Diet Drugs – A Miracle Cure?

Obesity is one of the most difficult and frustrating disorders to successfully manage, and is one of the most common disorders in clinical practice. Defined as a body weight 20% or more above “desirable” weight, over one-third of adult Americans are overweight, with approximately 50% of women dieting at any one time. Americans also spent over $30 billion last year on diet books, diet meals, weight-loss classes, diet drugs, exercise tapes, and other weight-loss aids.

Some women, in the search for a “miracle cure,” have turned to over-the-counter diet drugs such as Acutrim and Dexatrim (phenylpropranolamine), which is a stimulant. Stimulants are substances which get the body ready for the “fight or flight” response; as diet aids, they are thought to activate the central nervous system to reduce food intake.

Acutrim and Dexatrim are chemically related to amphetamine. If you remember, years ago amphetamine was prescribed for weight loss because it suppresses the appetite. When I was 16 years old, and maybe 10 pounds overweight, my mother took me to the doctor to “see what he could do.” He put me on amphetamines – “speed,” as we called it. I think I took it two days before stopping – I was so hyper, I couldn’t sleep at night. I’d be cleaning my bedroom at 2:00 a.m.! Don’t get me wrong – I’m not “blaming my mother” for this; back in the 1970’s, we weren’t as educated about safe, healthy weight-loss techniques as we are today. Amphetamines often led to drug abuse, so pharmacologists rearranged its molecular structure to develop comparable, but safer, compounds. One of those is phenylpropanolamine, the active ingredient in Acutrim and Dexatrim – the only FDA approved over-the-counter weight-loss drug. Others include the active ingredients in several prescription weight-loss medications: Tenuate, Mazanor, Sanorex, Fastin, Ionamin, Bontrilk Plegine, Clenbuterol and Didrex.

When used in a weight loss program that includes a low-fat diet and exercise, Acutrim and Dexatrim can increase weight loss by a small amount (about 5%). However, weight loss is usually not permanent after these drugs are discontinued.

Possible side effects of Acutrim and Dexatrim include nervousness, irritability, headaches, sweating, dry mouth, nausea, and constipation. You also should not take these drugs if you are also taking any antidepressant with an MAO (monoamine oxidase) inhibitor.

Diet aids such as Acutrim and Dexatrim should not be used for more than three months. Even small doses of phenylpropanolamine can cause increased blood pressure by constricting your blood vessels and increasing your heart rate.

It becomes obvious that choosing diet drugs is not the solution for long-term weight loss and a healthy body. The importance of exercise for successful weight loss and maintenance is more firmly incorporated. In addition to increased energy expenditure, exercise affects the composition of the body substance lost during weight loss. When exercise is directly compared to diet, or when exercise plus diet is compared to diet alone, exercise results in greater prevention of lean body mass. For example, for each pound of weight lost, less fat and more muscle is lost during weight loss programs without exercise. This is meaningful since the body’s resting metabolic expenditure is closely utilized with lean body mass.

Because of the interest in starting or preserving lean body mass, women are turning more and more to resistance training (weight lifting, circuit training, etc.). Couple this with regular aerobic exercise, and you will see results and benefits of improved cardiovascular health, decreased appetite, a general sense of well-being, decreased blood pressure (in hypertensives), improved glucose metabolism and insulin action (in diabetics), and improved blood lipids (in lipid disorders).

So why turn to drugs with potentially dangerous side effects to lose a little bit of weight, when you can choose to eat a healthy, low-fat diet and exercise for better health – and keep the weight off for good?

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