2011) Cite this as: BMJ 2011;342:d2469

New drug combination shows promise for weight loss

A phase III trial tested two dose regimens of phentermine plus topiramate against placebo as an addition to modification of lifestyle for weight loss and reduction of metabolic risk. Participants were 2487 overweight or obese people, aged 18-70 years, with a body mass index of 27-45 and two or more of the following comorbidities—high blood pressure, unfavourable lipids profile, diabetes or prediabetes, and abdominal obesity. Less than a third made it to the end of the trial at 56 weeks.

Average weight loss with placebo, the low dose drug combination, and the high dose combination was 1.4 kg, 8.1 kg, and 10.2 kg, respectively. Compared with placebo, people who took the low dose combination had 6.3-fold better odds of losing at least 5% of body weight, and participants allocated to the high dose regimen had a 9-fold improved odds. For weight loss of 10% of body weight or more, this was 7.6-fold and 11.7-fold for the low dose and high dose drug …

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