Last month, the FDA approved yet another diet drug in a continued effort to help Americans fight obesity and the deadly health problems that go along with it. However, if history is any indication, soon the drug will be linked with serious and adverse side effects and will eventually be taken off the market. The FDA hopes its newest approved weight loss drug, Qsymia, will not go the way of the Dodo bird and previous weight loss drugs such as Ephedra and sibutramine that were once approved and considered safe but are now off the market due to health concerns.
So what makes Qsymia different? Almost impossible to pronounce (kew-SIM-ee-ah) and sounding more like a city somewhere in the Middle East than a weight-loss drug, Qsymia is a combination of a stimulant (phentermine) and an anti-seizure drug (topiramate). Phentermine has been a player in the weight-loss/stimulant arena for a while. It is similar in both chemistry and effects to amphetamine, a well-known stimulant often used recreationally, as a “study drug,” and to treat ADD (the drug Ritalin is amphetamine). Phentermine works by releasing the neurotransmitter called norepinephrine in the brain, which induces a fight-or-flight response and reduces hunger. The fight-or-flight response would be present if you’re, say, running from a hungry lion. The lion may be hungry, but when you’re worried about getting away from it, hunger is the last thing on your mind. Phentermine also helps to encourage the body to break down and burn stored fat, but the hunger reduction is its main mechanism of action. Side effects attributed to phentermine are plentiful and include restlessness, anxiety, insomnia, dizziness, heart palpitations, diarrhea, constipation, increased blood pressure, and increased heart rate. I could go on, but you get the point. Imagine your mental state when you’ve just had waaaaaaaaaaaay too much coffee and you’ll get an idea of what being on phentermine might feel like.
The other drug in Qsymia, topiramate, is a drug that is thought to be a mood stabilizer. It is prescribed for a vast number of conditions such as epilepsy, alcoholism and other drug addictions, migraines, bipolar disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Common side effects include nausea, diarrhea, numbness and tingling, memory problems, and loss of appetite. It would seem that the creators of Qsymia are doing the age-old trick of combining an upper and a downer (see: Irish coffee or vodka/Red Bull). Because phentermine often causes restlessness and anxiety, Qsymia’s creators must have needed a relaxing, mood-stabilizing drug to balance out the drug’s effects.
So is this new drug safe? Is it effective? Even though the FDA has approved the drug for now, that is always subject to change and there are many precedents for the FDA banning a drug that it had once previously approved. And getting FDA approval on Qsymia was no easy feat, they took a long time to approve the drug and its approval is still controversial and opposed by many doctors. In one study, the drug was found to be effective, with about half the 4,430 patients losing 10% of their body weight. Even a small reduction in body weight like this is enough to positively impact cholesterol, blood sugar, blood pressure, and overall cardiovascular health. And perhaps the crux of the issue lies right there. Is Qsymia perhaps harmful and almost sure to induce negative side effects of some sort? Yes. But is obesity harmful and almost sure to produce negative side effects? Yes. Only the patient and his or her doctor can know what is right for sure, but the bigger point here is that the majority of Americans are still looking for a “magic bullet” that will lead to weight loss. Even if a drug does help one lose weight, you can be sure that there will be many negative side effects and that rebound weight-gain once the drug is stopped is almost a certainty as well. Overall, a weight loss drug will never be an effective, long-term, sustainable solution. A well-balanced diet and consistent exercise, on the other hand, are sustainable. Study after study has found that not only do diet pills not work long-term, diets don’t work either. Lifestyle change, which doesn’t mean giving up all the foods you love and exercising 4 hours a day, is really the ticket to long-term, sustainable weight loss and body weight management. Taking shortcuts, cutting corners, and taking diet drugs may work in the short-term, but if the side effects are severe and the weight comes right back on, is it really worth it?
Article Courtesy: Andrew Steingrube