Weight Loss Drugs 

Some 300,000 people die of obesity related diseases each year.  Obesity is associated with diabetes type 2 and consequently with hypertension, heart attack, kidney failure, and stroke.  In addition, obese people have diseases of the knee and feet.

The weight loss drugs have nowhere near this level of morbidity associated with them and can be used by doctors to effectively help people lose weight and get into shape.  The usual weight loss drugs are non-addicting.  If you take an elevated amount of phentermine, your jaws clench tightly and are painful.  There is no high or euphoria from taking any of these drugs; therefore, drug addicts are not interested in using them.  

The drugs are safe.  They do not have side effects other than according to some medical authorities, a rise in blood pressure of 5 points.  When a person loses 40 pounds, the blood pressure drops 30 to 50 points.  It is really a beneficial effect of weight loss. This  cannot be compared to the accusation that the medication causes a rise in blood pressure. 

It could be true patients taking weight loss drugs for the first time feel hyperactive and nervous.  This is an indication that dose is too high and it takes approximately four days for liver to learn to detoxify the drugs.  It is imperative that they be started at a very low dose and gradually raised over a period of the first month.  All evidence of tachycardia and hypertension is eliminated with a minimum (less than 15 mg) initial dose. 

The weight loss drugs are effective until they stop working.  This is called tachyphylaxis and is a problem for medical management by knowledgeable bariatrician. 

All this information has been reviewed in a book and titled "Obesity" edited by Dr. Michael Steelman associated with the American Society of Bariatric Physicians (ASBP).  The information in this section is echoed in the chapter "Obesity."

Some common drugs used are listed below:

PHENTERMINE

Phentermine is the most commonly used weight loss medication.  It effectively helps people stop obsessing about food.  For most patients, this is a happy moment because they have been possessed by thinking about food.  In addition, phentermine creates the feeling of having had enough to eat.  This is a problem for all obese patients, who keep on eating and eating and eating, and never get a feeling of satiety or satisfaction.  It seems that satisfaction center has been injured by their excessive eating.  People who develop obesity are really good eaters.  They are successful at eating.  They are so successful at eating that they become addicted to the process and this addiction leads to the obesity.  An addictionologist has to help them puzzle their way out of this problem. 

Phentermine is used in small doses to begin with.  The initial starting dose is somewhere between 7.5 and 15 mg in the morning.  That can be gradually increased as high as 37.5 mg./day. Phentermine causes a dry mouth.  The satiety center is right next door to the thirst center in the hypothalamus and contrary to acupuncture lore, thirst is associated with loss of appetite when taking the weight loss medication.  Phentermine is very effective if it is managed properly and the people complain about the dry mouth.  People may have a headache during the first week and this may be a sinus headache.  After that, they begin to lose weight and they can lose a great deal of weight and stay on phentermine for a protracted period of time.  The PDR operates under the basis of a study done in 1952 by Dr. Scoville.  He did a study of drug addiction in Milwaukee, Wisconsin.  He was only given three months' worth of money to complete his study.  He concluded that the weight loss pills only work for three months and this fiction has found its way into the PDR and the general population.  It is only adopted as true from a study in 1952.  Actually, phentermine works for a considerably longer period than that, particularly if one is acquainted with the work of Marty Hinz, M.D., who has taught us about the use of precursors in order to achieve a stage III.  He uses L-tyrosine, L-tryptophan, and Mucuna Pruriens, with other amino acids to increase the level of these chemicals in the brain and thus obviating the problem of tachyphylaxis.  The extent of use of phentermine has been described in the book "Obesity." 

DIETHYLPROPION 

This weight loss medication was formerly known as Tenuate.  Like phentermine, it has been on the market for over 55 years.  It has withstood the test of time and is extremely effective.  Interestingly, the generic name for Tenuate is diethylpropion.  This compares to the generic name for the antidepressant Wellbutrin.  Wellbutrin is bupropion.  Tenuate is diethylpropion.  So Tenuate serves a double purpose of suppressing appetite as well as functioning as an antidepressant.  If you learn how to use diethylpropion properly, you can use it as a substitute for the antidepressant medication and it works better than  almost all of the antidepressants on the market in my experience.  It is particularly effective for seasonal affective disorder, which occurs very commonly in people with obesity.  Diethylpropion is used in small doses up to 75 or 100 mg a day.  It is moderately effective in suppressing appetite.  It does suppress obsessions about eating and food.  If continued over a period of time, can result in a really substantial weight loss of over 50 pounds. 

PHENDIMETRAZINE TARTRATE 

This medication has an energy boosting function.  Patients who take it have previously complained of fatigue.  Fatigue is a main clinical problem and often these patients in addition to obesity, have been diagnosed with chronic fatigue syndrome.  People that have chronic fatigue syndrome do quite well on phendimetrazine tartrate.  It energizes and stimulates people.  It is probably not as good an anti-appetite drug as the phentermine, but in patients who have lack of energy and overeat with a delusion that they are getting energy from food, it helps bridge that gap and provide energy as well as moderate appetite suppression. 

BENZPHETAMINE 

Benzphetamine has the -phetamine name, but  is not an amphetamine.  It is the most expensive of all of the appetite suppressant medications.  It is used as a treatment when the patients are dissatisfied with phentermine or get diethylpropion.  It is a fact in some patients and they like it enough to stay on it for a period of time. 

HYDROCHLOROTHIAZIDE AND POTASSIUM 

In case there is any concern about hypertension, and in case there is severe premenstrual tension with holding of fluids, the diuretic hydrochlorothiazide with potassium is used.  Some patients prefer Dyazide, which is potassium sparing and you do not have to take a potassium pill with Dyazide.  Some people prefer Aldactazide, which is a rather strong diuretic and is usually not indicated in the treatment of obesity.  If one uses hydrochlorothiazide and potassium, any concerns about hypertension are pretty well obviated and the patients feel much better.  Women patients, who fly in airplanes usually gain about four or five pounds for mysterious unknown reasons and it is a good idea to have them take a diuretic after they get off of the airplane and their ankles are swollen and their knees hurt them from being on the airplane.  This is also a cause of blood clots of the legs and it is well to have a patient that is on the diuretic medication.  They never seem to have blood clots in their legs from excessive sitting on an airplane flight from here to Korea. 

METFORMIN 

Metformin is a commonly used medication to stabilize blood sugar.  It is often used in the treatment of diabetes.  The drug has been adapted for use in bariatrics.  Obese people do have fluctuating sugar levels.  Metformin is given to help them stabilize their blood sugars so that there are not so many ups and downs and with that stabilization, patients feel better and it enables them to lose weight.  Recently, metformin has come under observation as a really effective anti-cancer medication.  Whether this finding will hold up over the long term is unknown. 

TOPAMAX 

Topamax is an anti-seizure medication.  It has been found in the treatment of schizophrenic patients to prevent weight loss associated with the use of major tranquilizers.  When this finding occurred, many people started to use Topamax to help people lose weight.  It is occasionally extremely effective.  It is generally not very effective.  The problem with Topamax and other seizures in this class are memory loss and severe cognitive impairment.  Some patients say that it does not bother them and they do not use their brain that much anyway and those people continue to take it with the knowledge that it is interfering with their memory for names.  Many people are acutely sensitive to the cognitive impairment caused by Topamax and they stop it on their own.  Weight loss is sporadic, but when it occurs, it is really remarkable. 

That is a brief summary of the weight loss drugs.  It is not intended to be detailed.  It gives you a general concept of the medications that are used in the treatment of obesity.  Overall, the medications are very effective and they are supposed to be used under a contract that has been formed between the individual bariatrician and the American Society of Bariatric Physicians.  When used in this way, the drugs are reasonable, safe, and extremely effective in helping people gain control of their mind and their eating behavior. 

So call us at 1-847-236-9999 and make an appointment today. We look forward to helping you achieve your goals.