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Combination lorcaserin, phentermine therapy decreases food cravings

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January 24, 2018

Adults with overweight or obesity assigned to combination lorcaserin and phentermine therapy for 12 weeks reported a greater reduction in food cravings vs. patients assigned to lorcaserin alone, according to findings reported in Obesity.

“If food cravings were psychological manifestations of energy depletion reflected as a metabolic need and expressed as hunger, the reduction in energy intake during the treatment period would be expected to increase food cravings,” Candida J. Rebello, PhD, LLB, RD, FTOS, of the Pennington Biomedical Research Center at Louisiana State University, and colleagues wrote. “However, in our study, there was a reduction in food cravings despite energy restriction, which is consistent with other studies whose findings were contrary to this expectation.”

Rebello and colleagues analyzed data from 235 adults with a BMI of at least 27 kg/m² and one or more weight-related comorbidities, but without diabetes. Patients were randomly assigned to 10 mg lorcaserin (Belviq, Eisai) twice daily, 10 mg lorcaserin twice daily plus 15 mg phentermine once daily, or 10 mg lorcaserin twice daily plus 15 mg phentermine twice daily. Participants completed the Food-Craving Inventory and the Control of Eating Questionnaire (COEQ) at baseline and weeks 4, 8 and 12. Researchers used an analysis of covariance model to estimate how ratings for each question on the food-craving scales changes from baseline through week 12.

Researchers found that scores from the Food-Craving Inventory and COEQ fell for all three groups over 12 weeks. Least square means for the total scores were 20.65 for the lorcaserin-only group, 20.75 for the lorcaserin and phentermine once-daily group and 20.84 for the lorcaserin and phentermine twice-daily group.

In the lorcaserin twice-daily and phentermine twice-daily group, researchers found that ratings on questions related to cravings, in general, as well as mood in the COEQ were more improved when compared with participants in the lorcaserin-only group. When assessing scores for frequency and strength of food cravings, difficulty in resisting food cravings and eating in response to craving, the lorcaserin twice-daily and phentermine twice-daily group saw greater declines vs. the lorcaserin twice-daily and phentermine once-daily group.

In assessing cravings for specific foods, researchers observed a reduction from baseline to week 12 for chocolate, other sweets, non-sweets, starchy foods and dairy in all three groups.

The researchers noted that the study lacked a control group and that “one could argue that part of the reduction in craving with the lorcaserin group was due to caloric restriction.” – by Regina Schaffer

Disclosures: Eisai supported this study. Rebello reports no relevant financial disclosures. Please see the study for the other authors’ relevant financial disclosures.

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