online conference transcript

Bob M is the moderator.

BEGINNING

Bob M: Our topic tonight is Diet Drugs and Weight Control. We get emails daily about the diet drug controversy and other weight control issues. That's why we've brought Dr. Ben Krentzman in to be our guest. Dr. Krentzman is an M.D. in California. He is an expert on the issue of weight control, obesity and diet drugs. I believe his entire practice now consists of working with patients concerned about their weight. Dr. Krentzman also has an extensive internet site and we'll be giving you the URL at the end of the conference. Good Evening Dr. Krentzman. Can we start off by you telling us a bit about your expertise?

Dr Krentzman: Thanks Bob, For the last 23 years I have been interested in obesity. I switched from being a Board Certified Family Physician to only taking care of obesity patients in 1993. For the past 2 1/2 years I have maintained the largest website on obesity and have continued to research this subject. My Curriculum Vitae is online on my site.

Bob M: I'd like to start off by having you define "overweight" vs. "obese".

Dr Krentzman: Overweight is defined as being over 20% heavier than the Insurance companies Ideal Body Weight chart for your height and weight. Obesity is having too much fat on your body. You can be overweight and not obese if you are a weight lifter. The Body Mass Index (BMI) is a single scale used by obesity researchers as a measure of fat. It is a combination of height and weight to give one number. A BMI of 22 is considered about ideal. On the BMI scale the government says that 25 or above is overweight and 27+ is obese. The BMI does not measure fitness.

Bob M: What is the cause(s) then for being overweight vs. obese.

Dr Krentzman: Mostly people are overweight because they were born with the genetics which lead to being overweight. The genes are the program within our bodies that tell our brains how to operate. How we process food seems to be of little importance to obesity. There is an organ in the brain which regulates how much fat our body maintains. That organ is the hypothalamus and through a complex of neurotransmitters in the brain and the sympathetic nervous system, it closely regulates what we want to eat.

Bob M: So, if being overweight or obese is a function of genetics, what then is the point of dieting?

Dr Krentzman: Since the success rate of long term weight maintenance is 2%, I do not see much point.

Bob M: Alright. Now I guess is as good a time as any to bring up the diet drugs. And I want to mention, before we get into it, that everyone here I imagine has heard the FDA warnings about taking fen-Phen and other diet drugs. It is very important that you check with your doctor before taking any weight control drugs.

Dr Krentzman: There is a tremendous amount of misunderstanding about the announcements in the press. The media has missed the point. The Mayo Clinic Press Conference on 7/8/97 was an announcement of a suspected condition (heart valve disease) which MIGHT be connected with obese women. At the press conference, a transcript of which is on my website, the doctor reading the message said that NO patient should stop their medicines without talking to their doctor. There is NO PROOF of any long term problems with the diet drugs as there has been only one article of a study longer than one year. All others are shorter.

Bob M: Are you saying, contrary to the FDA warning, that taking drugs like Fen-phen and Redux is safe?

Dr Krentzman: No, I am saying that the "Warning" is a routine way that the FDA asks all the doctors in the USA to be on the lookout for similar problems and to phone in with case reports when we find one. So far about 70 cases have been found out of the 8,000,000 users of diet drugs. Compare this with the 300,000 people who die each year from obesity related illnesses.

Bob M: Everybody has been so patient in the audience. I want to let a few audience questions on, then we'll continue with my questions. We are talking with Dr. Ben Krentzman. Dr. Krentzman is an expert in obesity and weight control. He has an extensive website on the subject and I'll be giving you his URL at the end of the conference.

Lady: I have never been to a conference, but I have a question... Why is it soooo much harder if you only have 20 pounds to lose than if you have 100 ?

Dr Krentzman: It is not harder. If you have, for instance, two people who are 5 foot 7 inches tall and one is 150 pounds and the other is 250 pounds then it takes more calories to keep the 250 pound person at that weight. Therefore they can burn more calories in a day than the more slender person can.

River: Whether or not there is proof, why would anyone want to create health problems in addition to their weight problem.

Dr Krentzman: The FDA asked our help in finding cases so they could get some idea if the diet drugs are somehow involved with heart valve illness. This has not yet been proven, only partly suggested. These may be the only 70 cases in all of time. Should this cause tens of thousands of obese people to die by avoiding the diet drugs WHICH WORK?

River: I understand your point. BUT my overweight is my only health problem (30 pounds) and although I've considered taking the drugs, I've decided against it BECAUSE of the FDA warning. I guess the choice is the health problem I understand vs. the health problem I don't . Ultimately, it's a consumer choice.