By Dr. Jennifer Landa, Chief Medical Officer of BodyLogicMD
I was on vacation last week and read in More Magazine about the increasing popularity of combo-pilling. Then, this morning I saw a segment on the Today Show with the editor-in-chief of More Magazine and Nancy Snyderman, MD discussing combo-pilling again. This is a down-right scary practice that is undertaken by many women in their desperate fight to get control of their weight.
Patients are looking for combinations of different weight loss pills to try to mimic the effects of the drug combination Phen-fen (Phentermine-Fenfluramine). Phen- fen was a very successful combination of weight loss pills that did lead to more weight loss than either pill alone, but Fenfluramine was ultimately taken off the market because of an increase in fatal pulmonary hypertension and valvular heart problems. Phentermine has not been shown to have harmful effects and is still on the market. Unfortunately for women, Phentermine doesn’t work as well by itself.
Several drugs have been tried in combination with Phentermine to help control weight gain. One example is the anti-seizure drug called Topamax, which has been shown to have a side effect of weight loss. Combining Phentermine and Topamax has been shown to increase weight loss in patients, but with the possibility of many other side effects. The side effects of Phentermine by itself are so great that some patients can’t even take the drug on its own.
Phentermine side effects include:
- Difficulty sleeping
Topamax side effects include:
- Nervousness or anxiety
- Numbness or tingling of the skin
- Stomach pain
- Weight loss.
The combination of these two drugs has not yet been extensively studied and could be dangerous. The scariest part is patients are sometimes purchasing these drugs on the Internet from unknown and unreliable sources.
I myself have many of my patients approach me wanting help with their weight loss. I think this particular news story underscores a simple fact that I consistently tell my patients:
There is no magical pill!
Simply put, nutrition and exercise is the key combination to lose weight and keep the weight off. I encourage my patients to eat a modified Mediterranean diet as this diet has been shown to lead to loss of fat in addition to weight loss. I encourage a diet that is low in carbohydrates obtained from grains. Instead, I tell my patients to emphasize fruits and vegetables in their diet for obtaining the carbs and fiber they need. I also encourage adequate amounts of protein and healthy fats in their diet. Eating smaller meals more frequently through the day is also very important for many of my patients.
In addition to a healthy diet, one must exercise to lose weight – a combination of cardio and strength training has been shown to yield the best results. A good detoxification regimen before starting a new nutrition regimen can also be helpful so the body is ready to rid itself of toxins that will be given off during the fat loss that is soon to occur.
The key, though, for many of my patients is getting their hormones balanced with bioidentical hormone replacement therapy (BHRT). Many of my patients feel that they do not have the mental where-with-all (or even the energy) to start a regimen that is difficult to stick to and that requires stamina and planning. I find that when they start getting their hormones into balance, their outlook and energy improve and they can then start a fitness routine and stick to a nutritional plan.
What I call the upward spiral, starts here! One positive thing builds upon another until my patients feel like they are living in a whole new world where they eat healthier, lose weight easier and have a more positive outlook on life in general.
Sure, it’s more complicated than taking a pill (or a combination of pills for that matter), but these changes are lifestyle changes, and my patients feel so great that they become addicted. Not addicted to pills, but addicted to a healthy new lifestyle! So forget the idea of a magic pill. It doesn’t exist. Instead, look for a doctor in your area that can help you by balancing your hormones naturally to get you on your way back to looking and feeling your best!