Whilst watching the news this morning, I was alerted to the practice of "combo-pilling, " taking supposedly unrelated medications together to produce stronger results toward a desired outcome. Combo-pilling diet drugs went mainstream in the 1980s, with the pairing of phentermine and fenfluramine (later known as "fen-phen"). This pairing, as well as a commercial related version, was heralded as the first effective weight loss drug treatment. Later, mainly because it was found out that the commercial drug was associated with potentially fatal pulmonary hypertension and heart-valve problems, it was withdrawn from the market and the manufacturer was sued to the tune of more than ten billion dollars.
Combo-pilling remains, in part because single diet drugs never have yielded the results many seek. After sibutramine (Meridia) was removed from market late last year, the only FDA-approved drug for treating weight problems for more than a couple weeks is orlistat. However, if dieters eat fat-heavy foods, the results are some less-than-pleasant side effects (oily stains on one's underclothing, being one).
So combo-pilling continues.
Recently, the combination of Topomax, an anticonvulsant approved for treating epilepsy and migraines; and phentermine, the above referenced appetite reducing drug, are making their way to the collective dieters' mind. It appears that Topomax effectively "shuts off" the desire to eat. When combined with phentermine, the results can be downright staggering. I monitored some on-line discussion organizations and found it not uncommon for participants to claim weight losses of four or five pounds a week for extended periods. (A healthy sustainable weight loss is considered to be one to two pounds weekly. )
Using medicine for what it is not intended is called "off-label" use. Even though no official data can be found as to the extent of this practice, a March 2009 study phenq released in Obesity found that 65 percent of weight specialists belonging to the American Society of Bariatric Physicians who responded to a survey do indeed prescribe "off-label" combinations. The practice is legal; actually based to a 2006 evaluation in the Archives of Internal Medicine, approximately 20 percent of common adult drugs are recommended as such. (Since the drug is approved and on the market industry, physicians may utilize it as they see fit. )
While some doctors are unconcerned, many are raising red flags, pointing out that these medical "cocktails" might be taken for years, creating extensive adverse interactions and unpredicted side effects. Since the FDA is not checking such usage, authorities might never find out about such problems; and even should they do, it could lead to catastrophic results for those experimenting with untested combinations.
Referencing the aforementioned Internet discussions, the risk appears to be of little problem to some who demand on doing "whatever it takes" to attain their proper weight; consequences be darned. Said one post, "I started... one week ago and I've lost eight pounds already. I agree with the post above that this might not be 'healthy' weight reduction, but being overweight isn't healthy either. If this gets myself to a proper weight, then so whether it be. " Alarming, isn't it?
Of higher concern to me is not the threat of obesity, but that being overweight is considered such a stigma and so uncongenial that some would actually risk life and limb to drop pounds. If it is indeed so essential to lose the weight, wouldn't it appear like it might be important enough to rearrange one's life to eat a less and walk a bit more? It's a slower process, yes; but the most severe side effects in that situation are a growling belly and sore feet.