Heart-Stressing Stimulants Are Risky Weight-Loss Aids

By Suzy Cohen, R.Ph.

QUESTION: I've been taking the prescription drug phentermine every day to help myself lose about 30 pounds. What exactly does this pill do inside me to reduce weight? Is it harmful? Does it affect the heart?

ANSWER: You know that feeling you get when you're in imminent danger or a heated argument? Your heart beats in your throat, and you get dry mouth and shallow breaths. It's called the "fight-or-flight" response, and you can almost feel the adrenalin surging through your body. People who experience panic attacks know this feeling well. Certainly it is not a time for hunger.

Phentermine tricks your body into reacting to brain chemicals (including adrenalin), which effectively triggers this fight-or-flight response. In normal doses, it's a mild reaction that speeds your heart up and gives you energy, while reducing appetite.

Some scientists theorize that phentermine also raises leptin, one of our "feel full" substances, so we eat less. The drug does affect the heart rate and can occasionally cause PPH (primary pulmonary hypertension), a dangerous cardiac problem, especially if combined with other medicine.

Is it harmful? Yes, it can be. Stimulants are my last suggestion for overweight people, who already have a serious burden on their heart from the extra weight. Why further tax the heart with drugs? The risks just don't seem to be worth it. Typical side effects include dizziness, headache, insomnia, hypertension, irritability, tremor and dependence. If you get chest pain, psychosis, swelling in the hands or feet or lightheadedness, skip your dose and call your doctor or 911.

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