This blog is written by Canadian journalist Donna Laframboise. Posts appear Monday & Wednesday.
Whether it’s climate science or medical science, a fake crisis leads to bad decisions that harm real people.
Athletic Mary Linnen had been on the swim team in high school, and on the tennis team in college. At age 29, wanting to slim down prior to her wedding, her doctor prescribed Fen-phen, a combination of two diet pills (fenfluramine and phentermine) approved by the US government 14 years apart.
The Boston, Massachusetts woman stopped taking the appetite-suppressing drugs after 23 days, due to breathing problems. Six months later she was told she had a fatal lung disease, might survive as long as four years, and that having children was out of the question.
Mary spent the remainder of her life with a tube running from a portable pump into her chest, at constant risk of a heart attack, dependent on medication that cost $200,000 a year. Eight months after beginning Fen-phen, she went blind in one eye. A month later, she died at age 30.
Her tragic story is recounted in Alicia Mundy’s 2001 book, Dispensing with the Truth: The Victims, the Drug Companies, and the Dramatic Story Behind the Battle over Fen-Phen.
With the passage of time, it’s now clear the 1990s Fen-phen scandal is a case study in failure: Medical journals. The US Food and Drug Administration (FDA). Pharmaceutical companies. They all failed. And innocent people died horrible deaths as a result.
But this story is also about the power of dogma. In climate science, there’s the myth that 97% of scientists agree humans have triggered a global warming crisis. Spend 20 minutes looking into where that number comes from and you discover it’s nonsense (see here, here, and here). It’s pure propaganda, a number invented by activists and then cited by politicians.
In the case of Fen-phen, the dogma concerns obesity. We’re told ad nauseam that 300,000 Americans die prematurely each year due to the obesity crisis. Therefore, a vigorous medical response is required. Sure, the argument goes, drug side effects kill some people – but thousands more will be saved.
It turns out the 300,000 obesity deaths claim is bogus. It, too, was invented by activists and then amplified by government officials. Yet it was cited repeatedly in 1996 by those urging the FDA to approve Redux, a new drug that was chemically similar to Fen-phen, even though (while marketed as Isomeride in Europe) it had already alarmed the medical community.
This single, erroneous FDA decision led to hundreds of unnecessary lung disease deaths, hundreds more surgeries involving heart valve damage, and lawsuits totalling billions of dollars.
What role did medical journals play? Let’s start with the Journal of Clinical Pharmacology and Therapeutics. In 1992, it published a 65-page supplement describing new research.
Divided into 9 parts, each part was written by the same person, pharmacology professor Michael Weintraub. He was also the supplement’s Guest Editor. Which means he was put in charge of publishing his own work.
In essence, this was a 65-page advertisement for one man’s alternative theories about drugs and weight loss. The study involved 121 human beings at its start date, who were given the two drugs that would later become known as Fen-phen.
When approved years earlier by the FDA, these medications were considered safe if used on their own for a few weeks at a time. But Weintraub believed obese people should take drugs continuously.
Experiments that haven’t been done before are normally conducted on animals first. But that didn’t happen. Some of the participants in Weintraub’s study were given both drugs for more than 3 years. The 9-part research report described what transpired.
I’ve read all of it, and the short version is that some people lost significant amounts of weight, but almost all of them gained it back as soon as they stopped taking the drugs. Moreover, all of the participants in the study kept to a strict diet, exercised regularly, and attended frequent group therapy sessions.
Medical journal supplements aren’t free. They get printed when outside funding is available. Journals also receive significant amounts of money when reprints are ordered for mass distribution.
Through his lawyer, Weintraub later admitted that a drug company funded the supplement. Each of the nine sections tells us his research was paid for by the US government. Not one of them mentions that the government grant only covered part of the costs, and that a drug company funded the remainder.
Reprints of Weintraub’s supplement found their way to doctors and journalists. On the strength of this single study, large numbers of US physicians began prescribing Fen-phen to their own patients.
Word spread via women’s magazines. The first article appeared in Allure, in February 1995. It got reprinted in Reader’s Digest in May of that year – a full 12 months before Mary Linnen starting talking Fen-phen. The article discusses pulmonary hypertension, the lung disease that took her life.
It mistakenly describes the disease as ‘potentially fatal.’ Actually, it’s a death sentence. As this 1993 medical consensus statement explains, there “is no cure,” and patients “frequently die suddenly.” Even now, 20 years later, the only question is how long this horrific disease takes to kill you.
But the article contains a far more egregious claim. Weintraub apparently advised the reporter that this incurable medical condition ‘disappears when the drug is discontinued.’ If he was misunderstood, he certainly had time to correct the record, since the the Reader’s Digest version appeared months later. But that didn’t happen.
Instead, the public was told a fairy tale about diet drugs. By a man who used human beings as guinea pigs and who then concealed the source of much of his funding.
The editor of the journal that gave this ethically dubious research a sheen of respectability, spreading it far and wide? His name was Marcus Reidenberg.
Two years after both fenfluramine and Redux were pulled off the US market, two years after Mary Linnen was carried up the aisle of a church in a casket instead of walking down it in a wedding dress, the American Society for Clinical Pharmacology and Therapeutics (which owns the journal) gave Reidenberg an award for his ‘outstanding efforts on behalf of the organization.’