Brenda Khan
Diet pills, also known as appetite suppressants, are a type of weight-loss medication that can be prescribed to people with obesity. They work by lessening appetite or creating a sense of fullness after eating a smaller amount of food. While some diet pills like Orlistat (Xenical or Alli) do not affect the central nervous system, others like Bupropion and Naltrexone (Contrave) can cause side effects such as headaches, dry mouth, dizziness, and nausea by impacting neurotransmitters in the brain. Fenfluramine, another type of diet pill, has been linked to irreversible loss of brain serotonin nerve terminals, leading to potential psychiatric symptoms like anxiety, depression, cognitive issues, and sleep problems. Stimulant-type weight loss medications like Phentermine and Diethylpropion are typically recommended for short-term use due to the risk of dependence and other side effects. It is important to note that diet pills should be used in conjunction with a reduced-calorie diet and regular physical activity to be most effective, and they may not prevent weight gain once a person stops taking them.
| Characteristics | Values |
|---|---|
| How they work | Affecting how the body and brain experience appetite and hunger |
| Types | Prescription and over-the-counter (OTC) |
| Side effects | Headache, dry mouth, dizziness, nausea, vomiting, constipation, stomach pain, allergic reactions, hair loss, acid reflux, etc. |
| Risk | Addiction, anxiety, depression, cognitive and sleep problems, brain damage |
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What You'll Learn
- Fenfluramine-based diet pills linked to brain serotonin loss
- Bupropion and naltrexone (Contrave) cause headaches, dizziness, nausea
- Orlistat (Xenical, alli) doesn't affect the nervous system
- Phentermine and diethylpropion are short-term stimulants
- Zepbound, Wegovy, and Saxenda are approved for chronic weight loss
Fenfluramine-based diet pills linked to brain serotonin loss
Diet pills, also known as appetite suppressants, are a type of weight-loss medication. They affect how the body and brain experience appetite and hunger. Appetite suppressants can make users feel less hungry or feel full faster after eating less food. Prescription appetite suppressants can help with weight loss for people with obesity.
Fenfluramine is a serotonergic medication that was formerly used as an appetite suppressant in the treatment of obesity. However, its use for weight loss was discontinued due to cardiovascular toxicity. Fenfluramine acts as a serotonin releasing agent and increases serotonin levels in the brain. Serotonin is a neurotransmitter that regulates mood, appetite, and other functions. However, fenfluramine has been linked to several side effects, including decreased appetite, sedation, lethargy, diarrhoea, constipation, abnormal echocardiogram, and increased blood pressure.
According to a newly published report on fenfluramine side effects in the Journal of the American Medical Association, users of widely prescribed fenfluramine-based diet pills may suffer irreversible loss of brain serotonin nerve terminals. This loss of serotonin can potentially result in symptoms of anxiety, depression, cognitive and sleep problems. The report is based on a review of 90 animal studies on serotonin neurotoxicity and primary pulmonary hypertension from fenfluramine and its chemical cousin dexfenfluramine.
In one study, monkeys' brains showed signs of damage even 17 months after taking a course of fenfluramine. Fenfluramine was found to damage serotonin-secreting neurons by pruning their axons, which do not regrow in monkeys, although they do in rodents. Since the human brain is more similar to that of monkeys, any such damage would likely be permanent. However, the neurotoxic potential of fenfluramine in humans has not been systematically evaluated.
The functional consequences of brain serotonin neurotoxicity are still largely unknown. However, some case reports indicate that users have experienced psychiatric disorders, which tend to be under-diagnosed in clinical practice. Fenfluramine has also been linked to an increased risk of developing primary pulmonary hypertension, a rare but life-threatening illness.
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Bupropion and naltrexone (Contrave) cause headaches, dizziness, nausea
Bupropion and naltrexone (Contrave) is a prescription weight-loss medication for people who are overweight or obese. It is a combination of two medicines that work in the brain to affect appetite. It is intended to be used in conjunction with a reduced-calorie diet and exercise.
The most common side effects of Contrave are nausea, constipation, and headache. However, it can also cause vomiting, dizziness, insomnia, dry mouth, and diarrhea. Bupropion, one of the medicines in Contrave, can also cause some people who were previously manic or depressed to become manic or depressed again. It may also increase the risk of suicidal thoughts or actions in a small number of children, teenagers, or young adults.
It is important to consult a doctor before taking Contrave, especially for those with a history of mental health problems. Certain medications, such as monoamine oxidase (MAO) inhibitors, should not be taken with Contrave as they may lead to serious side effects.
While appetite suppressants and diet pills can aid in weight loss, they may also carry risks. Some widely prescribed diet pills have been associated with irreversible loss of brain serotonin nerve terminals, leading to symptoms like anxiety, depression, cognitive issues, and sleep problems. Animal studies have shown brain damage lasting 17 months after the drug course, indicating potential long-term risks for humans.
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Orlistat (Xenical, alli) doesn't affect the nervous system
Diet pills can have a range of adverse effects on the nervous system. Psychiatric symptoms such as anxiety, depression, cognitive issues, and sleep problems have been linked to the use of fenfluramine-based diet pills, which can cause irreversible loss of brain serotonin nerve terminals.
However, Orlistat (also known by the brand names Xenical and alli) is different from other diet pills in that it does not affect the nervous system. Orlistat is a weight-loss medication that can be obtained over the counter or by prescription from a doctor. It is intended to be used in conjunction with physical activity and a low-calorie diet. Unlike other diet pills, Orlistat does not work on the central nervous system, which includes the brain and heart, but rather in the digestive system.
While Orlistat does not directly affect the nervous system, it does have other side effects. Orlistat can cause gastrointestinal (GI) side effects, including loose or more frequent stools that may be challenging to control. This is because Orlistat inhibits the absorption of about 25% of dietary fat, and the likelihood and severity of GI events increase with the amount of fat consumed. Orlistat can also impair the absorption of vital vitamins and nutrients, leading to nutritional deficiencies.
Despite these side effects, Orlistat has been studied extensively, with over 25 million patient treatments and more than 100 controlled clinical trials. It is the only FDA-approved, over-the-counter weight-loss product. However, it is important to note that Orlistat can be a sign of disordered eating or an eating disorder, and it should be used with caution in these cases.
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Phentermine and diethylpropion are short-term stimulants
Phentermine and diethylpropion are prescription appetite suppressants used for short-term weight loss in patients with obesity. They are approved by the FDA for short-term use and are central nervous system stimulants. Phentermine is the most commonly prescribed weight loss medication due to its low cost, long history of use, and low addictive potential. It is typically prescribed to patients with a body mass index (BMI) of 30 kg/m2 or greater, or a BMI of 27 kg/m2 or greater with other risk factors such as high blood pressure, diabetes, or high cholesterol.
Phentermine and diethylpropion are both structurally similar to amphetamines and work by stimulating the release of and inhibiting the uptake of catecholamines such as norepinephrine, dopamine, and serotonin. This results in increased heart rate and blood pressure, and decreased appetite. The average maximum dose of phentermine is 56 mg, almost double the approved amount of 15-37.5 mg. The typical dosage for phentermine is 18.75 to 37.5 mg once a day, taken before or 1-2 hours after breakfast. It is not usually taken at night due to its potential to cause insomnia.
Diethylpropion is another short-term appetite suppressant that can be used long-term if a physician deems it suitable and effective for the patient. It is typically prescribed for 12 weeks and should be taken as directed by a doctor. It is important to note that these medications should be combined with a reduced-calorie eating plan and regular physical activity to achieve the most effective weight loss results.
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Zepbound, Wegovy, and Saxenda are approved for chronic weight loss
Diet pills can affect the nervous system and cause psychiatric symptoms. A study on monkeys showed that fenfluramine, a diet pill, could cause irreversible loss of brain serotonin nerve terminals, leading to anxiety, depression, cognitive issues, and sleep problems. Human brains are similar to those of monkeys, so the damage caused by fenfluramines could be permanent.
Zepbound, Wegovy, and Saxenda are approved medications for chronic weight loss. They are injectable medications that work by reducing appetite, hunger, and food cravings, leading to decreased calorie intake and weight loss. Zepbound (tirzepatide) has been shown to be more effective than Wegovy, with an average weight loss of 20.2% compared to Wegovy's 13.7%. Wegovy is approved for adults and adolescents aged 12 and older, while Zepbound is approved only for adults. Saxenda, also known as liraglutide, was the first GLP-1 agonist approved by the FDA for obesity treatment in 2014.
Zepbound, Wegovy, and Saxenda belong to the group of drugs called incretin mimetics, impacting GLP-1 and GIP receptors. Wegovy and Saxenda are GLP-1 agonists, while Zepbound is a dual agonist, affecting both GLP-1 and GIP receptors. The safety and side effects of these medications are similar, primarily gastrointestinal issues. They should not be taken during pregnancy or when planning to become pregnant.
These medications are intended to be used alongside a reduced-calorie diet and increased physical activity, as recommended by a doctor. They can also help manage cardiovascular risk and other health conditions. It is important to consult with a healthcare provider to determine the most suitable medication based on medical history, insurance coverage, and patient preference.
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Frequently asked questions
Diet pills are a type of weight-loss medication for people with obesity (a body mass index or BMI of over 30). They are also known as appetite suppressants as they affect how your body and brain experience appetite and hunger.
Diet pills work by lessening your appetite or making you feel full faster. As a result, you may consume fewer calories and lose weight. Diet pills should be used in conjunction with a low-calorie diet and a doctor-approved exercise plan for best results.
Diet pills can have various side effects, including headache, dry mouth, dizziness, nausea, vomiting, constipation, stomach pain, and the possibility of serious liver injury. Some diet pills can also lead to psychiatric symptoms such as anxiety, depression, cognitive and sleep problems.
Yes, Orlistat (also known as Xenical or alli) is a prescription and over-the-counter weight-loss medication that does not affect the central nervous system. Instead, it acts peripherally to help prevent the absorption of fat from food. However, it can still cause side effects such as oily spotting, gas, and stomach pain.
Many diet pills are only recommended for short-term use due to the risk of dependence and other side effects. It is important to speak to your doctor before starting any weight-loss medication to understand the potential risks and benefits.
