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Obesity has been called the #1 health problem in America. It increases the risk of heart disease, stroke, diabetes, high blood pressure, high cholesterol, high triglycerides, sleep apnea, gall bladder disease, gout, and some cancers.’ We’re told losing weight is just a matter of diet and exercise. However, Americans spend $30-$40 billion every year on weight loss treatments, yet we keep getting fatter.‘ Obviously, losing weight is not as easy as it sounds.

Three of the diseases caused by obesity, including high blood pressure, high cholesterol, and diabetes, are recognized as long-term diseases, yet we have failed to recognize obesity itself as a long-term disease. We accept long-term drug treatment of these diseases, yet we have failed to accept long-term drug treatment of obesity. Fortunately, this view is finally changing. We are now realizing that — obesity is a long-term disease requiring long-term treatment.

The purpose of drugs is to reduce disease, reduce suffering, and ultimately, save lives. Diet pills, when used long-term, have been shown to cause long-term weight loss,5 which is known to reduce disease, improve the quality of life, and in many cases, extend lifespan. Diet pills are useful drugs. Although diet pills, just like aspirin, ibuprofen, and acetaminophen, are powerful drugs with potential side effects – they are safe and effective when used properly.

The misbelief that all diet pills are amphetamines continues to be perpetuated to this day.  Some people may argue that the new diet pills are “bad” because they are amphetamine-like. But if amphetamine-like drugs are somehow “bad”, we must also condemn chocolate (which contains the amphetamine-like chemical beta-phenyl ethylamine), the drug Ritalin used for Attention Deficit Disorder (which is an amphetamine-like drug called methylphenidate), and even our own bodies which naturally produce an amphetamine like chemical (beta- phenylethylamine, the same one found in chocolate)!

Making an intelligent decision about using any drug requires knowing the risks and benefits about the drug as well as the condition/disease being treated. This article provides you with information about the risks and benefits of diet pills, as long-term problems require long-term solutions.

Why Consider Diet Pills?

  1. Aren’t diet pills just amphetamines?
  2. Not any more. The first diet pills were indeed amphetamines. They were very effective at causing weight loss, but because they gave people a feeling of stimulation and euphoria they were sometimes abused, which gave diet pills got a bad name. Amphetamines are still available by prescription, but are not recommended for weight loss. Today, amphetamines and amphetamine-like drugs (like Ritalin) are used to treat children and adults for Attention Deficit Disorder (sometimes called A.D.D.) and are also used to treat narcolepsy (uncontrollable asleep attacks).

The new diet pills are amphetamine-like in their chemical structure, but this isn’t justification to condemn them. A few examples will best demonstrate this. Chocolate contains an amphetamine-like chemical called phenyl ethylamine, which is also naturally made in the body from the amino acid never losing weight at all. Weight loss needs to be long-term to have health benefits. With the failure of diet and exercise to cause long-term weight loss, diet pills may be preferable for people who were never losing weight at all. Weight loss needs to be long-term to have health benefits. With the failure of diet and exercise to cause long-term weight loss, diet pills may be preferable.

  1. Do diet pills cure obesity?
  2. No, they don’t cure obesity, they control it. While an antibiotic can cure an infection, drugs for high blood pressure, high cholesterol, diabetes, and glaucoma don’t cure their conditions either; they control them. Realize that diet and exercise don’t cure obesity either; they too only control it.
  3. How long do diet pills work?
  4. Diet pills work for as long as you take them. The typical pattern of weight loss with diet pills is weight loss for the first 6 months followed by weight maintenance for as long as the diet pills are taken. Weight loss followed by weight maintenance is typical of any weight loss program including diet and exercise. Weight maintenance is evidence of diet pills continued effectiveness, not tolerance as was suggested in the past.
  5. So how long should diet pills be used?
  6. Maybe the rest of a person’s life. People take drugs for the rest of their life to control blood pressure, cholesterol, diabetes, and glaucoma. Being overweight increases the risk of several diseases and increases the risk of premature death, so doesn’t it make sense to reduce those risk by controlling weight with diet pills? These drugs only work for as long as they are taken. Does it make any sense for someone with high blood pressure or diabetes to take medicine for a couple months and then stop? Of course not. Long-term conditions require long-term treatments.

It makes sense to take a medicine when taking it has more benefits than not taking it; when the benefits outweigh the risks. We know that long-term weight loss has definite health benefits; however, short-term weight loss followed by weight gain is worse than never losing weight at all. Weight loss needs to be long-term to have a positive effect on health. Diet pills are effective at maintaining long-term weight loss while posing little risk. You could say they have a favorable risk-reward ratio. Our attitude of using diet pills long-term is finally changing.

  1. Do diet pills have other uses besides weight loss? A. Indirectly they do. Because losing weight lowers blood pressure, lowers cholesterol, and helps control diabetes, I imagine you’ll see doctors starting to use diet pills to treat overweight people with high blood pressure, high cholesterol, and diabetes. Some people will still need additional medicine, but the dose will usually be less which will reduce the likelihood of side effects.
  2. Do diet pills have side effects?
  3. All drugs have potential side effects, but not everyone experiences them. Some side effects diminish with continued use. Sometimes reducing the dose helps. Sometimes combining two different types of diet pills, using V: the normal dose of each, minimizes side effects. Or sometimes it works best to switch to a different diet pill. The same strategy is used with drugs for high blood pressure, etc. It is important to remember that different people require different medications.
  4. Do many doctors prescribe diet pills?
  5. Most doctors have probably prescribed diet pills for some patients, but few have utilized them on a long-term basis. Many doctors have the same biases that the general public does. They have a negative image of diet pills going back to the first amphetamine diet pills. (In the last couple months I heard a young doctor on the radio tell a caller not to use diet pills be used because they are just “speed”, the street name for amphetamines. That is the association that doctors as well as general public make, but it is simply not true.)

Doctors have also been taught for many years that diet pills should only be used for a few weeks or a few months to help initially lose weight and then will power should help people maintain the weight loss. (I heard another radio doctor answer a question about diet pills by saying “Sure they help you lose weight, but what do you do when your done? You can’t take them forever, right?” My answer is —- of course you can!) The value of using diet pills long-term is finally being recognize.

Doctors also still believe being overweight is just a matter of eating too much and losing weight is just a matter of will power to eat less and exercise more in spite of overwhelming failure of diets and exercise to produce long-term weight loss. You will witness a paradigm shift over the next several years in which the public will recognize obesity is long-term disease requiring long- term treatment. We’ll look back and wonder why it took us so long to realize this.

Diets Don’t Work

Of people who diet to lose weight 19 out of 20 gain it all back! This is a failure rate of 95%! Would you go to a dentist if you knew that 19 of out 20 of his patients lost their fillings in the first few years? Would you hire a painter if you knew that 19 out of 20 of the houses he painted had to be repainted within a couple of years? Would you bet on a coin toss if you could only win 31 but had to pay $20 if you lost? Would you use a cookbook if you knew 95% of the recipes didn’t work? So why do we spend our time and money on diets and exercise with this amount of failure?

Does Exercise Cause Weight Loss?

The good news for women is that exercise combined with dieting causes weight loss in women. The good news for men is that numerous studies have shown that exercise alone (without changing calorie intake) causes weight loss in men.

The bad news for women is that exercising without dieting is not very effective at causing weight loss in women.” In a recent article in the journal of the American College of Nutrition‘ the following evidence was given. During a 4 month college athletic season, female swimmers and tennis players who increased their level of physical activity and did not change their calorie intake did not lose weight.’ A group of untrained women who began running an average of 15 miles per week for 1 year (a total of 790 miles during the year) and did not change their calorie intake, did not lose weight.” A group of sedentary women who began training for a marathon while not changing their calorie intake and were followed for a year and a half did not lose weight.“

The reason that exercise is effective at causing weight loss in men, but is ineffective in women is that the male hormone, testosterone, increases the breakdown of fat, whereas the female hormone, progesterone, increases the storage of fat.‘ Women should not feel a sense of personal failure if they don’t lose weight by exercise alone, but rather should realize it’s the same chemistry that makes feminine that protects them from exercise-induced weight loss.

This information isn’t meant to discourage exercise; it’s only meant to inform you what’s effective, and what not. Because most people have a limited amount of time and money to spend on losing weight, it’s important to focus on what’s most effective. Exercise is certainly encouraged because of its many health benefits including: increased mood, increased bone strength, increased “good” HDL cholesterol, decreased “bad” LDL cholesterol, and decreased insulin levels.

How About Behavior Modification?

Based on 4 of the best studies using behavior modification to lose weight, there was an average weight loss of 5.3 lbs. after 4 years.” While this is certainly significant, a long-term study of diet pills reported an average weight loss 21/: times this much (13 lbs.) after a similar period of time.”

A Long-Term View of Obesity

Chronic diseases require chronic treatment! Obesity is usually a chronic, life-long condition. We recognize and accept the chronic nature of other diseases like high blood pressure, high cholesterol, diabetes, and glaucoma, and we treat them accordingly — with long-term treatment. However, we have failed to accept obesity as a long-term disease also requiring long-term treatment.

Most drugs do not cure diseases; they only control them. Drugs for high blood pressure, high cholesterol, diabetes, or glaucoma control these conditions. They don’t provide a cure. The drugs work for as long as they are taken; when the drugs are stopped the condition returns to its previous state. The same is true of diet pills. Diet pills do not cure obesity; they only control it. Diet pills work for as long as they are taken, and when they are stopped, weight loss is regained.

Many doctors still believe that diet pills are a failure because they don’t cure obesity and people regain weight when they stopped taking them. Of course this happens! Diet pills, like high blood pressure medication, etc., only work for as long as they are taken. Chronic diseases require chronic treatment!

Many doctors also mistakenly believe that we build up a tolerance to diet pills so they’re only effective in the short-term. This is absolutely false! This mistaken belief comes from the typical pattern of weight loss seen from using diet pills. There is weight loss for the first 6 months followed by weight maintenance for as long as the diet pills are taken. Weight maintenance isn’t an indication of tolerance, it’s an indication of continued effectiveness. Diet pills are the chronic treatment for the chronic disease of obesity. Chronic diseases require chronic treatment!

PPA = Phenylpropanolamine, Old PPA Studies =pre-1982, New = 1982-1992

Two Pill Combination Better Than One?

Combining two types of diet pills is likely to be more effective at causing weight loss and less likely to cause side effects than using any one diet pill alone. The reasoning behind this is simple. The classical diet pills work by increasing either noradrenaline or serotonin. (In general noradrenaline has a stimulating effect and serotonin has a relaxing effect.) By combining two diet pills, a noradrenaline diet pill + a serotonin diet pill (such as the combination of phentermine + fenfluramine), it not only works in two different ways, the dose of each pill can usually be cut in half which reduces side effects.

Conclusion

Because being overweight increases the risk of several diseases and increases the risk of dying, doctors are starting to view obesity as a long-term disease requiring long-term treatment. Realizing that diets are not effective at causing long- term loss, while diet pills are effective at causing long-term loss and pose little risk when used properly, the value of diet pills is finally being realized.

 

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