Rush Limbaugh's recent weight loss sent shivers down Janet Chrostowski's spine.
It wasn't that the radio talk-show host dropped almost 90 pounds in less than five months that worried Chrostowski, a Hamot Medical Center registered dietitian.
It's how Limbaugh lost the weight.
Limbaugh said on his show that he hooked up with a Florida-based weight-loss center that combines a low-calorie diet with office visits and pills, including appetite suppressants.
"Over-the-counter appetite suppressants are not proven to be effective or safe," Chrostowski said. "They don't work."
Diet pills have been around for decades, promising a quick and painless way to lose weight.
The problem, Chrostowski said, is that most of them, especially the ones you can buy without a prescription, are a waste of your money.
"The makers of these pills say in their ads that they can decrease your appetite, control your hunger and boost your metabolism," Chrostowski said. "It's simply not true."
Even worse, some appetite suppressants are dangerous.
Herbal dietary supplements often used to contain ephedrine. It did lightly suppress people's appetites, but it also made their hearts beat faster and increase their risk of heart attack, stroke and death.
In 2004, the Food and Drug Administration banned the sale of ephedrine in any dietary supplement sold in the United States. Another herb sometimes used to control hunger, St. John's wort, doesn't interact well with prescription medication such as blood thinners, antidepressants, heart medications or birth control pills. It can cause the body to absorb those medications more slowly or quickly than usual. "Research on St. John's wort was slow at first because it was considered natural and safe," said Craig Johnston, D.O., a physician with Pinecrest Family Practice, 3535 Pine Ave. "The National Institutes of Health then found that it had drug interactions with more than 40 medications." The only over-the-counter appetite suppressant that is effective, Johnston said, is Alli, a reduced-strength version of the prescription drug Xenical. It works by decreasing your intestines' ability to absorb fat. "The problem is that I can't get anyone to take Alli because it can cause oily diarrhea and, in some people, incontinence," Johnston said. "Who wants that?" Xenical causes the same problems Alli does, and another popular prescription appetite suppressant, Meridia, can lead to increased heart rate and higher blood pressure.
And the FDA recommends those drugs only for a few weeks or months at a time, not for long-term or permanent use. So what is an obese person to do if they want to drop pounds like Rush did? "We've known the answer for years and years: decrease your caloric intake and increase your caloric expenditure -- eat less and exercise more," Chrostowski said. "There is no magic pill." But Johnston said new drugs are being developed that offer hope to people who have tried and failed repeatedly to lose weight. Some people have more trouble losing weight than others, even if they eat the same foods and exercise similarly, Johnston said. That's because the body secretes hormones to prevent us from losing weight. They make us feel hungry and slow down our metabolism. These hormones have a stronger effect on certain people, Johnston said. But researchers at Indiana University in Bloomington, Ind., recently published a paper in Nature Chemical Biology explaining how a new synthetic hormone helps obese mice lose weight. "These new medications work by altering these hormones that are your body's mechanism to maintain your current weight," Johnston said. "It's a whole new way of treating obesity." These new medications could be available in one to two years, Johnston said.
