In a thorough review of the medical literature published in the winter quarter of The Bariatrician, Michael Anchors, MD, PhD, found no credible evidence of any dangerous side effects of phentermine use as an appetite suppressant.  Dr. Anchors’ review was unable to document any instance of addition of significant hypertension, heart valve damage or serotonin syndrome in patients on prescribed doses of phentermine, although these problems are often cited by medical professionals as reasons not to take phentermine for appetite suppression.  In addition, after an exhaustive search, Dr. Anchors found no evidence in the medical literature that prolonged use of phentermine produced any ill effects.

 

The Prescription Perspective:  Many physicians have a “knee jerk” reaction against the use of appetite suppressants to aid weight loss.  This reaction is based on genuine concern about the welfare of their patients, but unfortunately it is a concern that appears to have no data supporting it.  Appetite suppressants are chemically related to amphetamine-like medications, but all of the commonly used appetite suppressants provide minimal cardiovascular or neurologic stimulation in most patients.  Furthermore, several large studies have failed to identify an increased risk of cardiovascular complications in patients using appetite suppressants or in those using similar, but more powerful, medication for treatment of attention deficit disorders.  Significant obesity clearly poses a much greater health risk than do the appetite suppressants.

 

Those patients who want to use appetite suppressants to facilitate rapid weight reduction should not be denied access to these medications based on an unfounded fear that they will increase cardiovascular problems.  Nevertheless, it is always best to utilize these medications as part of a medically supervised weight loss program in which patients are seen frequently and followed closely.  Also never forget, appetite suppressants alone do not make patients lose weight!  They just make patients comfortable while doing an effective low calorie diet as part of their weight reduction program!

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