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Sunday, October 5, 2008

Pros & Cons Of Weight Loss Pills

A reader recently e-mailed me about the weight loss pill Phentermine, which she's been taking from a weight loss clinic. "Is this the same as the Phen-Fen weight loss pill that was taken off the market a few years ago?" she asked.

The answer is yes and no.

Phentermine was one half of the weight loss pill combination called Phen-Fen. Several years ago the Fen part (Fenfluramine) was pulled from the market due to adverse health risks. Phentermine is a very effective weight loss medication, however it should not be taken lightly, and certainly is not for everyone.

Our reader isn't alone out there looking for some help in losing weight. Obesity affects more than one-half of our population and is linked to health problems ranging from heart disease to cancer. Unfortunately, with our busy schedules and the easy access to fast food, exercising and eating right is easier said than done.

Phentermine has recently had a resurgence in use with the growing popularity of weight loss clinics that combine high doses of the drug with vitamin injections and very restrictive diets (as low as 500 calories a day).
So what is it? How does it work? Is it safe?

Most of the supplements and medications on the market that have any effect on weight loss typically contain caffeine or another type of stimulant.

Phentermine falls into that category as well. It has a stimulant effect similar to an amphetamine and works in the brain to increase your metabolism and reduce appetite.

It is given in doses of 15 to 37.5 mg daily, usually in the morning or during the day so it doesn't interfere with sleep.

Since it acts as a stimulant, phentermine can have wide-ranging effects including elevated blood pressure, heart palpitations, rapid heart rate, dizziness, headache, insomnia, restlessness, stomach upset and nervous tremors. There is also an association with the development of heart valve disease.

Even more worrisome is that Phentermine can be habit-forming with long-term use. That means it can be addictive. Bottom line, while Phentermine would likely be OK for most people without chronic medical problems (such as diabetes, high blood pressure, heart disease), it should be used only after a thorough discussion with your doctor of the risks and benefits.

Most of you are likely still wondering, "but does it work?" The answer is yes, at least short term. Patients have lost 30 to 40 pounds in some studies, however no long-term studies have been conducted. Another similar-sounding drug, Phendimetrazine, is similar to Phentermine in effectiveness and side effects. Other prescription medications such as Meridia or Xenical have shown a weight loss of 10 percent over a year when combined with diet and exercise.

And that is the take-home lesson. As much as we all would love a simple pill to resolve a weight problem, anything that does not include diet and exercise has little chance of long-term success. Be wary of quick fixes, and make sure to talk with your doctor. Even over-the-counter remedies can be dangerous for some patients.

Do you have a health question relating to adult, pediatric, or women's health issues? E-mail Dr. Andy.

Editor's note: The information in this column is meant to discuss medical issues in general. Any individual decisions should be made by the reader only after consultation with his or her physician.

- Andrew Oakes-Lottridge, M.D., is the only concierge physician in Southwest Florida exclusively making house-calls in Lee, Collier and Charlotte counties. He has pediatric and adult privileges at HealthPark Hospital. E-mail Andy@DrAndy.US or call 239-694-6246.

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Paige said...

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Paige said...
This comment has been removed by the author.