By Ed Cara
The drug Ozempic, after just a few years on the market, has already become a household name synonymous with weight loss. The popularity of it and similar medications has skyrocketed so immensely and rapidly that one drugmaker ran commercials telling people to stop using the products if they’re only looking to drop a few pounds.
It’s clear that these drugs actually work, helping people with obesity lose far more weight on average than diet and exercise alone. And every week seems to bring new findings on other potential benefits, such as helping prevent cardiovascular disease or treating drug addiction.
But for some people, Ozempic and its ilk are simply the latest iteration of a well-worn cautionary tale: too-good-to-be-true weight loss aids that will inevitably prove to be dangerous and even deadly.
Perhaps the most infamous example is the drug combination fen-phen, which was taken off the market in the late 1990s after it was found to raise the risk of severe, even life-threatening heart problems. While there are enduring lessons to be learned from the saga of fen-phen, there are also several important differences between it and the newest generation of obesity drugs.
Fen-phen is short for the drugs fenfluramine and phentermine. Both are appetite suppressants, but they work in different ways. Fenfluramine increases levels of serotonin, while phentermine primarily increases levels of norepinephrine—two neurotransmitters that have many important roles, including the regulation of appetite.
Starting in the 1950s, the drugs were separately approved as short-term (a few weeks) obesity treatments. But on their own, they only seemed to help people lose a bit more weight than they would normally and came with plenty of irritating side effects like dizziness, dry mouth, and trouble sleeping. In 1979, Michael Weintraub, then a professor of clinical pharmacology at the University of Rochester, had the idea of combining the two, reasoning that since the drugs affected the body differently to suppress appetite, they might have an even greater synergistic reaction that could also limit side-effects by requiring a lower dose.
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