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Abstract
To investigate whether a serotoninergic drug such as dexfenfluramine (dF) may have
some beneficial effects on energy expenditure (EE) during therapeutic weight reduction,
a 3-month study was conducted in a double-blind, placebo-controlled trial. Thirty-two
obese, premenopausal women received either dF or placebo (P) in addition to a very—low-calorie
diet (VLCD) prescription. All patients started—when hospitalized at the metabolic
ward—with a 500-kcal regimen and fulfilled the 3-month trial on a ±760-kcal protein-sparing
modified fast. Although not statistically significant, women receiving dF lost more
weight (16.0 ± 1.4 v 12.8 ± 1.3 kg, P = .111) over the 3-month study period. Resting metabolic rate (RMR) decreased significantly
by 5% in the dF group (4.79 to 4.53 kJ/min) and by 9% in the P group (5.09 to 4.63
kJ/min). When expressed per kilogram body weight, RMR significantly increased from
0.050 to 0.057 kJ/min/kg in the dF group (P < .001), versus 0.053 to 0.056 in the P group (NS). When expressed per kilogram fat-free
mass (FFM), RMR remained stable in the dF group, whereas it significantly decreased
in the P group (P = .024). No significant differences could be found between groups. Glucose-induced
thermogenesis (GIT), expressed as percent increase above RMR, did not show significant
differences between groups. When expressed per kilogram body weight, mean GIT increased
in the dF group from 0.14% to 0.16% above RMR, with a significant decrease from 0.15%
to 0.13% in the P group. Only during the first hour did GIT per kilogram body weight
significantly (P = .038) increase in the dF group during the outpatient period (between day 16 and
day 90). These results show that a serotoninergic drug seems capable of limiting the
weight reduction—associated decrease in RMR and dietary-induced thermogenesis (DIT),
certainly when expressed on a per-kilogram-weight basis.
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© 1995 Published by Elsevier Inc.
