Weighing worth, safety of diet pills

PEOPLE'S PHARMACY

January 10, 1995|By Joe Graedon and Dr. Teresa Graedon | Joe Graedon and Dr. Teresa Graedon,King Features Syndicate

OK, we admit it. We overate, just like millions of other people. Holiday treats were too enticing.

Now there are other temptations. The diet pill industry is cranking up to convince us there is a quick fix for those additional calories. Soon ads will appear in supermarket tabloids and our mail box encouraging us to fire up our fat-burning cellular machinery so we can shed pounds overnight while we sleep.

Who doesn't want increased energy and enhanced metabolism? Effortless weight loss that involves no dietary deprivation or strenuous exercise is a never-ending American dream. Perhaps some day pharmaceutical science will come up with a compound that works like magic to rev up metabolism and prevent fat from accumulating. Until then, all we have are appetite suppressants.

There are many brands of over-the-counter diet pills. They rely primarily on the ingredient phenylpropanolamine (PPA), also used as a decongestant. It is found in Acutrim, Appedrine, Control, Dexatrim and Thinz Back-To-Nature, among others.

This drug has been controversial as an appetite suppressant. Although there are numerous studies that demonstrate measurable weight loss, the actual benefit over the long term appears modest. One of the best trials compared PPA to placebo in a doctor-supervised program of weight loss with behavior modification, exercise and diet. After 14 weeks, the women taking PPA lost about four pounds more than those who got an inactive tablet.

Although most people can take over-the-counter diet pills without problems, some may experience side effects. Serious increases in blood pressure have occasionally been observed. Other complications may include palpitations, nervousness, insomnia, anxiety, dizziness, nausea or headache. In rare cases, zTC psychiatric reactions have been noted, including agitation, hallucinations or bizarre behavior.

Prescription diet pills are substantially more powerful. For years, some physicians have prescribed drugs like amphetamine, dextroam phetamine (Dexedrine), phentermine (Fastin, Ionamin), fenfluramine (Pondimin) and phenmetrazine (Preludin).

There is still controversy about the benefits of such drugs. One long-term study found that the combination of fenfluramine and phentermine led to a sustained weight loss as long as patients remained on the drugs.

Other experts believe that amphetamine-like diet pills can be abused and might have serious side effects. Changes in heart rhythms and blood pressure are possible. Agitation, insomnia, euphoria, depression, headache, stomachache, confusion and occasional psychotic breakdowns have been noted.

Diet pills may play a role in helping some people lose weight, but for most of us the boring approach is better and safer. If we eat less food and get more exercise we will end up healthier and slimmer a year from now.

Joe Graedon is a pharmacologist. Dr. Teresa Graedon is a medical anthropologist and nutrition expert.

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