FAT AMERICA

"Hey I'm trying to loose weight.... I'm drinking a Diet Coke."

Diet Pill Phenom

Americans love their food. We love those all-you-can-eat buffets. Lately it has been with a lot of fast food. The national girth has proven in recent years that we are a nation of fat people. Those of us that actually care about our appearance and our general health often times want a quick fix. Heaven forbid we actually have to shut our pie-holes to the offerings of McDonalds and Burger King. Oh no, we need some painlessly easy means of fixing things. Both big pharma and the nutritional supplement industry provide us with the lots of options. Yes just one more thing to stuff into our mouths. Diet pills have been around for years, but there are a few new agents on the market and Americans are spending hard earned cash on them.

Meridia is one of only two FDA approved long-term medications for weight loss. It is a sister drug to Prozac and Zoloft and alters the feel-good brain chemical serotonin in our brains. This can be a rather useful start to a weight loss program if used in conjunction with proper diet and exercise. However, some side effects include a rise in blood pressure. Not a good idea for the obese hypertensive.

Xenical came out a few years ago. It is the other FDA approved drug for weight loss. Was the FDA on crack? Does the drug company that manufactures Xenical have a very evil sense of humor? This drug from day one was on my poop-list (no pun intended). Besides commanding a price tag of over $100 per month it is dangerous if you ask me. Xenical (and it's over the counter twin Alli) inhibits the absorption of fat in the digestive tract. As a consequence it can block absorption of the very good fat-soluble vitamins (A, D, E and K) as well as some rather important Omega-Fatty Acids. If that ain’t enough, it can cause severe bloating and diarrhea. OK, you are at a dinner party and sample the duck pate and bang you have created a very embarrassing moment.

There is a new drug in the wings called Acomplia, currently under FDA review under the name Zimulti for the US market. This drug is an antagonist to the Cannabinoid-1 receptors in the brain. This drug turns off the eating pleasure sensors in the brain lowering the urge to overeat. Preliminary studies show side effects from dizziness to diarrhea. There is even some reports that this drug may be useful in smoke cessation. Jury is still out on this one until the studies are published and drug goes to market. The other drugs used by doctors are typically stimulant (amphetamine like drugs) which should only be used for a very short term.

Then there are those late night infomercials that boast “too good to be true” weight loss promises. Most are untested, most are absolutely false in the claims they make and they hide under the skirt of the Dietary Supplement Health and Education Act (DSHEA) of 1994, so the government can’t touch them. Shame on them. Oh come on guys, do some real research to prove these supplements effective. If they are you will make four-fold in profits on what you spend on R&D. They are worth mentioning here because you are bound to come across them at the supermarket checkout line next to issues of tabloids the Star and National Enquirer. There are quite a number out there, but a popular supplement is Zantrex-3. Alleged to boost metabolism with caffeine and guarana. Same effect as a double expresso from Starbucks and side effects are about the same: increased heart rate, jitters and some serious insomnia. Hoodia is all the rage these days. Like an old Arab saying goes “There are those that cannot find a miracle at their local church”. The exotic herb from far off lands may yield the answer. Hoodia originates from a cactus-like plant in South Africa and Namibia, and was used by natives for stamina. Rumors leaked out that the cast members of “Desperate Housewives” used the stuff and sales of the herbal supplement have gone nuts. Once again no good peer-reviewed articles that show if this really works to reduce weight and keep it off. So in conclusion, Americans need to put less in their mouths including diet pills and muster up enough will power to get off their ever widening rear ends make a trip to the gym to work those extra pounds off and not stop at the Krispy Kreme on the way home.. Good luck with your New Year's resolutions.

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JP Saleeby, MD is medical director of the Emergency Department at Marlboro Park Hospital. He lectures at GSU School of Nursing to graduate Nurse Practitioners. He maintains a blog at docsaleeby.blogspot.com and can be reached for comment at jpsaleeby@aol.com

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