A few years ago, one of my friends had a minor heart attack and was rushed to the nearest hospital. She was 30 years old at the time and taking Delganex, an illegal diet pill with a chemical composition similar to cocaine.
This week, the Food and Drug Administration approved Arena Pharmaceuticals’ weight-loss drug Belviq, the first weight-loss drug approved by the FDA in 12 years. Although my friend is well today, when I heard about Belviq and the excitement expressed by obesity elimination advocates, I had to investigate.
Weight management medication has been around since the 1930s. Amphetamines, a highly addictive drug that increases metabolism, was popular until the 1960s, when it was determined as the cause of death for a number of patients. Fen-Phen (a combination of Fenfluramine and Phentermine) works by suppressing appetite and was popular in the 1990s. In 1997, the FDA requested its withdrawal from the market after it was revealed that Fen-Phen caused heart valve malfunction in a third of the patients taking it.
Today a lot of people struggling with obesity are giving Orlistat (AKA Alli) a chance in hopes that by decreasing absorption of dietary fat they will be able to lose weight and improve their health. Unfortunately, several clinical trials have shown that when Orlistat is taken as recommended (i.e. not overused) the weight loss results are minimal. In addition, Orlistat also comes along with serious side effects such as loose stools, frequent and hard to control bowel movements, and although rare, serious liver injury.
An individual taking Alli deprives their body of all fat (essential and unhealthy) and consequently the fat-soluble vitamins A, D, E, and K which need dietary fat to be properly absorbed by the body. Another problem with taking fat-inhibiting drugs is that it completely ignores that body fat does not come from healthy fat consumption but rather from over-consumption of trans fats, processed carbohydrates and refined sugars. There is a lot of hope for Belviq and what it can do to help obese Americans manage weight loss. The history of diet pills shows the FDA’s lack of timely accountability and a lack of internal quality assurance practices on the part of pharmaceutical corporations.
Finally, given the recent approval of President Obama’s health care reform, more financial resources allotted for obesity prevention and education, and not only medication, would be a nice breath of fresh air for health and wellness advocates. While Belviq is supposed to be used as “as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adult patients” it is likely that many will expect drastic results without engaging in a more holistic health management regimen that includes nutrition and exercise.
Individuals who are serious enough about their health, to consider taking weight management medication, should consider the following natural and sustainable long-term steps to regain control of their health.
• Food Journal: Start by keeping a journal of what, when, where, and how you eat. This information will help you understand the nutrient composition of your diet, your negative and positive patterns, and your addictions. This information helps you find realistic solutions to your overeating which, for many people, may related to emotional well-being and not physical hunger.
• Snowball Exercise: It is most important to build your exercise habit by starting with exercising once a week and progressing up to 2-4 times a week, depending on your schedule and weight loss goals. This prevents burnout and injuries, and promotes commitment and permanent change in your routine.
• Find Allies: There is a lot of shame around being overweight. The mental aspect is really important because you may be dealing with depression, anxiety, stress, body image, lack of confidence, and even anger with yourself and those around you who (although with good intentions) remind you that you have to lose weight. Find a small group of friends and family members who can support you in the process. People who love you and will not judge you, when you have setbacks or miss an exercise day, but who will hold you accountable with compassion and love for your effort and your journey are necessary. If you can afford it, a personal trainer and/or health coach can also provide support and guidance in this area. Remember, there’s no magic pill for weight loss and the only right time to start taking care of yourself is when you are ready and committed to making changes you can integrate into your lifestyle.