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Ephedra and other weight-loss products are under intense scrutiny because of the health risks they may pose.
Doctors, of course, would prefer that people shed pounds by eating less, by having a more healthful diet and by exercising.
But can you use any weight-loss drugs safely?
The answer is yes if you work closely with your doctor to develop a treatment plan that fits your needs.
There are some relatively safe drugs that can make a big difference in getting to a healthy weight, says Dr. Steven Heymsfield of the New York Obesity Research Center at St. Luke's-Roosevelt Hospital.
The three drugs most commonly prescribed for weight loss:
- Phentermine, an appetite suppressant, was approved for use in 1959 and is the most commonly prescribed because it costs less than the other major drugs. Some users report that it makes them jumpy.
- Xenical decreases the amount of fat your body absorbs from food by 30 percent, which results in lower calorie intake. But diarrhea is a common side effect.
- Meridia increases levels of brain chemicals that help reduce appetite. Appetite suppressants work by increasing serotonin or catecholamine chemicals that alter mood and appetite through means that are not well understood. Meridia can raise blood pressure and heart rate, so people with heart disease shouldn't take it.
These drugs are considered moderately useful and approved for use over various periods of time, Heymsfield says. But increasingly, we are seeing them used in combinations or "drug cocktails" to decrease side effects and to maintain weight loss, which tends to slow over time.
Phen-pro, for example, is a weight-loss cocktail that combines phentermine with Prozac or other antidepressants. The use of the antidepressant in these cocktails is not to treat depression, and medical experts aren't sure why these combinations appear to improve weight loss.
Two other drugs - Topamax, an anti-seizure medication approved for treatment of epilepsy, and Wellbutrin, an antidepressant - are also being used for weight loss.
And Axokine is in the final phase of testing. It may help not only with weight loss but also in treating type-2 diabetes.
Some doctors - such as Californian Ray Sahelian, an expert on dietary supplements - say that even Ephedra can be taken if a doctor is monitoring the dosage, the frequency of use and the medical condition of the user.
Edited and compiled by Pete Alfano.
(c) 2003, Fort Worth Star-Telegram. Distributed by Knight Ridder/Tribune News Service.