Over-the-Counter Drug Works to Suppress Appetite
May 29, 2000 -- It's almost here, that strip-down moment of truth: bathing
The need to squeeze into beachwear will lead some to crash diets and others
to the local pharmacy, where they can pick up a nonprescription diet aid. These
products often contain phenylpropanolamine (PPA), an appetite suppressant that is also used as a
decongestant. One obesity expert says PPA
can work -- but there's a risk of serious side effects.
"Phenylpropanolamine can significantly increase blood pressure and heart rate
in individuals, and there seems to be no way to predict who will have this
response," says Denise Bruner, MD. "There have been a number of cases
of people who have suffered strokes, heart attack, cerebral
hemorrhage,and died because they had pre-existing conditions." Bruner is
president of the American Society of Bariatric Physicians, whose members
specialize in managing obesity and related diseases.
PPA, the only over-the-counter appetite suppressant approved by the FDA,
limits the appetite because of its effects on the hypothalamus, a control
center in the brain. It is found in the popular diet aids Dexatrim and
Accutrim, among others. These medications are designed to be
used along with exercise and a sensible diet, and
Chattem Inc., which markets Dexatrim, notes in a statement that "PPA has
been effectively used by millions of consumers for more than fifty years in a
variety of over-the-counter products."
Still, before people opt for an appetite suppressant, Bruner says, they
ought to at least have their blood pressure measured -- and they should never
consider pills the mainstay of weight loss therapy.
"Suppression of the appetite is a particular aspect of the management of
obesity," she says. "However, the cornerstones of management are
physical activity and a sensible food plan."
Fifteen years ago, Marian Mocchietto of New Britain, Conn., sought the
Dexatrim cure for weight loss after seeing commercials that featured
"The first two days my appetite was suppressed. But I also had feelings
of stomach churning and my heart beating a little faster," Mocchietto says.
"My appetite was suppressed for only two or three days. So I took two
capsules. That worked for a day or two, and then I took three."
Mocchietto stopped there. But some people don't.
"I had a patient in my practice using three to 10 boxes of these a
day," Bruner says. "Thank God she didn't have any adverse effects. But
she became dependent and it took her four months to withdraw."
"There's a false sense of security people have," says Patrick
McKinney, MD, medical director of the New Mexico Poison Center in Albuquerque.
"Since these are not a prescription drug, they think they can play with the
dosage guidelines." But, he adds, some who are sensitive to the drug can
have serious side effects even when following the recommended dose. Exactly how
many get into trouble is unknown, but McKinney believes overdoses of PPA are