Obesity and use of Medications

[lmt033167]

I'm not going to hi-jack Dawn's post any longer with my blabber, so I wanted to put some thoughts and info here because I see a trend in that section.

If you are overweight or taking Phen or any other meds for that matter, please take the time to go to the CDC, FDA ; Wikopedia or Mayo Clinic and educate yourself on the complications of obesity and weight loss.

Have you stopped to consider the complications of weight gain and obesity versus the complications of using weight loss medications?

I did back in Jan 2006 when my PcP first asked me if I had thought about taking them. I was really dead set against any type of medication, but was ok with having Lap Band Surgery until I researched medications for almost 4 full months.

It took me until July to go back with a book choc full of information to ask for a prescription. I had been researching weight loss since June 2005 and felt pretty good in my decision.

Consider this from the Mayo Clinic:

If you're obese, you're more likely to develop a number of potentially serious health problems. These may include:

• High blood pressure. As you put on weight, you gain mostly fatty tissue. Just like other parts of the body, this tissue relies on oxygen and nutrients in your blood to survive. As demand for oxygen and nutrients increases, the amount of blood circulating through your body also increases. More blood traveling through your arteries means added pressure on your artery walls.
  
  Weight gain also typically increases the level of insulin, a blood-sugar-controlling hormone, in your blood. The increase in insulin is associated with retention of sodium and water, which increases blood volume. In addition, excess weight often is associated with an increase in your heart rate and a reduction in the capacity of your blood vessels to transport blood. All of these factors can increase blood pressure.
• Diabetes. Obesity is a leading cause of type 2 diabetes. Excess fat makes your body resistant to insulin, the hormone that helps your body maintain a proper level of a sugar (glucose) in your blood. If your body is resistant to insulin, your blood sugar is high — which isn't good — and leads to negative health effects.
• Abnormal blood fats. A diet high in saturated fats — red meat and fried foods, for example — can lead to obesity as well as elevated levels of low-density lipoprotein ("bad") cholesterol. Obesity is also associated with low levels of high-density lipoprotein ("good") cholesterol and high levels of triglycerides.
  
  Triglycerides are the form in which most fat exists in food as well as in your body. Over time, abnormal blood fats can contribute to atherosclerosis — the buildup of fatty deposits in arteries throughout your body.
  
  Atherosclerosis puts you at risk of coronary artery disease and stroke.
• Coronary artery disease. This is a form of cardiovascular disease. It results from the buildup of fatty deposits in arteries that supply your heart. Over time these deposits can narrow your heart's arteries, so less blood flows to your heart. Diminished blood flow to your heart can cause chest pain (angina). Complete blockage can lead to a heart attack.
• Stroke. Obesity is associated with atherosclerosis — the buildup of fatty deposits in arteries throughout your body, including arteries in your brain. If a blood clot forms in a narrowed artery in your brain, it can block blood flow to an area of your brain. The result is a stroke. Being obese raises your risk of a stroke.
• Osteoarthritis. This joint disorder most often affects the knees, hips and lower back. Excess weight puts extra pressure on these joints and wears away the cartilage that protects them, resulting in joint pain and stiffness.
• Sleep apnea. This serious condition causes a person to stop breathing for short periods during sleep and to snore heavily. The upper airway is blocked during sleep, which results in frequent awakening at night and subsequent drowsiness during the day. Most people with sleep apnea are overweight, which contributes to a large neck and narrowed airways.
• Cancer. Many types of cancer are associated with being overweight. In women, these include cancers of the breast, uterus, cervix, ovaries and gallbladder. Overweight men have a particularly higher risk of cancers of the colon, rectum and the prostate.
• Fatty liver disease. When you're obese, fats can build up in your liver. This fatty accumulation can lead to inflammation and scarring of the liver. Such scarring can cause cirrhosis of the liver, even if you're not a heavy alcohol drinker.
• Gallbladder disease. Because overweight people may produce more cholesterol, which can be deposited in the gallbladder, the risk of gallstones is higher in obese people. Fast weight loss — more than 3 pounds a week — also can increase the risk of gallstones.
• Obesity can also contribute to gout, a joint disorder.

Now consider the side effects of Phentermine:

• dry mouth
• nausea
• vomiting
• dizziness
• lightheadedness
  
  ***Side Effects of This Medicine***
  
  Appetite suppressants may cause some serious side effects, including heart and lung problems.
  
  Along with its needed effects, a medicine may cause some unwanted effects.
  
  More common
  
  Increased blood pressure.
  
  Check with your doctor as soon as possible if any of the following side effects occur:
  
  Less common or rare
  Difficult or painful urination;
  fast or irregular heartbeat;
  feeling that others can hear your thoughts; feeling that others are watching you or controlling your behavior;
  hallucinations (feeling, seeing, or hearing things that are not there);
  headache (severe);
  mental depression;
  numbness, especially on one side of the face or body;
  skin rash or hives;
  sore throat and fever (with diethylpropion); talking, feeling, and acting with excitement and activity you cannot control;
  unusual bleeding or bruising (with diethylpropion).
  
  Check with your doctor immediately if any of the following side effects occur:
  
  Rare
  
  Chest pain; decreased ability to exercise; fainting; swelling of feet or lower legs; trouble in breathing.
• This medicine may cause some people to feel a false sense of well-being
• Check with your doctor immediately if you notice a decrease in your ability to exercise, if you faint, or if you have chest pain,
  swelling of your feet or lower legs, or trouble in breathing .
  
  These may be symptoms of very serious heart or lung problems.

The good news is that losing even modest amounts of weight can:
lower your blood pressure,
reduce your risk of cardiovascular disease and stroke,
improve glucose control in diabetes,
improve signs and symptoms of osteoarthritis
and sleep apnea,
and lower your risk of cancer.

The amount of weight you need to lose to improve your health may be much less than what you feel you need to lose.

The first goal in dealing with obesity is to achieve and maintain a healthier weight.

That usually requires reducing your weight by approximately 5 percent to 10 percent.

That means that if you weigh 200 pounds and are obese by BMI standards, you would need to lose at least 10 to 20 pounds.

That doesn't mean you should stop there. But it's a place to start.

Slow and steady weight loss of 1 or 2 pounds a week is considered the safest way to lose weight and the best way to keep it off.

In many cases, losing weight can be accomplished by committing to eating a healthier diet, exercising and changing behaviors.

Other treatments for obesity include prescription medications and surgery

Now consider this:

National Estimated Cost of Obesity from the CDC:

According to a study of national costs attributed to both overweight (BMI 25–29.9) and obesity (BMI greater than 30).

Medical expenses accounted for 9.1 percent of total U.S. medical expenditures in 1998 and may have reached as high as $78.5 billion ;$92.6 billion in 2002 dollars

(Finkelstein, Fiebelkorn, and Wang, 2003).

Direct medical costs may include preventive, diagnostic, and treatment services related to obesity. Indirect costs relate to morbidity and mortality costs.

Morbidity costs are defined as the value of income lost from decreased productivity, restricted activity, absenteeism, and bed days.

Mortality costs are the value of future income lost by premature death.

$78.5 billion in 1998 and $92.6 billion dollars in 2002.

Yes that is $92.6 BILLION US dollars just in 2002 alone, thats an astounding amount of money.

I don't know about everyone else, but I would much rather be "addicted" to or "need" Phen or something else than be addicted to food.
*************************************************

Weight-loss drugs can improve your health, if used in combination with a healthy diet and regular exercise.

Find out if you could benefit from taking these medications.

Weight-loss drugs may sound like a dieter's dream. But they aren't a good choice for everyone who's overweight.

In fact, many doctors reserve them for people with weight-related health problems.

It's best to lose weight through a healthy diet and regular exercise.

But if you're among those who struggle to lose weight and the excess weight has produced medical problems, weight-loss drugs may be able to help you.

Prescription weight-loss drugs aren't intended for people who just want to lose a few pounds for cosmetic reasons.

They're generally reserved for people who are unable to achieve or maintain a healthy weight through diet and exercise, and often have health problems as a result.

Your doctor may consider you a candidate for medication treatment if these criteria apply:

• Other methods of weight loss haven't worked for you.
• Your body mass index (BMI) is greater than 27 and you have medical complications of obesity, such as diabetes, high blood pressure or sleep apnea.
• Your BMI is greater than 30

Two prescription drugs have been approved by the Food and Drug Administration (FDA) for long-term weight loss.

These drugs work in different ways and cause different side effects.

1 -- Sibutramine (Meridia) Changes your brain chemistry, making you feel full more quickly 10 milligrams (mg) once a day

Side Effects: Increased blood pressure, headache, dry mouth, constipation and insomnia

2 -- Orlistat (Xenical) Prevents the absorption of fat in your intestines 120 mg three times a day

Side Effects: Frequent oily bowel movements, diarrhea, bloating and abdominal pain

Though not prescribed as often, several medications, such as phentermine (Adipex-P, Ionamin), are approved for short-term use.

These drugs suppress appetite,but haven't been the subject of many long-term studies.

When used for a short time — generally less than 12 weeks — the medications usually lead to only temporary weight loss.

Side effects of these drugs include dry mouth, nausea, vomiting, dizziness and lightheadedness.

Effectiveness: Modest but can improve health

Combining weight-loss drugs with a low-calorie diet and regular exercise can help you lose more weight than can either drugs or lifestyle changes alone.

Combining all three — medication, fewer calories and more activity — can help you lose anywhere from 5 percent to 10 percent of your total body weight within a year.

This may not seem like many pounds lost, but even modest weight loss has a significant benefit to your health.

Losing just a small percentage of your weight can decrease:

Blood pressure
Blood triglyceride levels
Blood glucose levels
Insulin levels

Weight-loss drugs don't replace the need for changes in your eating habits or activity level.

They mainly improve your chances of achieving clinically significant weight loss — the amount of weight loss that has a positive impact on your health.

If you're among those who can benefit from a weight-loss drug, you'll likely need to take it indefinitely.

When you stop drug treatment, however, much or all of the lost weight generally returns.

The dilemma with taking the drugs indefinitely is that the most common weight-loss drugs are so new that possible long-term effects are unknown .

Sibutramine(Meridia) can cause a small increase in blood pressure that, for some people, may warrant discontinuing the drug.

This drug isn't recommended for people with uncontrolled high blood pressure, heart disease, irregular heartbeat or a history of stroke.

Orlistat (Xenical)decreases the absorption of certain fat-soluble vitamins — for example, vitamins A, D and E.

If you're taking this drug, your doctor will recommend that you take a daily vitamin supplement to prevent potential nutrient deficiencies.

These medications can help you with weight maintenance, especially if you continue exercising regularly.

But keeping off the pounds once you've lost them is an ongoing concern. And despite your efforts, you might still regain the weight.

As you consider weight-loss drugs, make sure that you make every effort to exercise, change your eating habits and adjust any other lifestyle factors that have contributed to your excess weight.


Weight-loss drugs aren't the easy answer to weight loss, but they can be a useful tool to help you make the necessary diet and lifestyle changes.

Now take a look at the FDA Approved "long term" medications for weight loss - how can we honestly say those 2 medications are any "safer" than any other ones.

The FDA states: Though not prescribed as often, several medications, phentermine (Adipex-P, Ionamin) , are approved for short-term use

These drugs suppress appetite,but haven't been the subject of many long-term studies.

If you're among those who can benefit from a weight-loss drug, you'll likely need to take it indefinitely

Now for the really interesting part about "addiction":

***If you have been taking this medicine for a long time or in large doses and you think you may have become mentally or physically dependent on it, check with your doctor***

Some signs of dependence on appetite suppressants are:
[LIST] [*]A strong desire or need to continue taking the medicine.[*]A need to increase the dose to receive the effects of the medicine.[*]withdrawal side effects -- for example:
mental depression, nausea or vomiting, stomach cramps or pain, trembling, unusual tiredness or weakness when you stop taking the medicine.

Abuse of a sympathomimetic appetite suppressant (taking the medicine in larger doses or taking it more frequently or for a longer time than the doctor ordered) can cause the following side effects:

Changes in personality; excessive, excited activity; irritability (severe); mental illness (severe), similar to schizophrenia; skin disease; trouble in sleeping (severe).

***After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it.***

During this time check with your doctor if you notice any of the following side effects:

Extreme tiredness or weakness; mental depression; nausea or vomiting; stomach cramps or pain; trembling; trouble in sleeping or nightmares.

If you have been taking this medicine in large doses or for a long time, do not stop taking it without first checking with your doctor .

Your doctor may want you to reduce gradually the amount you are taking before stopping completely. This will help prevent withdrawal side effects.

Does this mean if we quit one day cold turkey and don't use it again for a day, a week or weeks, we aren't really addicted or are we addicted because this medication helps us achieve our goals and it's only a mental thing?

Whatever it is, the medication is helping me achieve my goals of a healthy lifestyle and making decisions of "true hunger".

We are all in this fight together and when we pick apart others decisions in the end we only hurt ourselves.

If this has helped one person, I'll feel better

[lmt033167]

Bump, please read this fully.

It has alot of great information for everyone so you can make an "informed decision" about weight loss and medications.

I was really amazed the FDA didn't do long term studies on Phen, but did Meridia and Xenical and Phen has been around longer if I read this right.

[missus]

This is very interesting and informative. Thanks Imt.

Missus

[pjward]

Imt033167~
YOU ROCK! Thanks for the GREAT information. It should be mandatory reading for anyone beginning their weight loss journey. Thanks for taking the time to find and post the info, and for presenting it in a non-demeaning or judgmental way. I found lots of facts that I wasn't aware of.

[lmt033167]

thanks PJ

as with all things in life, there are good and bad, we just have to decide which is the lesser evil lol j/k

[beckyinvb]

Thanks for all the info! My doctor said it's critical for me to maintain a healthy weight since my father and older sister were diagnosed with diabetes. I *really* don't want to go down that road. He agreed Phentermine is a good tool to assist with that as long as I continue to exercise. He said more drugs were in the pipeline to assist with this and help prevent people from becoming diabetics. Who can say if the drugs I might need for diabetes one day aren't worse than taking an appetite suppressant to help keep the weight off and developing diabetes in the first place?

[OnMyWay1967]

Bump...lots of new people so this info may be useful for you.

[GamecockGirl]

Very good information...I am here to say that taking this medication (phen) and dieting and exercising WILL improve many areas of your health. I am diabetic and was taking the max amount of diabetic pills with A1c bloodwork showing a 10.5 level. After 3 months of the meds, diet and exercise, my A1C was 5.4, better than my doctor's and my meds have been cut in half!

Good luck everyone and lmt (onmyway), thanks for posting this info. You are an angel.

[ItsJustMeAgain2007]

great info