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Doctors' Answers to "Frequently Asked Questions" - Diet & Dieting
Drugs for Weight Loss
Answer: Meridia is an option, but doesn't work extremely well. We don't have good drugs for weight loss currently.
Appredrine Concerns [posted 12/02/98]
Question: My 17 year old has recently started taking something called Appredrine. I think it must be some kind of appetite suppressant. He is 6'4" and weighs about 235lbs. My question is are these appetite suppressors dangerous or even of any help? I am well aware that a heathly balanced diet and exercise are the best weight loss program, but what does a mother know, eh? Thanks for any information and education in this regard you can offer us.
Answer: Most of them don't work very well, or everyone would be on them. However, usually little risk except for cardiac irregularities.
Diet Drugs [posted 11/17/98]
Answer: Well, Meridia is touted;but, I haven't had much success. Worth
a try however.
Nonfat Diet [posted 11/13/98]
Answer: Should be very healthy, olive oil etc is very high in fat.
Medication & Your Diet [posted
Answer: Happy to help, but, I'm not sure what you are asking. Most "foods" would not affect potassium enough to bother with, an exception being English licorice.
Phen - Phen [posted 10/6/98]
Answer: Try increasing the dose. But, it doesn't seem to work as well as the other drugs -unfortunately.
Dietral Diet Pill [posted
Answer: Not a prescripton drug, I'm not familiar with it.
Salt In Your Diet [posted
Answer: Excess iodine intake can produce hypothyroidism in some patients. The exact dosage necessary varies a lot from person to person;but, I would not take any extra iodine intake personally. The information concerning salt intake is very hotly debated. Years ago, a low salt intake was about the only way to treat hypertension. Actually only about 10-25% of patients will actually respond to a low salt intake. This is usually 4 gms or less a day with a severe restriction of 2 gms a day. I would limit my salt intake-especially if you are not caucasian since patients of color tend to respond to salt restriction more than caucasians. However, at this point in medical research, I wouldn't make it a religion to avoid salt. It may well be that a high potassium/calcium diet(usually the opposite of high salt) is necessary for good health-not the actual salt content. But, hotly debated currently.
Diet Drugs [posted 8/11/98]
Answer: Try Meridia, to be released this March. It's similar to the medications you were taking without the cardiac side effects.
Answer: So are a lot of people, but nothing seems to work nearly as well. Hopefully, they will restore the medication. Some people are combining Prozac with other drugs, but this is not currently researched very well.
Answer: So far, we haven't found any subgroup of individuals for which a high fat diet is healthy. It is clear that young children need more fat in their diet to synthesize myelin and aid in brain growth. However, adult fat need is far less than growing children. There are some fats that appear to be tolerated better than others and some fats(like olive oil) may actually be somewhat protective against heart disease. In general, a lower fat diet is beneficial to most adults.
Answer: Calcium carbonate is easily absorbed and is usually the drug given by physicians.
Answer: This drug seems fairly safe; however, there have been recent reports of valvular damage in patients taking the drug for over one year(reported by the Mayo Clinic). This is in addition to reports of increased numbers of patients with pulmonary hypertension( a potentially fatal disease). While the numbers appear small and the data is early, it has made most physicians be careful in their prescribing. A recent editorial in the New England Journal of Medicine recommended only treatment of patients with diabetes mellitus, elevated cholesterol, etc. where the benefit of weight loss clearly outweighed the risks.
Zoloft & Fastin
Answer: There is a specific warning not to use Fastin with any SRI antidepressant like Zoloft. Having said this, I am aware that many physicians have prescribed this combination-I would not recommend it.
Heart Surgery Diet
Answer: Best to ask the dietitian at the hospital. But, generally-low fat foods.
Answer: Not clear ;but, appears to be only Redux and fenfluramine.
Answer: These drugs are now off the market being re-evaluated. There is currently no evidence that the SRI antidepressants produce this problem. The serotonin syndrome is seen in Carcinoid Syndrome and is symptoms caused by high levels of serotonin. This is flushing, diarrhea and sometimes dyspnea.
Answer: This is not a good combination and there is a specific warning not to mix SRI antidepressants and fen-phen. However, the fen part is now off the market.
Dinitel & Dnromine
Answer: I am not familiar with these drugs. In general, anorectics will not cause infertility unless one loses sufficient body mass to decrease or stop your period. This is a function of body mass, not the pill you take to lose mass.
Answer: Like any anorectic it varies with the individual. We currently don't know of any long/short toxicity of Dexitrim when taken as suggested. Using the stairmaster will accelerate the weight loss ;but, has no effect on the Dexitrim or vice versa.
Answer: If it worked before don't mess with success. Start with one and see if it works. Two would probably not be a problem; but, is less predictable in side effects. Your lean body mass will predict your side effects, not your total weight.
Answer: Don't know really, research in progress-I'd avoid it for the time being.
Answer: Phendimetrazine is a medication that is used for weight control. Although the medication does act by suppressing appetite, there are other, less well understood ways in which this medication produces its effect. According to the Physicians Desk Reference, the medication, once absorbed from the intestinal tract is cleared from the body by the kidneys. The half-life of the medication, or the time it takes for one half of the medication to be cleared from the system, is 1.9 hours (or 9.8 hours for the timed release form). Patients who have advanced atherosclerosis (hardening of the arteries), heart disease high blood prcssurc, hypcrthyroidism, glaucoma, or patients on any other nervous system stimulants should avoid the use of this medication. Tolerance to the drugs effect does occur, in other words, after some time of its use, the ability of the drug to suppress appetite will decrease. The dose should not be increased above recommended levels, but rather should be stopped, and the patient switched to a new medication. This medication has not been tested for safety in pregnancy and should be stopped under the supervision of your health care provider prior to attempting a pregnancy, unless under the strict direction of your health care provider, and only if the risks outweigh the benefits. Side effects can include, but are not limited to rapid heart rate, high blood pressure, restlessness, anxiety, insomnia, headache, tremor, dry mouth, constipation or diarrhea, nausea, urinary symptoms, and changes in sexual function. If you are experiencing a symptom that you feel may be related to a medication, visit your health care provider. He or she can determine whether the symptom is possibly due to the drug, and determine the best course of action to take.
Phn-Fen & &chocardiogram
Answer: I have had over 200 patients on this medication and have seen none of
the described valvular problems. All of my patients received an initial and a follow up
echocardiogram at 3 months or so. This is the definitive test and will cost $325 or
so(usually covered by insurance). It is similar to the echo test done on pregnant
women-just a different processor and is painless. I doubt that you would have problems at
5 months. Most of the patients experienced problems at one year or so. However, we don't
know the true incidence or the true causal factors yet. If you are concerned I would get
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