Friday, February 11, 2011

Diet Pill Death Shouldn’t Destroy Your Hope

Won't be long before they're pushing diet pills for him
Weighing In On the Risks of the "Quick Fix"

Another diet pill bit the dust. Last week, the FDA killed the promise of a quick fix for losing weight. They demanded of Orexigen Therapeutics a long-term study for safety, concerned about the possible risk of heart attacks that might result from use of Contrave, it’s new product. Apparently Contrave had already demonstrated success in raising blood pressure, something those with obesity hardly need to add to their woes.

So why a post on this? I am delighted with FDA’s stand, yet alarmed by the details of diet drug and laxative availability and the potential harm to users. Meridia, for instance, another useless diet pill, approved for 13 years, was only recently removed due to a 16 % increased risk of heart attack, stroke and death.

Chai, not Senna tea!
Some weeks ago I was visiting my mother, searching her cupboard for a tea I would like. “Dieter’s Tea” popped out, a product I was unfamiliar with. My mother, of course, didn’t purchase this product, but rather was given it “by a friend”. The box was open, but she had never tried it. No, she had no idea what was in it or how it “worked”. 

So I read the ingredients, and then began to Google. My greatest concern was the Senna. You know, that natural plant substance that helps constipation. Gotta be healthy, right? And here’s one of the many articles that confirmed my suspicion:
Because it is over the counter, readily available, comes without a warning, and marketed as a natural remedy, it is most worrisome. Because I know people are seeking a quick fix. And they are not researching the ingredients and their risks while at the supermarket deciding between Earl Grey and Dieter’s Tea.

 So back to Contrave.

At best, subjects lost 4.3 % more weight, compared to placebo, the fake stuff. If you’re 5’4” 175 lbs,, with a BMI 30, you’re considered obese, making you eligible to use a prescription diet drug.
In 12 months, that amounts to just over 1/2 pound additional weight lost per month, 2 ounces more weight lost per week. Wow! Rapid? Significant, even? Enough to justify the cost, either financially or medically? And risk free? Hardly.

Interesting, no?
How much health benefit would you gain from that additional 2 oz. per week?  And self esteem? Would it change how you see yourself? And would it justify the unknown risks? The potential changes in blood pressure and increased heart disease risk?
And how necessary is it anyway to lose weight if we are obese, but fit? Yes, those two phrases can exist side by side!

Some months ago, the promise of a new medication for MS hit the news. A pill, the very first, to offer hope for those of us living with this potentially debilitating disease. The advantages were clear. Swallow daily, or inject daily or multiple times weekly. And the studies showed the medication to be at least as effective as the injectables.

Aren’t you thrilled, friends and family asked, knowing my 8-year history with this illness? Yet all I could think about was the cost. Not financial, as I am fortunate enough to have good insurance coverage. But the risk of this new med, with its list of horrific potential side effects, including blindness and fatal herpes infection, to name a few.

Now if the benefit strongly outweighed the risk, it might be worth it. But, thankfully, I am not debilitated by my disease. I am lucky enough to be able to engage in all activities I care to. And it’s possible that you, at your current weight, may not be debilitated, even if your doctor sees your weight as the number one “disease” for you to tackle. See my point?

We all want a magic bullet, for everything. So we’re drawn to lottery tickets, diet pills, surgical fixes for whatever might hold promise of a better life.

Would a new diet pill really change anything, even, if compared to placebo, it took off 5 % more of your weight? Because that’s enough weight change necessary to get it approved.

Disturbing photo from the MFA, Boston
Finally, those of you at the low end of the scale may cling to the benefits of staying there. The fear of change keeps you focusing only on the positives of where you’re at. Is it really so positive? Is the benefit of your eating disorder really greater than the costs, physically, psychologically, socially?

Reminds me of how we remember old boyfriends (or girlfriends). We longingly recall all the great times, how wonderful it was being together. Until we reality check and remember—I was miserable with him!

In summary, be an accountant. Look at the list of benefits of staying where you are, in terms of weight and behaviors. Then give some serious thought to the negatives, the risks. And hopefully the risk of taking diet pills, laxatives, and cleanses in addition to your own unhealthy actions, will be reconsidered.

As always, I'm eager to hear your opinions!


  1. Yes, I agree - just because something is packaged as a 'natural' or 'health' food doesn't make it good for you. After all snake venom is 'all natural' - doesn't make me want to ingest it :)
    Luckily I have an aversion to taking any exogenous chemicals so have never been drawn to diet pills or laxatives or even artifical sweetners (unfortunately this aversion also extends to vitamin supplements, but I am fightning this one).

    And I like your boyfriend/ED analogy btw - it is so accurate

  2. Sometimes we are so all-consumed with losing weight that no, in fact, the potential harmful side effects in diet pills are irrelevant... that in our mindset, it is worth any risks in order to lose a few pounds. Our logic is clouded so even reality checks regarding the dangers of weight loss pills may not prove helpful. We want to believe the side of the box and we will hold on to the information given... weight loss.
    Intellectually, though, most people are aware that some "thing" in the form of a pill can not possibly perform this kind of magic. I think that's what we need to hold on to and let go of the dream and fantasy of a magic weight loss pill, and focus more on changing unhealthy behaviors and negative thoughts.

  3. Three weeks ago I started counting calories. I got a food scale, and I have been amazed to find out exactly how much food I was eating before. I didn't have any idea what 200 grams of potatoes looked like, or 78 grams of tofu. Now I do, and I am keeping under a healthy 1,500 calories a day and losing more than a pound a week, without being hungry! I am so pleased and excited about using the correct amount to stay at a healthy weight without starving.

  4. So good you are all grounded enough to choose sensibly--defying misleading claims and promises in favor of trusting your instincts! And I fully support Dana's goal of letting go of "magical thinking".

    Regarding calorie counting--it is not the method I support, preferring instead to utilize more internal cues, like hunger and fullness--instead of being in our head, counting and choosing based on "should" and rules. You must all know that by now! That being said, it can be useful to have the awareness of how much (or how little) we are eating, relative to our need!

    Readers take note--everyone's needs are different, so mention of one reader's caloric intake has no bearing on your individual need.

    Personally, the last time I counted calories I believe was 26 years ago, for a grad school project. Really. And for the record I'm no heavier than I was then!

  5. Diet pills are one of the worst scams around. The vast majority of them have absolutely no effect whatsoever, and some of them are actually dangerous or addictive. So we need to be very much aware of that.