"In their quest to find drugs to curb obesity scientists have had about as much success as longterm dieters who want to stay thin  which is to say very little. In fact the last year has been so bleak on the research front that some experts are questioning whether a longdesired safe and effective diet pill can be found. Advisory panels for the Food and Drug Administration recommended against approval of two experimental weightloss drugs this year  Lorqess in September and Qnexa in July  citing unacceptable risks for unimpressive benefits. Another drug Meridia was withdrawn from the market in October after it was linked to higher risks of heart attacks and strokes. Last week an advisory panel did finally recommend approval of a weightloss drug Contrave a combination of two existing drugs the antidepressant bupropion and the antiaddiction medication naltrexone. FDA rulings for all three drugs are expected next year. But it did so with a marked lack of enthusiasm citing the medications poor effectiveness and a need to closely track health risks such as high blood pressure once the drug is in broad use. As drug after drug falters or falls by the wayside doctors who treat obese patients are growing increasingly frustrated. They say that the agencys standards for approving antiobesity drugs are overly stringent and fail to recognize the health risks associated with carrying extra weight  at a time when almost  of U.S. adults are obese and almost  are morbidly obese and when study after study has shown that the most that can be hoped for from diets and exercise on average is a  loss of body weight sustained for at least one year.   So gloomy is the climate for these drugs that some experts fear drug companies will outandout abandon the antiobesity market. Every big company is going to get out of the game and venture capitalists are not going to invest in the smaller companies to develop drugs Dr. Donna Ryan past president of the Obesity Society said in October during that groups annual meeting in San Diego. Everybody in the obesity field is upset. There is a lot of anger. Obesity drugs in the U.S. certainly dont have a terrific track record. Fenphen a combination of appetite suppressants fenfluramine and phentermine was hugely popular in the s but was pulled from the market in  after it was linked with primary pulmonary hypertension a potentially fatal condition and heartvalve problems. But the new generation of medications was supposed to be more finely crafted and therefore safer and better. The only prescription medication approved solely for weight loss is orlistat a drug that inhibits fat absorption that is sold under the trade name Xenical or as a weaker overthecounter version Alli. And though an FDA advisory committee did recently endorse expanding eligibility for LapBand surgery to allow people with lessextreme obesity to be candidates obesity experts say that not everyone is eligible for surgery and that this decision in any case does nothing to serve people who are overweight not obese. The FDA treats drugs for obesity as if they were in a different category said Judith Stern professor of nutrition and internal medicine at UC Davis. I think it is not taking it seriously as a disease and I have no clue why. We have a problem that affects over  of the adult population  the FDA should be jumping through hoops to give approval. FDA officials would not comment on this years advisory committee votes nor on its philosophy on obesity drugs. But in an era when the agency is holding all new drugs to more rigorous safety standards its clear that most of the new offerings havent cut the mustard in the key equation of whether benefits outweigh potential risks. I understand the frustrations people have  but I dont think we have great medications said Dr. Abraham Thomas division head of endocrinology at Henry Ford Hospital in Detroit who was acting chairman on the FDA advisory panels that reviewed Meridia and Lorqess also known by its generic name lorcaserin and a member of the panel that reviewed Qnexa. Its a balance Thomas added. Each panel carefully weighs a drugs effectiveness against its safety. If weightloss results look good then potential side effects unless theyre extremely serious might not be weighed so heavily. But if a drug isnt very effective then the safety issues become magnified. So for example in the case of lorcaserin panel members were hesitant to recommend approval because trials barely proved effectiveness Thomas said.   Obesity experts counter that the agency and its expert panels dont properly appreciate the health risks associated with obesity  diabetes heart disease stroke osteoarthritis certain types of cancers and possibly dementia. They are framing weight loss as a cosmetic problem Ryan said. Obesity is a medical problem."