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Product Quality Manager
Cambridge Health Alliance : Academics : Medicine
Pieter Cohen Internal Medicine/ PCP - Somerville Primary Care
"I'd rather spend $170 on fruits and vegetables and other wholesome foods and cook them at home than on a genetic test," said Dr. Pieter Cohen, an assistant professor of medicine at Harvard Medical School and a general internist at Cambridge Health Alliance.
"It's very unfortunate this is already being sold to people to use," Cohen said. "We have decades of data in weight loss that a balanced diet is the way to go," Cohen said. "They're saying that, with their test, only 5 percent of people are responsive to a balanced diet," he said. "I expect there to be a continued explosion," of research in this area, Cohen said. "But whether or not that will translate into actual benefit to us as a society is really unknown at this time." "[I] think that a deep understanding of the genes of obesity would not be as effective as serious, aggressive public health approaches to the obesity epidemic," including improving access to healthy foods and promoting activity in the workplace, Cohen said.
For example, studies have linked the drug to seizures, said Dr. Pieter Cohen, an assistant professor of medicine at Harvard Medical School who researches the effects of dietary supplements.
And the fact that pharmaceutical companies appear to be simply "repackaging" old pills in the hopes of generating a new solution for those who are overweight is also cause for concern, Cohen said. Contrave is made up of two medications - one antidepressant and one that treats addictions - that individually had been shown to lead to slight weight loss as a side effect. We spoke with Cohen about Contrave's safety, and whether such pills are really the way to go to tackle the obesity epidemic.
"This is exactly the same issue that we're faced with here," said Dr. Pieter Cohen, a general internist at Cambridge Health Alliance and an assistant professor of medicine at Harvard Medical School.
Cohen said that due to their surveillance procedures for drugs, researchers in Hong Kong are "often on the vanguard of identifying problems." "Fenfluramine is the bad actor of the Fen-phen diet pill," said Cohen, referring to the weight-loss drug pulled from the U.S. market in 1997 for its association with heart attacks. A second banned substance found in the supplements, the laxative phenolphthalein, was outlawed because of an association with cancer. Cohen said perhaps the most disturbing finding was the presence of analog drugs in the supplements. Analogs are drug molecules that have been further modified in a lab. "This hasn't even been studied in mice," said Cohen. "This is really using the consumer... as guinea pigs." The fact that herbal supplements may contain pharmaceuticals, allowing pills to show benefit to consumers while under the guise of being natural, is not a new discovery. But Cohen said findings like these make trouble for consumers, as they cannot simply make a choice to take a supplement based on the research. "In this case, as soon as you start dealing with adulterants, there's no ability to make decisions, because you don't know what is in there or what the side effects are," he said.
"There are prescription drugs in some supposedly natural supplements," says Pieter Cohen, MD, assistant professor of medicine at Harvard Medical School.
"Some manufacturers have made it more difficult for the FDA to detect undeclared ingredients in their products by creating pharmaceutical analogues-they take the formula for an approved prescription drug and alter a few molecules, which makes the drug undetectable but basically creates a new prescription-strength drug that hasn't been tested by anyone. And that has the potential to create new side effects, Dr. Cohen says. The results can be shocking. "I've had patients who lost their jobs because they were taking weight-loss supplements that contained hidden amphetamines, and they didn't realize it until they tested positive during routine work drug tests," Dr. Cohen says. In fact, he says, weight-loss, sexual-enhancement, and bodybuilding supplements in particular are often tainted with prescription medications, steroids, or analogues, so be wary of those.