For decades Americans have looked for a quick and easy way to lose weight. Despite the popularity of vibrating gizmos and battery-powered gadgets, diet pills are the preferred method. No muss, no fuss, no will power, no exercise.just swallow and the pounds are supposed to melt away like butter.
Diet pill popularity can rise and fall like the numbers on a dieter’s scale. During the 1950s and 1960s doctors often prescribed amphetamines to curb appetite.
Dexedrine (dextroamphetamine), one of the most popular products then, is still available by prescription. But because amphetamines have the potential for abuse, they are no longer doctors’ first choice for overweight patients.
During the 1970s and 1980s, over-the-counter weight loss products hit their heyday. Dexatrim (phenylpropanolamine or PPA for short) was one of the most popular brands.
As early as 1980 British researchers had raised a red flag. They gave PPA to healthy young medical students and noted side effects such as alarming elevations in blood pressure along with dizziness, heart palpitations, headache, insomnia, anxiety and restlessness.
By 1990, doctors in the U.S. had reported142 bad reactions to PPA, including strokes, seizures and even deaths. But it was ten years later before the FDA made a move. Yale investigators had found that women who took PPA for the first time tripled their risk of a stroke. Those using the drug as an appetite suppressant appeared to be at 16 times the risk.
FDA staffers estimated that PPA might be responsible for 200 to 500 strokes in people under the age of 50 each year. Extrapolating over the years, PPA might have accounted for as many as 10,000 strokes in people not generally vulnerable to that problem. At that point, the agency announced that over-the-counter weight loss products would have to be removed or reformulated without PPA.
The phen-fen phenomenon of the 1990s was the next big diet craze. Combining two old diet pills, phentermine and fenfluramine, appeared to produce better results than prior regimens. Millions of people begged doctors for prescriptions.
But by 1997 reports of heart valve damage finally pushed the FDA to request withdrawal of fenfluramine and dexfenfluramine (Redux) which had been approved only the year before. The bust phase of the phen-fen fiasco was more spectacular than previous diet pill disasters.
Ephedra (also known as ma huang) has not yet been banned from OTC weight loss aids in the U.S., but other countries have severely restricted access to it because of reports of heart rhythm irregularities, hypertension, strokes and death.
The most recent diet pill controversy involves the prescription medication Meridia. The consumer group Public Citizen has called for its removal because the drug can cause dangerous elevations in blood pressure and heart rate and has been associated with more than two dozen deaths.
By now, people should realize that the promise of effortless weight loss may have hidden dangers. Boring as it may be, the safest and surest way to lasting weight loss remains eating less and exercising more.

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