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Monday, July 23, 2018

Danger of weight loss pills

It is a natural and common human trait to seek instant relief for any affliction and ailment.

Written by Neelanjana Singh | Published: March 28, 2009 10:49:24 pm

It is a natural and common human trait to seek instant relief for any affliction and ailment. The realm of weight management is no exception. And it is common for pharmaceutical companies to play upon this human weakness.

The history of trends in weight control is replete with instances of magic bullet offerings in the form of weight reducing pills.

Alas! As I have said so often,nothing comes without a price. In our craze for ridding ourselves of unwanted fat,we ignore the very real and often potent dangers of the side effects of these pills.

The most recent instance of this is related to the drug rimonabant,which had to be pulled out of India — and other countries — because it induces suicidal tendencies in its users.

The drug was developed on basis of the fact that bio-active substances from cannabis (cannabinoids) stimulate appetite and therefore if the cannabinoid receptors are blocked off,a reduction of appetite will occur. It did work as expected,but as a trade off,it left the users feeling low and depressed.

What is the current situation vis-à-vis pills?

As of now,there are only two drugs approved by the FDA in the US for long-term use — which means not over two years. The safety and effectiveness of these beyond the two year period has not yet been established. I would like to advise those contemplating the use of these drugs to do so only if their Body Mass Index (BMI) exceeds 30. Potential users who need to reduce weight for medical conditions like altered lipids,hypertension and diabetes may do so if their BMI exceeds 27.

Last week I had discussed the Lipase inhibitor drug or the fat squirting drug — Orlistat. This drug is considered safe and effective because the longest study ever — of four years — on weight loss medications has been conducted on Orlistat.

As mentioned last week,it will soon be launched as a non-prescription or OTC (over the counter) drug. There is a second category of obesity controlling medication that acts differently from drugs like Orlistat. Instead of acting on the gut,like Orlistat,these drugs act on the central nervous system to suppress appetite (quite similar to Rimonabant).

The most prescribed and popular among this class of approved drugs is Sibutramine which was originally used to treat depression. Of course it has its share of side effects! These include symptoms such as dryness of the mouth,constipation and insomnia.

Almost 30 per cent of users have experienced these side effects. A rise in blood pressure or palpitations could also be experienced. Literally this pill is therefore not meant for the faint hearted!

Unfortunately,in my not inconsiderable experience,I have more often than not been besieged by patients seeking instant and effortless means of reducing body weight. The prime cause for weight gain is this extreme reluctance in humans to make lifestyle changes related to eating and physical activity. I would urge all readers who do try weight loss pills for whatsoever reasons to be aware that generally maximum weight loss occurs within six months of starting such drug therapy.

Thereafter the weight tends to level off or even increase.

Of course,very often,there are compelling medical reasons to lose weight quickly and in such instances it may be worth using pills,but this must happen only under strict supervision and monitoring.

For all other members of this growing army of overweight humans seeking remedies caused by their gastronomic indulgences and physical lethargies,I would urge them to alter their lifestyles. Permanent benefits of weight management occur through behavioural changes.

More recently,a lot of Ayurvedic remedies have gained significant popularity.

Ayurveda does have a store of foods and herbs that are known to induce anti-obesity action. The lemon-honey-lukewarm water combo is one of the most touted of folk remedies. But as the effervescent Shammi Kapoor was fond of saying in the film Manoranjan — “woh kissa agli baar”.

Next week: Ayurvedic remedies for weight loss

nsingh.rxpress@expressindia.com

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