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title pic More Is Not Always Better: The Risks of “Combo-Pilling” For Weight Loss

Posted by Fiona Cole on March 30, 2011

More Is Not Always Better: The Risks of “Combo-Pilling” For Weight Loss

As we all know, losing weight requires hard work, especially when it come to shifting the last 5-10 pounds between you and your ideal goal. In recent years, more and more dieters are turning to what is known as “combo-pilling” or taking two medications instead of one in order to increase weight loss while reducing side effects. Many different cocktails are being used and, more often than not, the combinations include a coupling of appetite suppressants and antidepressants.

It is a known fact that single diet medications have not been very successful over the years. Many have been taken off the market. Orlistat is the only remaining drug which is FDA approved as a single medication for the long-term treatment of obesity, but consumers have complained of unpleasant side effects. In the never-ending search for more effective weight loss solutions, doctors, pharmaceutical companies and frustrated dieters have gravitated towards “combo-pilling.”

Many doctors now prescribe “off label” or unapproved drug combinations for weight loss. This practice, which is perfectly legal, means that each drug has been FDA approved and is on the market as a single entity, but the combining of the two is the doctor’s own design. Without the oversight of the FDA, most of these drug combos have not been put through clinical trials or academic research. In “combo pilling,” the patient is depending entirely upon the doctor’s judgment.

While doctors make promises and claim success, off-label prescriptions allow doctors to slide under the radar — and inevitably, without proper monitoring and research, safety issues arise. As an example, one drug company attempted to market a single diet pill called Qnexa which was a combination of two medications: phentermine, an appetite suppressant, and topiramate (brand name Topamax), an anticonvulsant. Qnexa was rejected by the FDA owing to concerns about cardiovascular risks and birth defects. Yet, doctors are allowed to prescribe these two medications together “off-label” in a coupling known as “phen-Topamax.”

One of the earliest experiments with “combo pilling” was fen-phen in the early nineties. Fen-phen coupled phentermine and fenfluramine, a drug which increases serotonin release. But like many drug combos which followed, fen-phen came with risks. By the late nineties, fenfluramine had been associated with heart valve problems and was withdrawn from the market.

Phentermine has been associated with increased blood pressure and heart palpitations, but it has remained on the market and in the labs in search of new partners. Michael Anchors MD, a weight specialist from Maryland who has a Ph.D. in biochemistry from Harvard, discovered the coupling of phentermine with Prozac in a combo known as Phen-Pro.

After conducting preliminary studies, the company who produces Prozac, Eli Lilly, chose not to proceed with Phen-Pro. Sonja Popp-Stahly, Lill’s spokeswoman, stated that Lilly does not support off-label usage of any medication.

“Lilly does not recommend the combination of Prozac with other medications as a treatment for weight loss,” she added.

Anchors currently holds a patent on Phen-Pro, but no manufacturer has moved forward to produce the combo as a single pill.

In spite of the concerns expressed by both drug companies and medical experts, doctors are still free to prescribe “combo pilling” — including the couplings phen-Topamax and Phen-Pro — as an off-label solution for weight loss.

But if the drug companies are unsure, it means the rest of us should be extra cautious. There will always be success stories in which these combos have worked miracles without adverse effects, but as individuals we all need to weigh the risks and benefits of taking any medication.

If you are considering “combo-pilling,” consult with your doctor and consider the following guidelines:

1. Trust your doctor: Make sure your doctor is experienced, qualified and communicative about all of the risks and benefits of a prescription.

2. Do your research: If the FDA turned it down, then find out why. Research the views of consumers who have tried it.

3. Watch out for side effects: Be vigilant in keeping an eye out for possible side effects and report any unusual symptoms to your doctor immediately.

4. Assess your risk of heart disease: Know your risks and closely monitor your cardiovascular health while using any weight loss medication.

5. Never buy drugs online: Always use a reputable source.

6. Invest in long-term holistic health: Use the drug as a temporary solution. In the meantime, enroll in support groups, exercise programs and practice good eating habits that will last you a lifetime.

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