June 18, 2009
Do diet pills really work? Are there any concerns with them?
Do diet pills really work? Are there any concerns with them? Some are based on the drug properties of herbs, some are stimulants, some cause your body not to absorb food, and others are designed to make you feel full.
There are prescription diet pills that have a place in a supervised diet and exercise program. But none produce the miracle results touted on the Internet or television. Some of the prescription drugs are stimulants. They work by reducing your hunger. This won't help if a person has a high-fat or high-calorie diet, or if the person eats to relieve stress.
We used to say the key to weight loss was simple physics - have fewer calories coming in than calories going out. It sounds simple, but there's more to weight loss than simple calorie counting. Some of the factors that affect weight include:
Genetics – Increasingly we see that some people inherit a tendency to "hoard calories." We used to call it "a slow metabolism." While it's more complex than that, the fact remains that a person's genetics can create a challenge to successful weight loss.
Cultural and social conventions – Your environment and cultural background also can play a significant role in your diet. Some cultures have a tradition of high-fat foods or consuming large portions. If you live or work in a setting that promotes poor eating habits, this can affect your weight and motivation.
Fast food – Convenience food that's unhealthy has become a staple of modern life. With easy access and stressful, busy schedules, consuming this kind of diet can be a difficult personal habit to break.
Many people turn to diet pills to help them overcome the factors above. There are diet pills marketed as “all natural” because they are derived from herbs or other plants. The Food and Drug Administration (FDA) doesn't oversee such over-the-counter products. That raises safety issues. Many of these products have their own set of side effects and many will cause reactions with prescribed medications. For an excellent list of these over-the-counter weight-loss pills and their side effects visit the Mayo Clinic Website.
These kinds of medications have an uneven record. For instance, in the 1990s, the pill Redux was introduced. It contained a combination of stimulants, phentermine, and fenfluramine, which was known as Phen-Fen. After heart-related concerns were raised, Redux was removed from the market. Phen-Fen generated headlines.
Most people will develop a tolerance to stimulant medications over time. For that reason the FDA sanctions such pills for short-course therapy – that is six weeks or less. Side effects of stimulant diet pills are faster heart rate, feeling of nervousness, difficulty sleeping, dry mouth, and higher blood pressure.
Other kinds of pills work to reduce the body's ability to absorb fats. Xenical was the first such product. The problem is, that just by the way it works, Xenical tends to cause diarrhea. That effect is important in its method of action, but isn't a pleasant experience. People on Xenical typically lose less than 10 pounds.
Diet medications can help jump start a diet, but even with over-the-counter products, use of medications should be part of a coordinated program for weight loss that may be under a doctor's observation. Pills can have an impact, but should be researched and evaluated to understand their effects. Weight loss still requires understanding your social and cultural influences, dealing positively with stress, and working with your genetics.
It can be done, but there's no quick fix.
Dr. Tom James
Dr. James is the Healthcare Advisor for Humana's Strategic Advisory Group. Dr. James is board-certified in Internal Medicine and in Pediatrics. He received his undergraduate degree from Duke University and his medical degree from the University of Kentucky.
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