Why diet pills are not a safe way to lose weight

Liz Brody

Let's cut to the chase. If there were a safe, diet pill out there that really whittled your bod, would The Biggest Loser be in its ninth season? Would Kirstie Alley be on her second fat show? Would we be suffering through Jenny Craig, Atkins, acai berry scams, and deadly ephedra?


No. So what are these pills you can get from doctors? I'm not talking about the two on the market-Meridia and Xenical, which might budge off a few pounds if you're lucky. These fat cures have names like Topamax and Phen-Pro and Phen-5HTP.

In a telling survey of physicians in the journal Obesity, 266 weight specialists admit that they quite often dole out scrips for drugs "off label," as well as pharmaceutical cocktails that have never been tested. Off-label prescribing (i.e. in a way that has not been approved by the Food and Drug Administration) is common in medicine. But these are heavy meds, and their risks may not be worth the weight you might-or might not-lose. Weight, by the way, that will surely pile back on once you stop taking the pills.

Here's an underground diet pill cheat sheet:

Anti-seizure Meds:Half the doctors in the survey prescribe topiramate (Topamax). This is a drug for epilepsy and migraines. One potential side effect is weight loss. Another is memory loss. In fact, when Johnson & Johnson tested the med as a possible obesity treatment, one researcher says, "Instead of Topamax, the people in the trial called it Dopamax because they couldn't remember numbers and words. J&J just killed the development program." Inonline Topamax forums, women stress about their hair falling out so badlythey have to wear wigs and their minds going mushy-like "Carla" who writes,I was prescribed Topamax approx. 2-3 years ago as a weight-loss medication. I have difficulty forming sentences and remembering simple words. I used to consider myself quite intelligent. Now, I feel dumb... and I worry that it will be discovered that I just can't do [my] job anymore.

Adipex Megadose: Phentermine (Adipex) is "phen" of fen-phen. Remember that nifty combo that turned out to cause heart valve problems? Phentermine curbs the appetite, and is approved for short-term use of a few weeks. But the doctors in the survey prescribe it for much longer and, on average, at almost double the maximum recommended dose. Sidney Wolfe, MD, director of the Public Citizen's Health Research Group in Washington DC, is pretty emphatic: "If doctors are using a drug at twice the approved dose-the dose that had randomized trials showing the benefits outweigh the risks-they are risking your health."

Combo Pilling: Diet pill cocktails like Phen-pro (phentermine plus Prozac) are also being served up. One out of five doctors in the survey used Phen-5HTP (the 5HTP, like Prozac, affects serotonin). The authors of the Obesity article could not find a single study on that combination-which means that, if you're taking it, you're doing a pharmaceutical bungee jump.

Diabetes Drugs: Metformin (Glucophage) is sometimes offered as a diet therapy. "This drug can be helpful in supporting weight loss in people with insulin resistance," says David Katz, MD, PhD, director of the Prevention Research Center at Yale University School of Medicine. "If you don't have insulin resistance, however, it's generally not a good choice."

Meridia: This is one of the approved drugs for weight loss. Even so, recent research has shown it can increase heart attacks and strokes in some people. In fact it's been pulled off the market in Europe. The other drug, orlistat (Ali and Xenical), is known for its unpleasant digestive effects.

BOTTOM LINE? Three new weight loss drugs are awaiting approval. Qnexa, for example, combines topirimate and phentermine, and seems twice as effective as what's available now. But will it prove to cause memory problems? And will the preliminary results hold up under FDA scrutiny? The maker of another candidate, Contrave (a combo of an antidepressant and addiction drug), just announced it's not as effective as the first studies showed. And even if one of these newbies comes on the market....

Before you take any diet pill, just ask yourself first:

1) What else could I do to lose weight that doesn't have any risks?

2) What will happen when I stop taking the pill?

3) Why am I trying to lose weight in the first place?

Because if you're unhappy with yourself or your life, a pill probably won't fix it.

Have you taken diet pills? Which ones? Where did you get them? Did they work? Or have side effects? We're dying to know.

Meanwhile, we have so many better ideas for you.....

Get yourself ready to shape up

Snip a few calories while eating the good stuff

Try Jennifer Aniston's leg workout

[Photo Credit: Getty Images]