Every day we get at least one telephone call or e-mail asking about phentermine, which is a slimming aid with a molecular structure very similar to amphetamine (speed.) No matter how much we point out the dangers of this medication, a few people still seem determined to get their hands on the treatment as they have heard that it can have a dramatic impact on appetite. Whilst this may well be the case, we are aware of very serious short and long term side effects of taking this medication and are not prepared to prescribe it under any circumstances. No matter how much people beg and plead, there is no way that we would expose our patients to the potentially very serious consequences of taking this drug. Although phentermine was withdrawn from the European market a few years ago, it did have its license reinstated but for very short term use only. Even with its license now back in place for short term use, it is unlikely that any doctor worth his or her salt would be prepared to issue a prescription for the drug – especially when there is now a choice of medications which are effective in the management of obesity and with much better safety profiles than that of phentermine.
For patients who are overweight or obese we are prepared to prescribe one of three medications only. Xenical is a lipase inhibitor with a very good safety profile. This works by filtering out a certain proportion of dietary fat, thereby forcing the body to tap into fat deposits.
Another treatment is Reductil which affects appetite and trains patients to control food portions consumed by blocking the reuptake of two neurotransmitters released when we eat. As a result of the reuptake of these two neurotransmitters being blocked, the feeling of satiety kicks in much earlier than would otherwise be the case.
The final treatment is Acomplia which was launched in June 2006. This medication also affects appetite and appears to be particularly helpful in aiding the reduction of the dangerous visceral fat which can accumulate around the intestines. Acomplia works by normalising the endocannabinoid system, which is believed to regulate food intake and energy expenditure. It has been suggested that the endocannabinoid system in overweight people is overactive, so the normalisation of this system should lead to weight loss.
So in summary, with these three very different weight loss products on the market with good safety profiles, there is absolutely no reason for patients to resort to buying phentermine with all it attendant undesirable and potentially serious side effects.