Weight Loss Medications: For or Against?

Ginnykhatmaker

I have seen quite a bit of redditors discredit and slam the use of prescription weight loss drugs like phentermine, it has me wondering how a larger portion of the health/fitness/weight maintenance community feels about it outside of the ever-so-angsty reddit community.

In my experience, I was very fit and in shape, even after having my third child, then I got my tubes tied and the dink of a doctor screwed it up and I ended up with Post Tubal Ligation Syndrome, which caused rapid onset weight gain that I struggled to fight off for around a year to no avail. I was exercising rigorously 6 out of 7 days, drinking nothing but 3 litres of water and 3 cups of plain black coffee everyday, meeting my caloric and nutritional needs and eating clean, but the weight just piled on.

Once I finally got new insurance and switched doctors, my new doctor diagnosed me with PTLS and said my previous doctor hadn't diagnosed me because it is a complication that one can only get if the doctor screws up the procedure by cutting off the blood supply to the ovaries, even if only for a few seconds, which then throws your hormones completely for a loop and causes major complications such as menopausal symptoms, weight gain, fatigue, etc.

After about 3 or 4 months of being seen by this new doctor and having my condition properly treated and all the kinks worked out, they put me on phentermine to help me lose the weight because it still just was not coming off. (Something about the PTLS having caused me to have a much lower resting and active heart rate, so my body is not burning nearly as many calories as it should at my height/weight/activity level.)

Side note: I also have cPTSD from being beaten, raped, and locked in a room for about 6 months about 7 years ago and I still have severe panic/anxiety issues from that even after years of therapy and working on my coping methods, but as i have gotten older, it seems to just escalate and get worse and worse each year with the anxiety and depression.

So my doctor puts me on phentermine 37.5s and I take them as prescribed and continue my diet/exercise routine as is, using my HRM wearable chest strap, I monitored my calorie burn actively while I worked out. My heart rate could easily climb up to the 175-190 range (I'm 26 so this isn't wildly dangerous for me, as once it hits 190 I usually lower my intensity for a bit.) I was burning 3x what I was burning before the phentermine was added and the weight started melting off, almost literally. I have been on it 3 months and lost 31 pounds now, with about 20lbs more to lose. My doctor said it is most definitely fat, as I wasn't really retaining much water weight before hand because 3Ls water a day was my normal for several years even before I was into focusing on my fitness and i don't drink soda/juice/tea, just water and plain black coffee.

I am really seeing more muscle definition and can really see how much I have lost at this point, which is encouraging.

My doctor is also wanting to experiment with keeping me on the phentermine for a while even after I lose the weight, because i have also noticed my anxiety and depression have lessened substantially where literally every other prescription anti anxiety/anti depressant available on the market actually made it worse, it has given me clean, focused energy, with no rise or fall and no jitters, no paranoia or irritability as others have described being on phentermine. It has improved my physical and mental health 10 fold and my doctor said it very well could be that I had undiagnosed ADHD that I had managed to cope with or mask in various ways for years and it made my anxiety and depression worse because it made it almost impossible to compartmentalize and to focus on one stressor in life at a time, my brain was constantly jumping from issue to issue steadily through out the day and couldn't stop for anything.

So I guess I'm wondering why other people spit on this medication so much, especially since im definitely not the only success story out there, I have seen tons of people online say they all had huge success losing weight on phentermine. I'd think as long as you use your time on it to develop healthy and easy to sustain habits, it would be very effective at keeping your weight off, since it only takes 30 days to develop a habit.

mbaker566

i think that many look at it as a magic pill. it is good you are using it to help learn good habits. not everyone does, changing no habits.

LyndaBSS

As mentioned above, the problem with taking a pill for weight loss is that, for many, the behavior doesn't change. Without that modification, once the pill is removed, the initial weight is regained.

CSARdiver

The problem with people's perceptions is that we tend to project our beliefs outward onto others and expect them to act in a predictable way. Anything else appears irrational.

I'm in agreement with the above posters that to people who don't need it - pharmaceuticals appears to be a dodge. If one would only rely on pharmaceuticals, then there's some truth to this and why nearly every medical professional recommends some manner of behavioral change in connection with prescribed medication.

When it comes to online opinions anonymity brings out the worst in people. It makes people callous as they don't have to deal with the consequences of their actions.

Terytha

Partly because many people experience severe side effects. There's always the lucky few who don't but many do.

For me, being on them ruined my stomach
and going off them basically ruined my life. My appetite is 4 times stronger than it was. I'm hungry all the damn time now, even though with diet alone I'd managed to basically control it.

And for what gain? You're still tied to losing weight at a safe rate. The drugs don't let you lose more or faster. And if you haven't learned how to lose weight without them, you're not gonna keep it off when you're done.

bonniehatcher1949

Dam what other people think.

threewins

I think that a lot of people dislike weight loss medicine because they consider it "cheating" and they want to prove to themselves that they can successfully lose weight just using their own self control.

I wouldn't mind using the medicine that improves the efficiency of leptin receptors in the brain. They lose efficiency during middle age, which contributes to weight gain. However, it's expensive and I think that it's probably unnecessary for me.

LyndaBSS

@threewins I found your post interesting. I was leptin resistant up until a few months ago, when my leptin hormone suddenly kicked in. I'm 61. I've never heard of it lessening as we age. I'm just happy to now know when to stop eating.

Azdak

My antipathy towards weight loss drugs in general is that I have never seen anyone maintain the weight loss achieved by using them. I’m sure there are some who have but in my experience the number is so low that they seem to just delay people from starting an effective lifestyle plan.

Having said that, you have multiple issues and a strong clinical justification for your doctor’s treatment plan. So any general reservations about weight loss drugs are not relevant in your case—or in any other situation like yours.

Most of the criticism of weight loss drugs are really focused on people and doctors who use/prescribe them casually as a “fix” without any other lifestyle changes. Again, not relevant in your case.

Ginnykhatmaker

mbaker566 wrote: »

i think that many look at it as a magic pill. it is good you are using it to help learn good habits. not everyone does, changing no habits.

I think, for me, it was kind of a magic pill for my mental health issues. When I say that, I mean I put forth all the effort I could. I'd tried every anxiety/depression medication under the sun and all of them seemed to make my issues worse. I had gone to therapy for years, developed healthy coping skills, tried every natural or home remedy I could find when medications were failing me, practiced medicognition exercises that my therapist had taught me. I just kept spiraling deeper in.

By the time my doctor prescribed the phentermine I had gotten so bad I had developed thanatophobia (phobia of death) and was feeling agoraphobic type feelings, like I would feel a bit of panic and nervousness every time I left the house and it was getting worse.

Now I'm a functioning adult/mom. So I can see how some people might get frustrated when they have tried everything long term and exhausted every option and nothing has made it better, albeit I get what you are saying. Some folks just want to pop a pill, keep eating like *kitten*, not exercising, no effort, and still expect the weight to come off.

Ginnykhatmaker

Azdak wrote: »

Most of the criticism of weight loss drugs are really focused on people and doctors who use/prescribe them casually as a “fix” without any other lifestyle changes. Again, not relevant in your case.

Yeah, my doctor heavily stressed I would need to continue exercising and eating right. He said it probably wouldn't work if i got lazy because I was taking a WL pill.

rlsides

I lost weight on medication. I believe it destroyed my metabolism. It worked, but it is a drug like speed, so you're not hungry. I've gained all the weight back and now it is harder than ever to lose weight.

JBanx256

rlsides wrote: »

I believe it destroyed my metabolism.

except that metabolisms can't be "destroyed"...

Machafin

I don't believe they are necessary. In certain circumstances (such as OP's medical condition), I can see where they may be necessary. But for the majority of people, they want to take a pill and continue their bad habits. Everyone wants the easy way out. It may work for weight loss but what will happen if you ever stop taking the medication? What are the side effects of long-term usage? It is easier, safe, and better for your health long-term to make a diet change, expecially if the onset of the problems and issue were diet related in the first place.

ninerbuff

bonniehatcher1949 wrote: »

Dam what other people think.

That's what people who took HCG thought.

A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition

aokoye

My main issue with these medications is when it's found that said medications simply aren't safe or when people are taking them in ways that aren't safe. Obviously in some cases the dangers weren't found until after they were on the market, but if you're taking something after it's been found to be a dangerous medication, then I think that's a problem.

sammidelvecchio

I had a good experience with phentermine once I took a class on how to properly use it. I think it could help a lot of people if they are educated on it like I was.

heidijohnson430

Hello all, I am just coming back to my fitness pal today after a frightening experience with the scale on Friday. I agree with do what is right for you. I was on Phentermine and it scared me because I lost 8 lbs. in a matter of 4 days. I just don't do well with medicine and I am very sensitive to any meds but knowing that I lost that much in a matter of days and I didn't work for it felt wrong. Good Luck to all of you.

LIFOtheparty

I lost about 50 lbs 8 years ago by doing a medically supervised program that was basically just a prescription for phentermine. I was successful at the time because I had no appetite, but I gained back everything and then some over the course of the last few years. That's not phentermine's fault, but ultimately I did not learn how to control myself around food, and the old bad habits slowly resurfaced. Luckily, I had no lasting side effects from the phentermine (that I'm aware of), but I know a lot of people do. Because of that, I just don't think it's worth it for most people.

psychod787

ninerbuff wrote: »

bonniehatcher1949 wrote: »

Dam what other people think.

That's what people who took HCG thought.

A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition

Yeah, they got expensive water shots and drops. My opinion on weight loss medication is that some people might need a hand up to get started. The wellbutrin/phentermine combination is not one I would do, the Victoza shot, maybe. I I think it would be very helpful for people in maintenance as well. If I remember correctly it works directly by stimulating GLP1. Leptin injections on the other hand are not a great weightloss tool. People lose some weight, but a whole lot. Now as a weight loss maintenance drug, maybe. It has been shown to reduce many of the effects of weight loss on metabolism and hunger that happen post weight loss. Expensive right now and only approved for people with a genetic disorder that their body's do not produce it. Though, I do not believe companies would make it even if it were approved. No money in weight loss maintenance. More in losing and having people regain. Sell more products that way. There is a REASON its called the weight loss INDUSTRY. Not the weightloss maintenance industry.

BoxerBrawler

As long as the user is using it appropriately I think weight loss meds can be beneficial for people who need to get a jump start in the right direction. The person who, once they have a few pounds come off, get motivated to put in the effort without the aid of weight loss meds. Also - the person who educates themselves and changes their nutrition habits while using the meds is the one who will keep the weight off after the meds.

kshama2001

Phentermine plus fenfluramine (phen/fen) worked marvelously for me, but once fenfluramine was withdrawn from the market I didn't get the same results from phentermine alone or with some drugs that were supposed to be similar to fenfluramine. Plus the whole fenfluramine being withdrawn from the market due to damaging hearts soured me on the whole prescription diet pill thing.

I didn't internalize healthy eating habits when my appetite was artificially suppressed by taking a legal amphetamine-like drug and I gained all the weight back when I stopped taking it. And now I am on medication for heart palpitations.

Here's my favorite post about Phentermine: http://community.myfitnesspal.com/en/discussion/10329901/phentermine/p1

itschanelle wrote: »

I have seen a lot of posts on and off about this and other weight loss drugs. I can vouch that they absolutely work. I have lost a lot weight using Phentermine on and off throughout about a 10 year span.

BUT...

The weight doesn't stay off. And those side effects? They are real.

You could take Phentermine and lose the weight, but you might end up like me. I'm 30 years old, slightly over weight, and have moderate tricuspid valve regurgitation. As in, I might need open heart surgery because my heart was damaged by Phentermine. To be clear, I never took it for more than a few months at a time, was monitored by a doctor, and did everything "right".

My lifespan has likely been shortened to lose a few pounds. Weight I could have lost on my own with a little bit of gumption. It wasn't worth it.

Theoldguy1

For, only under the close supervision of a real physician.

PAV8888

I'm sorry to hear about all you've gone through and I'm happy to hear that you are now under the care of an attentive physician.

There is no real debate to be had in terms of your question because you are presenting that you're taking this stimulant drug for reasons beyond just treating your weight.

In general, the concerns that come to mind are the possibility of side effects from the various drugs one takes. And the likelihood they might occur either with short term or with long term use. A plan "B" should one have to discontinue using a dug is always good to have.

It sounds as if this drug is proving to be suitable for you. Were this universally the case, I am sure the drug would receive less push-back. But the number of significant side effects argues that the drug is not totally safe for everyone.

Ultimately this stimulant drug both suppresses appetite (decreasing calories in) and increases NEAT (non exercise activity thermogenesis, i.e. calories out) when taken as prescribed. Thus by itself, it creates a certain deficit, if you will.

If it is ever stopped appetite will increase and NEAT will decrease (i.e. this deficit assist will disappear) and regardless of prior education and mental preparation the person previously taking the drug will now need to make an immediate adjustment to living without this boost and with no previous experience of controlling their weight within their new limits.

francesca_grey

I’m sorry for what happened to you. In the future it would be polite to put a trigger warning when you talk about your traumatic experiences. I wish you the best in your healing.

Stimulants can be helpful for PTSD but phentermine is not a good drug for long term use. I’m not judging you at all for wanting to use it. 12 weeks is the max, then you have to cycle off. 37.5mg is the max dosage already — you will build up a tolerance and have to take more of the drug to get the same effect, otherwise the hunger will come back.

It is possible to maintain a lower weight, have a clear head and not rely on stimulants, they are powerful drugs that change your brain and they are addictive. But if you feel you have to take something long term, please reconsider phentermine, there are ADHD drugs on the market that are safer. A doctor that would offer it to you long term does not have your best interests in mind.

sofrances

No moral objection, if they work without horrible side effects. If they could give me a pill or a gene therapy to give me a smaller appetite, I would be very happy. Moralizers can go and boil their heads as far as I'm concerned. Its only giving people who struggle with their weight what the naturally slim get for free, and no one has any moral qualms about that unearned advantage.

However, I'm not convinced that such a therapy exists at the moment, apart from possibly barbaric surgery, which I think is very much a last resort given the irreversible nature of the most effective forms.