Objective: To investigate the effect of the serotonin receptor agonist dexfenfluramine on eating habits and weight loss in ambulatory, android type, moderately obese patients with an overconsumption of snacks.
Design: 9 week, randomized, double-blind treatment with either dexfenfluramine (30 mg/day) or placebo, without dietary intervention.
Setting: Outpatient clinics of four University Hospitals in The Netherlands.
Subjects: 112 healthy obese subjects, body mass index 28-35 kg/m2, waist-to-hip ratio > or = 1.0 for men and > or = 0.8 for women, consuming more than five snacks containing in total more than 500 kcal/day and/or more than 25% of total calorie intake in the form of snacks.
Main outcome measures: Changes in macronutrient composition of the diet, food intake (total, at principal meals and in between meals in the form of snacks) and weight loss.
Results: 104 subjects were included for efficacy analysis. In both the dexfenfluramine group (n = 51) and the placebo group (n = 53) the total energy intake decreased. The decrease during main meals was significantly greater in the dexfenfluramine group for all parameters tested except for simple carbohydrates. In between meals the decrease in intake was significantly greater in the dexfenfluramine group for total energy intake (P < 0.05) and intake in unsaturated fat (P < 0.05). The reported reduction in total food intake in the dexfenfluramine group was similarly due to reductions in carbohydrate and fat intake. No weight loss was seen in the placebo group. The treated group lost 3.1 +/- 0.2 kg (P < 0.01).
Conclusion: Dexfenfluramine effectively reduces the intake of carbohydrates as well as fat in ambulatory, non diet restricted android obese subjects by reducing food intake during and in between main meals.