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What Constitutes “Safe”?

This post was inspired by a very grim statistic that I read last night:  There have been over 50,000 deaths in the United States from the Covid-19 pandemic thus far.  Unfortunately, that number will grow, but thankfully, the initial models that predicted possibly 1 million or more deaths seem to have overestimated the number that will we finally see.  However, every death is tragic and we certainly all hope that the CDC Director’s prediction of another go-round with this next fall/winter will not transpire.

I have been on my soapbox for weeks now preaching the absolute need for much more seriousness in our weight control efforts.  As the U.S. studies/data are growing, it is crystal clear that obesity and the associated co-morbidities (hypertension, diabetes) are the greatest predictors of who will get very sick/die from contracting the virus vs. who will shake this off like a common flu.  

There has NEVER been a time in my professional life when I have been more passionate about trying to help people control weight.

Now, to the topic of “safety”:  Here is a pet peeve of mine that has simmered for years but now haunts me:  Over the years, we have had many patients come to our clinic for a free consultation, learn about the components of the program, including the use of phentermine, and then tell me they would like to talk this over with their doctor before joining the program.  With a great degree of certainty, I know that well over 95% of these patients will never return to our clinic.  When our staff follows up with patients post-consult, the reason that we hear:  “My Doctor told me that phentermine is not safe”.

So, concerning the “safety” of phentermine:  This appetite suppressant/metabolism booster was FDA-approved in 1959.   Over these 60 years, this medication has been used safely in millions and millions of patients. The major serious side effects (primary pulmonary hypertension and heart rhythm issues) are rarely seen and the most recent studies are clearly pointing toward safety way past the 12-weeks of use originally recommended decades ago.  Fenfluramine was the “bad fen” linked to the heart valve issue discovered about 20 years ago.

Phentermine is NOT a magic pill but it serves as a great medical jump-start to get an obese/overweight person aggressively into a weight control mode.  As you all know from being in our program, we only dole out small prescriptions at a time, knowing full well that for any chance of long-term weight control, this must have a structured, support dietary plan and counseling as part of the program.  Phentermine use alone without a program behind it will provide some short- term results but very low chance of long-term success.

Back to safety and my doctor colleagues that have discouraged their obese/overweight patients from entering a medically supervised weight program using phentermine as part of the protocol:  When compared to the horrific illness and death rates from obesity-related co-morbidities (over 300,000 deaths a year in the U.S. due to this before the virus, and now add 50,000 and growing), is the use of phentermine to help control weight less safe?  What would the U.S. hospitalization/death rate be if our country were 70% non-overweight as opposed our current 70% overweight prevalence now?

Sorry for the rant today but the milestone passing of 50,000 deaths had me waking up a number of times last evening thinking about how many more lives would have been saved if the affected people did not have weight control issues and/or the co-morbidities.

And to my doctor colleagues:  Please offer your patients help in controlling weight and if this is not in your comfort zone, refer them to a doctor that can help them…do not discourage people because of “safety” issues involving phentermine.  Their weight control problems are much less “safe”.

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