2020-12-15 OMA Agenda - Board of Trustees

term use. One suggested approach was to implement intermittent therapy. Regarding prescribing phentermine long-term, the authors advised: “ Direction and guidance provided by State Medical Boards and local laws always take precedence. However, in the many locations where these sources have not provided clear advice, clinicians are left to make their own best professional judgments. ” The authors also noted how phentermine was the most widely prescribed weight loss medication (at least partially because it is generic and low cost), and that likely much of this prescribing was “off label.” In this Endocrine Society Clinical Practice Guideline, the authors acknowledged minimal evidence of any serious long-term side effects when phentermine monotherapy was used alone for weight loss. Their conclusion was that it was reasonable for clinicians to prescribe phentermine long term as long as the patient: “1) has no evidence of serious cardiovascular disease; 2) does not have serious psychiatric disease or a history of substance abuse; 3) has been informed about weight loss medications that are FDA approved for long-term use and told that these have been documented to be safe and effective whereas phentermine has not; 4) does not demonstrate a clinically significant increase in pulse or BP when taking phentermine; and 5) demonstrates a significant weight loss while using the medication.” In its Obesity Algorithm, the Obesity Medicine Association has likewise acknowledged that while not studied in a prospective, large, randomized, controlled, clinical outcomes trial, clinicians often prescribe phentermine for longer than 12 weeks. Such clinicians believe this is in the best interest of their patients with obesity, and a style of obesity management supported by existing data and opinion leader recommendations. (6) To the extent that phentermine is to be

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