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Health issue: obesity vs. amphetamines

  1. Apr 7, 2004 #1


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    Amphetamines, commonly known as "speed", and adrenaline activate the body in a similar way. Breathing and heart rate speed up, the pupils widen, blood pressure increases, and appetite is suppressed.
    Overuse of speed (too much at once or too often) can cause heart attacks.

    I almost don't even need to explain why obesity is bad. Being fat puts incredible strain on the heart and can cause heart attacks.

    Would it be safe to sell amphetamines to fat people so they can lose weight? An online friend of mine (who uses drugs) said a friend of his lost a good 100 pounds (about 45kg) in about 3 months after he started taking speed specifically to lose weight (since he was about 300 pounds).
    Obviously speed also causes strain on the heart, but consider which is worse; taking speed for 3 months, or being 100lbs overweight for 30 years.

    A product used to be sold in the US that was similar to speed, it was called Ephedra or Ma huang. The active ingredient in Ephedra was ephedrine, the chemical which methylamphetamine "meth" is made from.
    Amphetamines (speed) should not be confused with methylamphetamines (meth) because that extra methyl group makes the drug easier to absorb. Comparing speed to meth is like comparing beer to vodka, they are similar but one is much more powerful. Those weird people at raves are on speed. Those crazy people who would kill for money are on meth (or some other really bad drug).

    With all that said, should amphetamines (in lower concentrations) be legal so people can lose weight?
    Last edited: Apr 7, 2004
  2. jcsd
  3. Apr 7, 2004 #2
    Not sure, people could also just eat less.

    Obviously they will gain weight again after stopping with 'speed' (if they can? I don't know if it is addictive).
  4. Apr 7, 2004 #3
    Stimulants as tools for weight loss

    This is widely believed to be too fast for optimum health. Continuous weight loss of about 1/10 of a pound per day (until stable weight is reached) is considered optimum for health by Roy Walford and the majority of the calorie restriction community.

    Many and various substances can change neurotransmitter levels. There is nothing unique about prescription stimulants as far as ability to change neurotransmitter levels is concerned. Some substances may work better for certain people and conditions, however. A problem with classic stimulants is that they come on too fast and this may lead to addiction. They also tend to burn out neurotransmitter cells. The burn-out problem can be addressed with widely-available and inexpensive neuroprotectants such as lipoic acid and N-Acetyl-Cysteine. The Parkinson's drug Deprenyl is known to protect dopamine cells from damage, and also by itself raises dopamine levels (both by way of inhibiting the enzyme that oxidizes dopamine).

    The word "speed" is used to refer to many different stimulants. Some truck drivers even call caffeine "speed."

    Amphetamines are already legal in the United States with a doctor's prescription. People can get prescriptions for amphetamines for weight-loss, for attentional deficits or for narcolepsy. Dexedrine is a popular prescription attention/weight-loss drug. Chemically, it is dextroamphetamine sulfate. The "dextro" part of the name means it is only the "right hand" stereoisomer of the amphetamine molecule.

    Adderall is another popular prescription amphetamine drug. It contains some Dexadrine, plus a few other amphetamine varieties in order to obtain a smooth release effect. It is made up of: Dextro-amphetamine Saccharate- 2.5 mg, Dextro-amphetamine Sulfate(USP)- 2.5 mg; Racemic-amphetamine Aspartate- 2.5 mg, & Racemic-amphetamine Sulfate- 2.5 mg. "Racemic" means it is a mixture of both the "right-hand" and the "left-hand" stereoisomers of the molecule in question.

    For losing weight, since different people are fat for different reasons, a variety of approaches might be tried. Some people apparently get intense cravings for sugars and other carbs since eating these tends to raise serotonin levels. Using drugs to raise serotonin levels may help these people eat less and lose weight. Some people have glucose intolerance and very little insulin sensitivity. Using drugs, nutrition, and lifestyle changes to raise insulin sensitivity in these individuals may help them lose weight.

    I would suggest for the typical person to try a variety of approaches and emphasize the ones that seem to work better. Many things lend themselves well to this sort of a variety approach to addressing weight loss since they address areas that, for overall health, could stand improvement in virtually everyone, anyway. For example, any person trying to lose weight (barring kidney or liver disorders that would preempt the use of certain nutrient intakes), might do best to first optimize his vitamin and mineral intake, and then look at other areas of nutrition/lifestyle to change.
    Last edited: Apr 7, 2004
  5. Apr 7, 2004 #4


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    Amphetamines are legal with a perscription? I would have thought more people would be talking about it rather than this trendy stomache stapling garbage.

    I was thinking of this idea just as a quick fix for being fat mostly. Diet and exercise obviously work but not everybody has time, energy, or desire to do those.

    Btw that guy who lost 100 pounds, he was taking cocaine as well :wink:
  6. Apr 7, 2004 #5


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    Over-the-counter diet pills containing amphetamines were pulled off the market a few decades ago because of their dangers. Amphetamines are highly addictive. This is due to long-term if not permanent changes to the brain...areas involved in motivation, reward, behavior. All of the other side effects are extremely dangerous too, such as the increased heart rate. Especially in obese people who are already prone to cardiac problems, this increased strain can lead to a lethal combination.

    Rapid weight loss is rarely a long-term solution. When people use stimulants or other drugs and supplements or extreme diets to lose weight quickly, they are not likely to maintain that weight loss once the diet is over or they stop taking the supplement because they haven't learned to change their eating habits in a healthy way. You shouldn't expect to lose more than a pound a week or 5 lbs a month. That rate of weight loss allows you to incorporate healthy eating into your diet in a gradual way so you can adjust to the reduced calories without feeling hungry. People can lose a lot of weight just by replacing sodas containing tons of sugar with water, same with a lot of fruit juices...read the label...if it has added sugar or isn't 100% juice, it's not healthy. Yes, some fruit juices are good for getting vitamins, but you can overdo it quickly. Just cutting those two things out of your diet can reduce your calorie intake quite a bit (I've seen kids walking around with 2 L bottles of soda instead of water on a hot day...it's no wonder childhood obesity is on the rise). Plus, getting rid of those non-nutritive sugar calories will also help reduce cravings for more sugars, so you'll find it easier to start cutting other things out of your diet.

    I don't have any more time to continue this now, so will have to comment more later.
  7. Apr 7, 2004 #6
    The guy who lost 100 lbs has 2 choices at this point.

    1) stay on the coke, which will completely ruin his life or kill him.
    2) get off the coke and gain the 100 lbs back plus another 50 lbs due to the destruction of his metabolism.
  8. Apr 7, 2004 #7
    In the case of losing weight I would say that speed is the worst way to do it. Speed can damage your nervous permantly and burn your brain by keeping you up for days. Not to mention it's addictive and people who don't even have weight problems use it as a party drug. Coming down off of speed can make you feel like killing yourself its really awful. A type of amphetamine is used for the treatment of ADD for teens. A couple of my friends were on it and it lead them to some cocaine use because their tolerance for amphetamine got so high that they needed something like cocaine to get them going again. I recommend a more natural way of losing weight like diet and exercise that way there is no bad side effects.
  9. Apr 7, 2004 #8
    I personally would stay away from any sort of drug that is both hazardous and addictive.

    Since fat has miles of blood vessles and puts a strain on the heart, a semi-temporary solution is possible: Do light-to-moderate cardiovascular work so that the heart can build itself up over time to accomodate the heavy load, at least until the person has a chance to lose weight through dieting, etc.

    Id recommend running, but then again, Im biased in my decision :smile:
  10. Apr 7, 2004 #9


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    If it came down to the lesser of two evils, I choose the amphetamines. With that said, the main issue is is that there are no long term data on the use of these anorectics which have high abuse potential. Phenteramine's clinical trials have not been conducted past 36 weeks so no doctor is going to prescribe it past 36 weeks,( if they are purists about outcomes data and practicing evidence based medicine.)

    The safety of prescription weight-loss agents has always been a source of contention and debate among health care professionals.

    Adverse effects can be divided into two categories: those that occur shortly after initiating therapy that are dose-related minor effects, and the rare but serious effects that can occur long after therapy has begun. Initial adverse effects are directly related to the drug's mechanism of action and are often mild and transient. They can frequently be avoided by dosage and schedule adjustments, careful drug selection for patients at high risk for these effects, and appropriate patient education and monitoring after initiating therapy or following dosage adjustments.

    Sibutramine has been approved for up to one year of use, and after that we have no long term data. It is associated with a mean increase in systolic or diastolic blood pressure and heart rate in normotensive patients or patients with controlled hypertension. These effects can be serious, especially in patients with preexisting hypertension.

    Orlistat, though not an amphetamine, (pancreatic lipase inhibitor) is minimally absorbed, causing gastrointestinal effects, such as oily spotting. And, it has been approved for up to only two years of use. The strange thing was, in the phase III and IV clinical trials, there was an inordinate amount of breast cancer ....not cause and effect, later trials did not show such a trend but stilll something not to shrug off. (Since it can impair absorption of fat soluable vitamins does it have unknown long term implications such as effect on cancer etc.?)

    The possible long-term effects identified with older weight-loss agents raise concerns about the safety of prolonged use of weight-loss drugs in general. Cardiac valve abnormalities, potentially attributable to the serotonergic agents fenfluramine and dexfenfluramine, were reported in July 1997 and led to the voluntary withdrawal of these drugs from the market in September 1997. At that time, data submitted to FDA from the echocardiograms of 291 asymptomatic patients exposed to fenfluramine or dexfenfluramine showed that approximately 30% had valvular abnormalities. More recent data suggest a lower prevalence (9-14%) of aortic regurgitation in anorectic-treated patients, which was significantly higher than in the untreated, and no increase of other valvular abnormalities was demonstrated. A strong relationship between the occurrence of aortic regurgitation and the duration of drug therapy was also described, with the incidence climbing to 21.2% in patients receiving these drugs for longer than 18 months. The Centers for Disease Control and Prevention issued public health recommendations for patients exposed to fenfluramine and dexfenfluramine. Echocardiographic evaluations of small numbers of patients receiving sibutramine treatment did not reveal cardiac abnormalities. Sibutramine's action as a serotonin-reuptake inhibitor, rather than a serotonin-releasing agent, may reduce this drug's risk of causing valvular abnormalities. Until more data are available, patients should be made aware of this potential risk and carefully monitored. No cardiac abnormalities have been reported with orlistat use.

    Primary pulmonary hypertension has been associated with the use of many weight-loss drugs, especially if prescribed longer than three months, so this is also a concern. Although the risk of this adverse effect is extremely low (approximately 1 in 500,000 patients receiving long-term anorectic therapy) i had a 28 year old woman on the lung transplant waiting list because of the severe, endstage pulmonary hypertension that developed after 18 mos on phenteramine and is sorry as hell she ever took the stuff.

    Most importantly, almost all the clinical trials showed that once the agent were stopped, almost all the subjects regained the weight they lost. Probably because we never corrected the behavioral problem as Nautica points out. In fact, those that get to gastric bypass surgery wont be approved by their insurance for the surgery unless all avenues have been exhausted, including prescription weight loss drugs.
    Last edited: Apr 7, 2004
  11. Apr 7, 2004 #10


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    I'm left wondering how many of those side effects are because weight-loss drugs result in too rapid of weight loss. Those suffering eating disorders such as anorexia nervosa wind up with heart valve abnormalities too. I suspect the shift in metabolism that goes along with a starvation-like weight loss breaks down muscle as much as it breaks down fat.

    Regarding weight loss medications, I'm aware of ongoing clinical studies on the effectiveness of SSRI's for treating weight loss. However, the rationale isn't that the SSRI's are affecting metabolism, per se, but are treating an underlying mild psychiatric disorder, such as an eating disorder or atypical depression. The criteria in that study includes psychiatric diagnoses that would not typically be picked up by your general practitioner, but are only picked up with extensive testing. The idea is they aren't people afflicted with severe disorders that prevent them from functioning normally, but just mild forms that lead them to having trouble regulating their eating habits. If that's the case, then I would think SSRI's wouldn't be a short-term weight loss solution, but a therapy these patients would need to continue for a lifetime. The effects on weight are secondary to the underlying problem and should normalize with ongoing SSRI treatment. But, like I said, this is still just a clinical study.
  12. Apr 15, 2004 #11

    • Prescrire Int. 2004 Feb;13(69):18-20. Related Articles, Links

      Hidden amphetamines: from smoking cessation to diabetes.

      [No authors listed]

      (1) Amphetamine-like drugs are not only authorised for use as appetite suppressants. (2) Bupropion, otherwise known as amfebutamone, is licensed as an aid to smoking withdrawal. It has amphetamine-like adverse effects, such as seizures; in addition it causes hypersensitivity reactions. (3) Benfluorex is sold in France as an adjunctive treatment for hypertriglyceridemia and diabetes with overweight. The lack of data on its adverse effects is hardly reassuring. A case of severe cardiac valve disease has been published. (4) The ephedrine derivatives norephedrine (phenylpropanolamine) and pseudoephedrine are used in ENT as decongestants because of their vasoconstrictive properties. They expose patients to serious cardiovascular risks. Ephedrine and plants belonging to the genus Ephedra (used in freshly prepared appetite suppressant mixtures) have negative risk-benefit ratios. (5) Methylphenidate is used as a psychostimulant in patients with narcolepsy and children with attention-deficit disorder. It can lead to serious mental and physical dependence.

      PMID: 15055218
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