MEDICATIONS: DIET PILL SAFETY

June 5, 2006 — You've probably heard the horror stories about the side effects of Fen-Phen and Redux. Is there a safe diet pill out there? The answer is yes and no. Side effects vary from person to person. Minor side effects are generally mild and transient, while major side effects are rare and typically only occur with long term use.

The physicians of Texas Medical Association urge you to discuss with your physician your personal risk for major side effects before taking any weight loss drugs, prescription or over-the-counter.

Beware of over-the-counter weight loss products that are not approved by the FDA, including ephedrine-containing products. Ephedrine has been associated with some deaths and is dangerous for those with cardiac conditions. Minor side effects include insomnia, dizziness, anxiety, palpitations, nausea, and vomiting. Major side effects include convulsions, chest pain, hypertension, shortness of breath and cardiac dysrhythmias.

There can be problems with FDA-approved drugs also. As the FDA system now works, a drug is approved based on clinical trials that involve relatively few patients who take the substance over a relatively short time. So if a drug is tested in a few thousand subjects over a three-month period, it may appear to be perfectly safe and effective.

But if tens of thousands take the same drug for six months or longer, adverse effects might begin to surface.

After a drug goes on the market, reports of adverse reactions may begin to trickle in — if physicians notice the reactions and notify the FDA. Then, if someone at the agency detects a troublesome pattern, the FDA may set in motion a process that could lead to a recall or a warning letter to doctors that a drug shouldn't be used under certain circumstances.

But can diet drugs really help diminish our epidemic of extra pounds, anyway? Despite the availability of diet drugs, obesity is more prevalent than ever. In 1980, 25 percent of the adult population in America was obese. (Obesity is defined as a male with more than 35 percent body fat and a female with more than 25 percent body fat.) Today 33 percent of the adult population in this country is considered obese.

Whatever method an individual uses to kick off a weight-loss program must be followed up with healthy lifestyle changes. Chronic yo-yo dieting only leads to low self-esteem, self-hatred, and a depleted nutritional status.

A goal of learning and living a healthy lifestyle is more realistic than trying to go "on or off" something that will be abandoned and possibly chalked up to another failure.