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So does that make Redux, in its stylish sweater-striped capsule, the ideal drug for our look-good, feel-good era? Hardly. Like any other medication, Redux has side effects. Some are merely annoying: fatigue, diarrhea, vivid dreams, dry mouth. But some are patently dangerous. The drug has caused significant, possibly permanent brain damage in lab animals--though not, as far as anyone knows, in humans. It can trigger a rare but frequently fatal human disorder called primary pulmonary hypertension, which destroys blood vessels in the lungs and heart. European research on fen/phen shows that using such drugs for more than three months boosts the risk of pph from the normal 1 or 2 in 1 million patients to 18 in 1 million. A study published three weeks ago in the New England Journal of Medicine suggests the rate is actually as high as 46 per 1 million patients.
That risk, of course, and the still unquantified chance of brain damage have to be weighed against the danger of remaining fat, which is considerable. Severe obesity puts people at risk for heart disease, diabetes and some cancers, and in the U.S. contributes to 300,000 deaths each year. If Redux can help these people get thin, it might be worth the risk.
For the merely overweight, though, Redux probably poses an unacceptable danger. While the drug is intended to be taken only by the clinically obese for a limited time, in conjunction with an ongoing diet and exercise program, there is no guarantee that this scenario will be followed. Predicts David Nichols, a Purdue University pharmacologist: "This drug will ultimately be overprescribed by every bumpkin doctor who has patients who perceive themselves to be slightly overweight."
That's already proved true with fen/phen, as Betty Moore, 64, a registered nurse living in Los Angeles, found out. Shortly after starting on the drug, she began experiencing noticeable mood shifts. "I kind of knew that it had something to do with the medication," she says, "because a couple of times when I went off it for a few days, it was almost like going off amphetamines." Moore had obtained the drug at a weight-loss clinic whose presiding doctor was rarely available to talk to patients. Such problems could be more widespread with Redux, which will be marketed not only to diet specialists but also to general practitioners--and the general public.
Americans are certainly primed to respond. The U.S. is one of the fattest countries on earth, and at the same time the most obsessed with slimness. Some 58 million citizens, nearly a fourth of the nation's population, are clinically obese--at least 20% above their ideal body weight. For a 5-ft. 3-in. woman, that's 162 lbs. or more. Millions more are significantly overweight. All told, Americans are carrying around tons of excess fat, and we are desperate to lose it.