Popular Science: What is "Sibutramine" that has become a hot topic along with Guo Meimei?

Guo Meimei is on the hot search again! She was detained again less than two years after being released from prison for selling weight loss foods that contained the banned substance "Sibutramine". Sibutramine, L-carnitine, fenflamin... These names are not unfamiliar to those who are obsessed with losing weight and beauty, but those who just want to lose weight with "withered vines, old trees, crows, air conditioning, WiFi, and watermelons" may need to read the full article.

As an oral central nervous system-acting weight loss drug, FDA launched sibutramine in December 1997. However, as of 2003, there were 54 deaths, 30 of which were caused by central cardiovascular events. In January 2010, FDA released a clinical safety report on sibutramine hydrochloride, the results of which showed that patients with a history of heart disease who took sibutramine hydrochloride had an increased incidence of cardiovascular and cerebrovascular risks. In 2010, the former State Food and Drug Administration organized relevant experts to evaluate the safety of sibutramine in my country, and drew on relevant foreign research data and measures taken. It was believed that the use of sibutramine may increase serious cardiovascular risks, and the risks of weight loss treatment outweigh the benefits. The production, sale and use of sibutramine preparations and APIs in my country were stopped, and the manufacturers were responsible for recalling and destroying the drugs that had been marketed. In 2012, the "List of Substances That May Be Illegally Added in Health Foods (First Batch)" was formulated to regulate a variety of drugs such as sibutramine and ephedrine. In 2016, the "Food and Drug Administration's Food Supervision No. 3 [2016] 68" was issued again to carry out special governance work on the illegal addition and illegal claims of three types of food, including sibutramine and other substances, and health foods.

What does sibutramine do?

Sibutramine is a non-amphetamine appetite suppressant that can make people easily satisfied with a small amount of food and reduce their craving for food. Sibutramine works in the opposite way to laxative-type weight loss drugs. It acts on the nerve center to reduce appetite and increase satiety to achieve the effect of weight loss. If you take both, the result is that you eat less and excrete more, so you lose weight.

What are the dangers of sibutramine?

Common adverse reactions include dry mouth, vomiting, nausea, constipation, difficulty sleeping, dizziness, headache, joint pain, etc. Severe cases may even cause arrhythmia, emotional confusion, depression, and suicidal behavior. Sibutramine significantly increases the incidence of cardiovascular disease and the risk of high blood pressure. Since sibutramine is a centrally active substance, it can cause the release of centrally active substances such as norepinephrine, 5-HT, and dopamine.

Who needs to take weight loss pills?

The only weight loss drug that is currently available as an over-the-counter drug in my country is orlistat, which is also the main ingredient of various "fat-removing pills" circulated on the Internet. Its mechanism of action is to act on enzymes in the digestive system, preventing fat from being broken down and absorbed by the intestines. 30% of the fat in the diet passes directly through the digestive tract, thereby reducing calorie intake. Due to its non-autonomous oil excretion, many patients even need to wear diapers when taking it. It can be seen that the effects of legal weight loss drugs are not that magical. They are just auxiliary measures based on "control your mouth and move your legs."

No matter what form of obesity, it is a simple problem of nutritional intake and expenditure. The correct way to lose weight is nothing more than two points, a reasonable diet and scientific exercise. Good luck! (Reporter Zhang Mengfan)

Scientific review: Du Boran, Chief Pharmacist, Beijing Obstetrics and Gynecology Hospital, Capital Medical University