Question: I wanted your opinion on dietary supplements containing the ephedrine/caffeine/aspirin stack. I have read that after two or so weeks there is no elevation in blood pressure or heart rate, and that this is a safe combination to use for a extended time. I was wondering what concrete, reliable studies there is on this subject and what your opinion is?

Answer: I think this is quite unwise. Stimulants such as ephedrine can have serious side-effects, such as insomnia, agitation, high blood pressure, restlessness, and palpitations. Stimulants also increase your level of stress hormones and tend to worsen stress. High doses of ephedrine may cause heart attacks, arrhythmias, or even death.

In addition to the potentially life-threatening side effects, the problem with all of these pills to lose weight is that they don't last. Most people who lose weight using appetite suppressants gain it all back when they stop taking the pills.

Instead, try following the guidelines that I outline in Eat More, Weigh Less. In our research, the average person lost 25 pounds in the first year and kept off half the lost weight five years later. Those who were the most overweight lost even more weight. You'll feel better, lose the weight permanently, and increase your health in the process. You may lose weight more slowly than the "quick fix" of taking pills, but the results are more permanent.

Stimulants are often marketed as "energy enhancers." In nature, you don't get something for nothing. When you take a stimulant, ranging from caffeine to ephedrine to cocaine, you get an initial increase in energy that is followed by a corresponding letdown in your energy level. In other words, you are "borrowing" your own energy, and it has to be paid back. There is a tendency to take more of the stimulant, which is what can lead to the addictive cycle.

A better choice is to increase your energy by improving your health. Many people find that when they change their diet, exercise, manage stress more effectively, and wean themselves off stimulants, they have more energy that is real, not borrowed. This increase in energy comes from being healthier. And when you make comprehensive lifestyle changes, you can lose weight and keep it off.

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