I've heard about several weight loss aids like herbal teas, "fat-burning" pills, etc. Do any of these work?


Some of the non-prescription drugs can temporarily cause your weight to drop, but not because they're eliminating excess fat from your body. Most over-the-counter "diet aids" contain stimulants, which hike up your central nervous system and decrease your appetite, and/or mild diuretics which cause you to eliminate fluids (by urination) more quickly than normal. The stimulants can cause unpleasant side effects such as dizziness and nausea, and the diuretics can make it difficult for you to get too far away from a bathroom. And as soon as you go off the pills, your weight bounces right back up to its previous level, making such nostrums useless for long-term weight loss.


  What about prescription drugs (phentermine, fenfluramine)?


On September 15, 1997 the prescription weight loss aids redux and fenfluramine were recalled by their manufacturers after the FDA recommended a that anyone who is taking them stop and consult with their doctors.  Phentermine, is not affected by the withdrawal, but patients could no longer use the combination.

The FDA asked manufacturers to withdraw the drugs after reviewing the records of 291 patients and found 30 percent had abnormal echocardiograms -- a test that shows doctors how the heart disfunctioning -- even though they had no symptoms yet. Some 92 patients had problems with their aortic or mitral heart valves, the data showed. The FDA said the numbers were much higher than it had expected, prompting the agency to recommend stopping sales of the drugs.

The withdrawal comes after doctors at the Mayo Clinic announced in July they had discovered 24 cases of a rare heart valve defect in women who took fen-phen. The FDA later announced that it had received 66 additional reports of this dangerous valve disorder, including some that were also seen inpatients taking Redux.

These prescription weight loss aids had show somewhat more promise than the non-prescription nostrums. Fenfluramine (marketed as "Pondimin") suppresses appetite by acting on the brain chemical serotonin. Phentermine (marketed as "Ionamin") is an amphetamine-type stimulant and appetite depressant. The two drugs are often used in combination with each other in order to provide more effective weight control while minimizing side effects; a study on the combined effects of the drugs is available at  http://www.weight.com/nongifphenfen.html. The newest addition to the pharmacological weight-loss arsenal is Redux (dexfenfluramine), which is essentially the active portion of fenfluramine and is used in smaller doses than fenfluramine. Studies indicate that these drugs do cause weight loss in many people, but they can also cause side effects: nervousness, dry mouth, rapid or irregular heartbeat, etc., in the case of phentermine, while fenfluramine and dexfenfluramine can cause dry mouth, sleep disturbances, diarrhea, depression, etc., and have been associated with a few cases of a serious condition known as pulmonary hypertension. Participants in studies of these drugs gradually regained the weight they'd lost when they stopped taking the medication.

Additional information on prescription drugs used in weight control and the recall of redux and phenfluramine can be found at http://pharminfo.com/pubs/msb/obesity.html and http://pharminfo.com/pubs/msb/seroton.html. Barbara Hirsch (bhirsch@vais.net) maintains a very comprehensive list of medication-related links on her Phen/Fen Web site at http://www.vais.net/~bhirsch/phenfen.htm. There is also a newsgroup, alt.support.diet.rx, which is devoted to the discussion of medications used in weight control.


  Do I need to take a supplement (vitamin/mineral pill) while dieting?

A balanced diet (see "Food Pyramid") which is low in fats, sugars, and alcohol and is adequate in calories (no fewer than 1,200 cal/day for women, 1,400 cal/day for adolescent girls, 1,600 cal/day for men) may contain sufficient vitamins and minerals to meet the FDA's recommended Daily Value. However, not many of us meet those requirements every day, and some physicians and researchers feel that the FDA's recommendations regarding many vitamins and minerals are too low to promote optimal health. (The recommended Daily Values are intended to prevent deficiency-related diseases such as scurvy and pellagra; they do not necessarily reflect the amount of a vitamin or mineral needed to sustain an adequate reserve against illness or injury.) If you do decide to take a vitamin/mineral supplement as insurance against an inadequate diet, you should look for a brand which contains a variety of vitamins and minerals, and keep in mind that excesses (amounts greater than 100% of the FDA's recommended Daily Value) of certain vitamins and minerals, in particular Vitamin A and iron, can be toxic.

  What is chromium? Can taking a chromium supplement help me lose or maintain weight?

Chromium is a nutrient which plays a factor in maintaining blood glucose (sugar) levels. Chromium occurs naturally in the diet, and is found in foods such as brewer's yeast, whole grains, liver, and shellfish. Individuals whose diets consist mainly of processed foods may not have an adequate intake of chromium; symptoms of chromium deficiency include weight loss and impairment in the body's ability to maintain blood sugar levels. Although there is no recommended daily allowance for chromium, a daily intake of between 50 and 200 micrograms (µg) is recommended by many physicians and nutrition experts. Chromium is available in several forms, including inorganic chromium, high-chromium yeast, chromium picolinate, and chromium polynicotinate. Of these, chromium polynicotinate seems to be the best absorbed. While chromium does seem to be of benefit in regulating blood sugar in diabetics, its role in weight loss or maintenance for non-diabetics is not yet clear. Some individuals who have made a conscious effort to raise their chromium levels through diet changes or dietary supplements have reported that chromium does seem to lessen their cravings for sweets, but I am unaware of any formal studies that support this. Additional information on chromium picolinate is available via WWW at http://www.lifelines.com/libry1a.html.