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Appetite suppressants, also called sympathomimetics, are used in the short-term treatment of obesity.

laparoscopic-bariatric-weight-loss-md.jpTheir appetite-reducing effect tends to decrease after a few weeks and that’s why these medicines are useful only during the first few weeks of a weight-loss program. Changes in eating habits and activity level must be developed and continued for a longer period of time in order for a person to continue losing weight and to keep the lost weight from returning. In the past two decades most of the Western world has become obsessed with losing weight. Appetite suppresants became very popular but it seems that most people are not aware that they could cause some very serious side effects. Epidemics of fatal pulmonary hypertension and heart valve damage associated with these medications agents have led to the withdrawal of several such products from the market. With appetite suppressants people are interrupting a very natural occurrence, and it is a shame that our society actually promotes these appetite suppressants as a safe mean of losing weight.

Obesity - disease of the modern age

Obesity is a disease that affects millions of American adults, adolescents, and children, posing serious health risks. Experts generally consider obesity to be a chronic illness requiring life-long treatment and management. One is considered obese if 20% over ideal body weight, according to standard height-weight charts, or if one's Body Mass Index, or BMI, exceeds 30The most important strategies for managing obesity are not medications but rather, a healthy diet coupled with moderate exercise. Of course, the use of prescription medications may help but it should never be the sole treatment for obesity, nor is it ever considered a cure.

Brand Names for appetite suppressants

  • Adipex-P®
  • Adipost®
  • Bontril PDM®
  • Bontril Slow-Release®
  • Didrex®
  • Fastin®
  • Ionamin®
  • Mazanor®
  • Melfiat®
  • Obenix®
  • Obezine®
  • Phendiet®
  • Phendiet-105®
  • Phentercot®
  • Phentride®
  • Plegine®
  • Prelu-2®
  • Pro-Fast®
  • PT 105®
  • Sanorex®
  • Tenuate®
  • Tenuate Dospan®
  • Tepanil Ten-Tab®
  • Teramine®
  • Zantryl®
  • Ionamin®
  • Sanorex®
  • Tenuate®
  • Tenuate®
  • Dospan®

History

The drugs in this class are frequently stimulants of the phenethylamine family, related to amphetamine.

They are very famous because they were widely issued to British soldiers during the First World War in order to suppress their appetites. In the Second World War, amphetamines were re-directed for use on the civilian market. They didn’t enter a market as an appetite suppressant until it was outlawed in most parts of the world. Many amphetamines produce side effects including addiction, tachycardia and hypertension, making prolonged unsupervised use dangerous.

Studies on this subject

Numerous studies have been done surrounding the effects of appetite suppressants on weight loss and most of these studies show that using the appetite suppressant along with diet and exercise will promote weight loss. But, are the results of these studies reliable? Many of these studies are seriously flawed. Some of them restricted caloric intake for their participants, while others increased activity level. Also, many of these studies only included a specific type of individuals. 

How are they being used?

You should always consult a doctor before you start taking this type of medications.

An appetite suppressant is best taken on an empty stomach one hour before a meal. Sustained-release or long acting products must be swallowed whole. Crushing or chewing the pills will destroy the long action and may cause increased side effects. They should never be taken more often or longer than directed. They are usually taken for 8 to 12 weeks. Combining more appetite suppressant medicines is generally not recommended.

Contraindications

Research has shown that the following contraindications may occur when consuming appetite suppressants:

Allergies
If a person has had some unusual or allergic reaction to this medicine or amphetamine, dextroamphetamine, ephedrine, epinephrine, isoproterenol, metaproterenol, methamphetamine, norepinephrine, phenylephrine, phenylpropanolamine, pseudoephedrine, terbutaline, or other appetite suppressants, this should be reported to the doctor

Diet
If a person keeps the same eating habits during the appetite suppressants treatment there will be no results! A reduced-calorie diet must be followed while using an appetite suppressant in order to lose weight. The changes in diet and exercise must be continued even after the weight has been lost.

Pregnancy
Taking appetite suppressants in high doses or more often than the doctor has directed in pregnancy might cause severe birth defects in the newborn baby.

Breast-feeding
Medications such as Diethylpropion and benzphetamine pass into breast milk and that’s why the use of sympathomimetic appetite suppressants during breast-feeding is not recommended.

Children
The use of appetite suppressants by children younger than 16 years of age is not recommended.

Other medicines

Certain medicines should not be used together with appetite suppressants. These medications include:

  • Amantadine
  • Amphetamines or
  • Caffeine
  • Chlophedianol
  • Cocaine
  • Medicine for asthma or other breathing problems or
  • Medicine for colds, sinus problems
  • Methylphenidate
  • Nabilone
  • Pemoline

Potential benefits of appetite suppressant treatment

The short-term use of appetite suppressant medications has been shown to modestly reduce health risks for obese individuals. These medications can:

  • lower blood pressure,
  • lower blood cholesterol,
  • lower blood fats (triglycerides),
  • decrease insulin resistance

How Much Will You Lose?

No one should expect to lose more than 5-10 percent of current body weight while taking an appetite suppressant. Most studies suggest that after six months of use, weight loss levels off and these medications lose their effectiveness.

Potential risks and side effects of appetite suppressant treatment

All prescription medications used to treat obesity are and should be used as controlled substances. This means that doctors need to follow rigid guidelines when prescribing them. Although abuse and dependence are uncommon with non-amphetamine appetite suppressant medications, doctors need to be cautious when prescribing them.

The good thing about these medications is that most side effects are mild and diminish as treatment continues. Appetite suppressant medications that affect serotonin have been withdrawn from the market. Medications that affect catecholamine levels may cause symptoms such as sleeplessness, nervousness, and euphoria.

Some of them could cause:

  • blurred vision,
  • dizziness,
  • dry mouth,
  • sleeplessness,
  • irritability,
  • stomach upset or constipation

Primary pulmonary hypertension is a potentially fatal disease that affects the blood vessels in the lungs. The patients who use the appetite suppressant medications that are prescribed for a use for three months are at an increased risk of developing this condition if used longer.

Both doctors and patients should be aware of this potentially deadly complication when they consider the risks and benefits of using appetite suppressant medications for long-term treatment of obesity.

Patients taking appetite suppressants should contact their doctors if they experience:

  • shortness of breath,
  • chest pain,
  • faintness,
  • swelling in the lower legs and ankles

Development of tolerance

Several studies of appetite suppressant medications indicated that an individual can develop a tolerance on appetite suppressants after four to six months of treatment.

Dependence

Some signs of dependence on appetite suppressants are:

  • 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 (mental depression, nausea or vomiting, stomach cramps or pain, trembling, unusual tiredness or weakness)

Over-the-counter appetite suppressants

There are a few over-the-counter agents for weight loss on the market. The most common called phenylpropanolamine is an appetite suppressant that is distantly related to the amphetamines. It is proven that this drug has the next side effect:

  • increased blood pressure
  • increased heart rate

That’s why it should not be used by people with hypertension or heart disease. Other over-the-counter medications contain fiber or bulking agents, and presumably work by increasing the sensation of fullness. Some preparations contain an anesthetic called benzocaine.