Excerpt: 'How the Rich Get Thin'

When I spoke with Julia, she was amazed to hear of the combined effects of her medications, as their potential for weight gain had never been explained to her. First, I suggested that she consult with her psychiatrist, whom she had not seen in over three years, to assess whether she could safely eliminate the antidepressant; she had been obtaining paroxetine (Paxil) prescriptions from her primary care physician. Her psychiatrist agreed that she did not need the medicine anymore. She was able to reduce her antihistamine, which she took for hay fever, to a minimal amount on high-pollen days. Julia lost the excess thirty pounds in about three months. She is now happy, confident, and slimmer.

The drugs were probably appropriate at the time they were prescribed, but she should have been told that weight gain was a possibility. Also, her use of medications had continued for longer than necessary. Additionally, mixing medications had had a cumulative effect with regard to weight gain.

The Myths of Diet Drugs

Baby boomers are known to demand the "instant gratification" factor. This is a real problem with weight management because there are no shortcuts. A magic pill that will cut appetite, raise metabolism, and give you a supermodel body does not exist. There are medications that treat obesity, but they only work when combined with diet and exercise. One of the worst things that a physician can do is to prescribe any of these medications without explaining the limitations of the drug, and not stressing that they won't work without changing the diet. And, like every medicine, they all have side effects.

Drugs That Reduce Food Intake

The drugs listed are prescription medications and should only be taken under a doctor's supervision. The Internet has made these medications available online, which has resulted in serious medical consequences, including death. If you have a significant amount of weight to lose, consult with your doctor about a diet and exercise plan.

Phentermine, which decreases appetite, is the most widely prescribed and oldest prescription weight-loss medication, having been around for thirty years. It stimulates the release of norepinephrine and dopamine from nerve terminals. As such, it increases the heart rate and raises blood pressure. Other side effects are dry mouth, constipation, and insomnia. Because of its effect on blood pressure and the heart rate, usage of phentermine should be carefully monitored, and the suggested treatment period is no longer than six weeks.

Several years ago, the combination of phentermine and fenfluramine (Phen Fen) was thought to be the answer for quick and easy weight loss. People who took the drug experienced dramatic reduction in weight and felt almost no hunger. But soon this "miracle drug" was found to be responsible for damage to the heart valves. Tragically, several deaths resulted from the drug and it has now been removed from the market. The gold standard of weight loss has always been a healthy diet and exercise. Don't risk your life by using this dangerous drug combination.

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