Phentermine- "only for obese people"?

splixi

Hi,

I've read different peoples opinions around here about who "should" be considered for using phentermine/duromine/metamine.

Many people say only when "obese" or "morbidly obese" - with 100+ pounds to lose.

What about trying to help people curb things before it gets to that? give them motivation and kickstart them just the way it happens for larger people.

I am not near the obese category, and only just scraped the BMI of 27 to get it. I think it isn't just about the weight....it is about the affect it has on you.

Being 21 and used to being very skinny, then having heavy steroid medications come along to treat my lung disease and put huge amounts of weight on (25kg) me. has made me so self conscious and I don't want anyone to see me. I feel so weighed down all the time trying to do things and get even more out of breathe than "normal"because of the weight...

I am only on 15mg and have been for two weeks (lost a bit of weight before I started it) but I have quite a tolerance to all medication, I don't get any side effects but I also don't really feel the effects of the drug. I have lost about 7kg in the last 4-5weeks (some of which was before I went on it) probably because I eat less than 1000calories a day...takes so much control

I don't actually fit the criteria for it anymore as i'm only in the "overweight" category by a few pounds....even though i've only been on it for 2weeks. But my doctor never weighed me in the first place and I doubt she'll weigh me anyway because I weigh myself. I want to ask her to take the 30mg tablet to see if it has any effect on me to move off all this medication weight...

Do you believe phentermine should only be used in the very obese? that it is ok for me to take it? that increasing the dose might increase the effects and let me lose weight faster?....I just want to be little again and feel like "me"...

lauren3101

I have to be honest, my knowledge of this drug is very basic, but personally, I don't believe anyone should be put on fat-loss medication unless their size poses more risks than the drug itself. Judging by your post, you don't fall into this category.

I am sorry to hear about your health problems, it must be hard being put into a position where your weight gain is inevitable and you can't control it. I do think though that with your health you should be giving your body everything it needs, so I don't think 1000 calories a day is a good idea.

splixi

I guess physical "risk" isn't the only thing to take into account?

maybe how much it affects the life of the person and for me it restricts me doing so much...and leaves me with no confidence. My disease has taken so much away from me and I just want to "keep" my body...people often fail to consider risks of being overweight on mental health....

I think this is why my dr gives it to me....I did ask for it and she saw where I was coming from.

perfekta

Phentermine may cause lung problems, and your profile says you have a lung disease. They say the risks exist even without taking it in the Phen-Fen combo. I realize when you say your weight is so distressing to you that you might not mind the risks, at this present time, but it's still something to think about.

If you need something to control your appetite, you can eat more fiber, or take fiber pills like PGX.

Good luck.

Willowana

Having been on Phentermine (100+ lbs. to lose), I can tell you that it isn't a miracle drug. I still struggled and binged until I learned what worked for me. Phentermine does not make you lose weight faster. In fact, I plateau'd while taking it. I stopped the pills, increased my calories between 1300-1600 a day, and ate more protein to stay full longer. I haven't binged in a long time now, I'm losing about 3 lbs. a week, and doing fantastic without it.

Just be careful of Phentermine's risks as well. It's mostly prescribed to us obese people because having more body weight makes medication less effective. I work with a skinny girl that takes it sometimes, and she pours sweat all day long and has heart palpitations and can't sleep at night. I don't have any of these problems. The smaller you are, the more alcohol and medications will affect you. So, just keep that in mind.

KarenJanine

As your BMI only started around 27 and you have already lost 7kg, your BMI is already going to be decreasing and approaching the healthy range (18-25). I'm not a doctor but I do not feel anyone of a healthy weight should be taking weight loss medication, especially given your young age.

I understand your issues relating to confidence but eating only 1000 cals a day is not a good idea. Doing this long term you may lose lean body mass (including muscle) and suppress your metabolism, as well as possibly not getting enough healthy fats needed for efficent running of hormonal responses.

This all means that when your desired weight and come off the drugs, you will probably have an increased chance of regaining weight. In my opinion it would have been far more sensible of your doctor to refer you to a registered dietitian who could have discussed a healthy eating plan for you.

twelfty

my best advice to you would be, you've fought this far, you need to dig deep and do this the right way, excersize and a good diet will see you back to your normal self in 6 months without tablets

the biggest side effect of this drug is a psychological dependence not to mention rebound weight gain (ie when you come off it you'll shoot back up)

by my workings you're about 5'8? and 55kg is only just in the healthy bmi range, so... not to be rude, but are you perhaps putting too much pressure on yourself? 1000 caloires a day is a very small amount, they say the lowest anyone should go is 1200 and eat back any calories you burn

now at this point i'd never suggest you have a real issue here but i'd ask you to consider where you're heading because to me this sounds like the begining of an eating disorder and you don't need to go there

it's normal to feel the way you do especially coming from being super skinny, but now isn't the time to panic and do things rushed, at 21 you have more than 2/3's of your life ahead of you to get this under control and as i said 6 months hard work and you'll be there or near enough

splixi

I'm sticking to such low calories...usually almost 1000 on the dot (or at least as an average) because I can't really exercise because I get too breathless. I plan to increase it slowly as I get to a better weight...

18-25 is such a HUGE range .... and I think maybe looking at what is normal for a particular person is sometimes important....like everything on me is fat with very little muscle (so all fat weight).

But like I said...i'm not actually convinced the drugs are doing 'that' much but i'm going to give them a bit more time....they defs aren't giving me any bad side effects! helping me if anything...more energy...can concentrate better...only downside is that people notice how dilated my pupils are!

With the dietician....I actually 'know' pretty much everything they have to say....spoken to them before but I think they just want to give up on me because I have I am so particular about the way my 'food has to be' and extremely picky...like ever since I was little I haven't been able to make myself eat majority of foods in the supermarket (mental thing...that has absolutely nothing to do with calories or weight gain- more just textures of food and not liking things to touch)

Doen a lot of research and through having done a few years of a medical degree we learn a bit too so I guess it comes down to the whole "knowing-->doing"....and the dieticians always come round when i'm in hospital for my lungs (which is a lot- about 8months of last year).

splixi

my best advice to you would be, you've fought this far, you need to dig deep and do this the right way, excersize and a good diet will see you back to your normal self in 6 months without tablets

the biggest side effect of this drug is a psychological dependence not to mention rebound weight gain (ie when you come off it you'll shoot back up)

by my workings you're about 5'8? and 55kg is only just in the healthy bmi range, so... not to be rude, but are you perhaps putting too much pressure on yourself? 1000 caloires a day is a very small amount, they say the lowest anyone should go is 1200 and eat back any calories you burn

now at this point i'd never suggest you have a real issue here but i'd ask you to consider where you're heading because to me this sounds like the begining of an eating disorder and you don't need to go there

it's normal to feel the way you do especially coming from being super skinny, but now isn't the time to panic and do things rushed, at 21 you have more than 2/3's of your life ahead of you to get this under control and as i said 6 months hard work and you'll be there or near enough

I started (before phentermine about a month ago) - my height is only 5'5.5
end of feb- 79.9kg
start of phentermine (2 weeks ago) - about 76kg
now about 73kg...still bmi of about 26 I think

twelfty

I'm sticking to such low calories...usually almost 1000 on the dot (or at least as an average) because I can't really exercise because I get too breathless. I plan to increase it slowly as I get to a better weight...

18-25 is such a HUGE range .... and I think maybe looking at what is normal for a particular person is sometimes important....like everything on me is fat with very little muscle (so all fat weight).

But like I said...i'm not actually convinced the drugs are doing 'that' much but i'm going to give them a bit more time....they defs aren't giving me any bad side effects! helping me if anything...more energy...can concentrate better...only downside is that people notice how dilated my pupils are!

With the dietician....I actually 'know' pretty much everything they have to say....spoken to them before but I think they just want to give up on me because I have I am so particular about the way my 'food has to be' and extremely picky...like ever since I was little I haven't been able to make myself eat majority of foods in the supermarket (mental thing...that has absolutely nothing to do with calories or weight gain- more just textures of food and not liking things to touch)

Doen a lot of research and through having done a few years of a medical degree we learn a bit too so I guess it comes down to the whole "knowing-->doing"....and the dieticians always come round when i'm in hospital for my lungs (which is a lot- about 8months of last year).

my best advice to you would be, you've fought this far, you need to dig deep and do this the right way, excersize and a good diet will see you back to your normal self in 6 months without tablets

the biggest side effect of this drug is a psychological dependence not to mention rebound weight gain (ie when you come off it you'll shoot back up)

by my workings you're about 5'8? and 55kg is only just in the healthy bmi range, so... not to be rude, but are you perhaps putting too much pressure on yourself? 1000 caloires a day is a very small amount, they say the lowest anyone should go is 1200 and eat back any calories you burn

now at this point i'd never suggest you have a real issue here but i'd ask you to consider where you're heading because to me this sounds like the begining of an eating disorder and you don't need to go there

it's normal to feel the way you do especially coming from being super skinny, but now isn't the time to panic and do things rushed, at 21 you have more than 2/3's of your life ahead of you to get this under control and as i said 6 months hard work and you'll be there or near enough

I started (before phentermine about a month ago) - my height is only 5'5.5
end of feb- 79.9kg
start of phentermine (2 weeks ago) - about 76kg
now about 73kg...still bmi of about 26 I think

take the advice or don't but bottom line you're not doing the right thing by taking them.

also i can't remember where i read it but iirc the average coma patient requires 1200 calories a day so unless you're in a coma and have a very slow metabolism you need more than 1000 calories a day

KarenJanine

...18-25 is such a HUGE range .... and I think maybe looking at what is normal for a particular person is sometimes important....like everything on me is fat with very little muscle (so all fat weight).

If you already have little muscle, following a very low cal diet which will likely cause you to lose even more muscle is surely not the right way to go. Sure, you'll weigh less, but with even less muscle there's a good chance you will not achieve the body you are chasing however low you let your weight go.

I've starved myself in the past thinking it would be the way to get the body I always wanted. I ended up 'skinny fat', still had the same body shape, was still flabby, I just weighed less on the scale and my BMI was underweight according to the charts. I'm now trying to rebuild some of my lost muscle and it's a much harder than losing it.

splixi

thanks you definitely have a point.....I just got very carried away with the idea of 'weight loss'- especially the fast way that everyone portrayed the pills to be....bit of a "miracle thing'. i'm a perfectionist and if I want to do something or achieve a goal i'll do anything to get there

Feel a bit lost only being able to do an hour of exercise a week....at the hospital....under physio/nurse supervision/oxygen and heart monitoring.... with a bunch of really old people who can mostly do more than I can. So I guess it all comes down to food to achieve weight loss.....

I will discuss it now with my DR for sure....get her opinions rather than just ask for it like I did before (she just checked it didn't clash with any other medications I was on).

I won't be asking for a higher dose after reading everything here....that is for sure

I have 2weeks left of them before I see her so I think at that point if I am in healthy weight range i'll just try to do this without them....seeing the scale go down already has given me motivation and made me realise that it is possible which is what I really needed to happen....

splixi

...18-25 is such a HUGE range .... and I think maybe looking at what is normal for a particular person is sometimes important....like everything on me is fat with very little muscle (so all fat weight).

If you already have little muscle, following a very low cal diet which will likely cause you to lose even more muscle is surely not the right way to go. Sure, you'll weigh less, but with even less muscle there's a good chance you will not achieve the body you are chasing however low you let your weight go.

I've starved myself in the past thinking it would be the way to get the body I always wanted. I ended up 'skinny fat', still had the same body shape, was still flabby, I just weighed less on the scale and my BMI was underweight according to the charts. I'm now trying to rebuild some of my lost muscle and it's a much harder than losing it.

I don't know much about the exercise things at all mainly because I just feel like "i'm not capable" of doing them. Are there ways to make your muscles better that aren't too stressful on the body?

twelfty

that's good to hear, you're in the advantage that by having just put it on it should fly back off, if you'll do anything to get there do the right thing

7kg loss is fantastic

as for excersize anything is good, push yourself forward, make your ambition to be back to your old self and it will happen without drugs you don't need

also a supplement called creatine will help in this area massively imo

albertabeefy

Phentermine is currently 'approved' in medical circles for short-term treatment of obesity as the possible benefits derived from weight-loss for these individuals outweighs the risks in taking the medication. The benefits for the non-obese - as they're not as high-risk for other complications/diseases - simply do not currently outweigh the risks.

The risks and side-effects are many. (Though in some cases, patients experience none. We're all unique.)

If you are determined to use this drug (and at 21 your metabolism should be high enough you do not need it) then you may want to talk to your physician about a prescription for phentermine combined with slow-release Topiramate. The two combined appear to have a synergistic effect, though there is no confirmation of that. What we DO know is the two combined appear to work better (both in terms of increased weight-loss and reduced effects) for long-term weight-loss than phentermine alone.

Maybe even review for yourself (and/or print for your doctor) the review of the research here: http://link.springer.com/content/pdf/10.1007/s13556-012-0003-1 which is titled "A Review of the Combination of Phentermine and Topiramate Extended-Release for Weight Loss" and is quite thorough.

Regarding your caloric intake: Unless you have hypothyroidism or other metabolic condition currently, I'd up it... Your BMR for your height/weight/age is about 1,550 kcal according to the most commonly-used formula. Add in normal daily activities (ie: sedentary work/school) and even without exercise your TDEE is over 1,800 calories a day.

Your 'healthy weight' BMR is likely only 100 to 150 calories lower than your current, as such I'd really not eat much fewer than say 1400 calories (again, unless you have a metabolic reason to do so). In the absence of exercise this gives you good (1lb/wk) weight-loss with the best chance at retaining your current LEAN body mass. Remember that caloric-deficits without strength training will catabolize your lean muscle tissue, so you don't want to be too restrictive on calories here.

If you are extremely limited on ability to exercise - try to do a little strength training during the week using compound exercises: Deadlift, Squats, Bent-over row, bench press and overhead press are the big 5 for compound exercises. Even a little bit will help.

splixi

thanks...I really needed this wakeup call....I sit here regretting what I wrote...but at the same time not regretting it because I have come to a point where I started questioning "do I really need phentermine" where it was my automatic thought that it was completely necessary before...

the whole "skinny fat" thing concerns me a bit though....going to try and find ways to avoid that look ...I never really thought about that happening but it makes sense. That with no muscle, even if you are skinny you don't look good...might ask my respiratory physio this week for some tips there!

splixi

Regarding your caloric intake: Unless you have hypothyroidism or other metabolic condition currently, I'd up it... Your BMR for your height/weight/age is about 1,550 kcal according to the most commonly-used formula. Add in normal daily activities (ie: sedentary work/school) and even without exercise your TDEE is over 1,800 calories a day.

Your 'healthy weight' BMR is likely only 100 to 150 calories lower than your current, as such I'd really not eat much fewer than say 1400 calories (again, unless you have a metabolic reason to do so). I

Thanks albert

It was telling me here that for weight loss I should have 1200per day....so I thought 'i'll have a tiny bit less because what i'm doing doesn't really include much exercise' . Guess I shouldn't really have taken that as gospel...i'm glad I posted here now....learned so many things...

LadyPakal

I know someone who had terrible asthma, his doctors got him into yoga - helps train the breathing and also keeps you active/flexible. Maybe you could try that? Also maybe a certain amount of (not too heavy or body weight) weight training to keep the muscles working (squats, wall push-ups)?

albertabeefy

It was telling me here that for weight loss I should have 1200per day....so I thought 'i'll have a tiny bit less because what i'm doing doesn't really include much exercise' . Guess I shouldn't really have taken that as gospel...i'm glad I posted here now....learned so many things...

MFP has a tendency to set almost every woman that joins at 1200 per day ... it's 'math' doesn't take into account the fact that eating below your BMR often results in reduced resting metabolic rates and lean-tissue catabolism, neither of which you want.

When I was still overweight and unable to exercise (due to extreme pain associated with my spinal issues) I found I could eat below my BMR without much issue if I stayed above my "healthy weight" BMR. But I only did that until I found an exercise that I could work with.

FYI I literally started with - no joke - 2 minutes of exercise a day. That's it - TWO. That was all I could manage due to my physical limitations. This vastly improved over several months, but progress was initially depressingly slow. My point is, do what you can, even if it's very little - then stick with it and increase as you're able.

LadyPakal

MFP sets people to 1200cal/day because everyone comes in and sets it to 2lb/wk loss - no matter how much they have to lose. That sort of loss is only really going to happen for the very overweight. For those with a small amount to lose, 1 or 0.5 lb/wk is more suitable.

Basically, if you get given 1200 calories/day, you need to change your desired loss a bit as you've put it too high. *

*Unless you are a not very tall & petite female, that is

dfonte

If someone wants to take it and become dependent on a pill for the rest of their lives - that's their decision. Let people make their own choices.

albertabeefy

... because everyone comes in and sets it to 2lb/wk loss - no matter how much they have to lose. That sort of loss is only really going to happen for the very overweight...

Or those larger individuals with high levels of lean body mass. I'm about 6'3" and 237lbs this morning and nobody considers me "fat", even though I want to lose another 20lbs before I take my shirt off at the pool... I tend to lose more than 2lbs on a bad week when dieting. Typical for me is about 4-5lbs a week, though I measure/weigh everything and work out 90 minutes a day minimum 6 days a week.

About a week ago at the gym I had a lady next to me on the elliptical tell me she was seriously unimpressed I was burning 2x the calories she was (we were both doing very similar resistance and RPM) ... she also mentioned she felt it vastly unfair that men lose weight faster than women. I asked her what she weighed, and she literally weighed HALF what I did (at the time I was 244). As such I told her that losing 10lbs for me was the same amount of fat loss (percentage wise) as only 5 lbs for her. She seemed to take that a little better...

Lyerin

1,000 calories per day is probably too low for you. I actually lose more weight in the weeks where my calories are higher than my "MFP goal." Eat good, whole, healthy foods, drink plenty of water, exercise (even a little bit helps - walking at a slow pace even helps) and keep moving forward. The weight loss will be a benefit, but you will also feel better and not have any nasty side effects. Best of luck to you.

twelfty

If someone wants to take it and become dependent on a pill for the rest of their lives - that's their decision. Let people make their own choices.

that's a ****ish thing to say, and why the question was posed in the first place, you must have lots of friends... which reflects on here too, what a suprise