​While in Paris to present my paper at the Eighth International Obesity Conference August 29 to September 3, 1998, I spent a lot of time walking among the crowds of people in the city. I was surprised to note that the French were all thin. The occasional overweight person I did see invariably turned out to be an older German or an American (any age). Why are the French so thin?

Reasons you might think are important, that aren't...

1. The French smoke more. 40% of their adults smoke compared to 25% of U.S. adults, but 60% of the French adults don't smoke and they are thin, too!
2. The French walk more than Americans, but they don't walk much more. And the people in Paris are thinner than the people in the countryside, although the rural folk get more exercise.

The true reasons for French thinness...

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​Initial report from Robert Skversky is that his appearance on the Dr. Oz show went very well. You will see the show on March 17. I feel relieved. But Robert said something in his analysis that set me thinking. He said, "My only disappointment (there's always something) was Oz's final comment of the show. He stated he thought meds for weight-loss on/off label were not to be used long term suggesting they were a crutch." But I may agree with Dr. Oz on this. Let's see...

​I do not see the moral value of a free press, or maybe I mean I don't see that the press in America is free. The TODAY SHOW yesterday did a scathing report on "combination (diet) pills", prompted by the botched editing of Liz Brody's article in the March issue of MORE magazine. That makes as much sense as opposing all pills that are round or yellow. It's just incoherent. Surely it's a case by case thing; real evidence and experience matter.

​Some of my friends have accused me of being a socialist, which is of course completely accurate and perceptive. And they wonder how I could possibly be one after the fall of Communism, to which I reply that Communism didn't fall. In the Soviet Union then and in China now, a wealthy class of party-members exploits the workers. Uh, that's not what Karl Marx proposed. I bet my friends never read the Communist Manifesto. If they ever do, they should read the new annotated version by Phil Gasper, especially pages 93-117 "Is the Manifesto Still Relevant?"

Dr. Michael Anchors is the author of the book Safer Than Phen-Fen. He is a clinical professor of medicine at Georgetown University and operates a family practice in Maryland.

​Fenfluramine was the original "fen" in phen-fen (also called fen-phen). Fenfluramine binds to the serotonin transporter protein on cells and blocks the reuptake of serotonin just as Prozac does, but fenfluramine binds to a different domain compared to Prozac and is actually taken up into cells. The resulting high intracellular concentration of fenfluramine stimulates the fibrosis cascade resulting in primary pulmonary hypertension (PPH) or heart valve disease, just as with aminorex, phenformin and Sansert (Rothman et al Circulation 1999;100:869). There is no doubt that fenfluramine altered the heart valves in approximately one-third of the patients taking fenfluramine while they took the drug. A few patients progressed to actual valve failure. In the other patients, after the drug was stopped, the valves reverted to a functionally normal state. There is no further need to do echocardiograms in asymptomatic patients who took fenfluramine.