Can I find someone in SF who will help me actually lose weight?
I don’t think people should overdose on caffeine, either. I certainly don’t advise them to. If I were advising them to, maybe your analogy would make some kind of sense. Also, caffeine doesn’t cause heart attacks or strokes, and its blood pressure effects are very modest in comparison to the sympathomimetics. In very high doses it can precipitate arrhythmias. I don’t care about liability or getting sued nearly so much as I do about harming my patients. Because of that, I’m always delighted when a patient who doesn’t appreciate that goes shopping and finds a different doctor, one who doesn’t care, to rubber-stamp his prescription requests. In that case the patient has found a better fit for his desires, and I get to quit worrying about it. Everyone wins.
I don’t think people should overdose on caffeine, either. I certainly don’t advise them to. If I were advising them to, maybe your analogy would make some kind of sense. Also, caffeine doesn’t cause heart attacks or strokes, and its blood pressure effects are very modest in comparison to the sympathomimetics. In very high doses it can precipitate arrhythmias. I don’t care about liability or getting sued nearly so much as I do about harming my patients. Because of that, I’m always delighted when a patient who doesn’t appreciate that goes shopping and finds a different doctor, one who doesn’t care, to rubber-stamp his prescription requests. In that case the patient has found a better fit for his desires, and I get to quit worrying about it. Everyone wins. From my point of view, it’s very, very difficult to take arguments about the efficacy and side effects of the medication when I’ve taken it successfully in the past under a physician’s care, without any significant presence of those sid
What’s going on is that phentermine probably isn’t ‘safe’ in the sense that you’re using the word. Drugs have good effects and bad effects. Phentermine might help a person lose weight. But it raises blood pressure, can cause fatal or nonfatal heart arrhythmias, and probably causes heart attacks and strokes when used over long periods. It may also produce mood changes like irritabiity, and psychosis or hallucinations, and it disrupts sleep. In combination with fenfluramine (fen-phen) it produced serious, permanent heart and aorta problems in a lot of users – how many we’ll probably never know for sure. It interacts with other medicines too – and these days, who ever really knows what a patient is taking? (I spend more time reviewing medicines in my clinic than the average PCP does on doing his entire encounter. Often this is all I need to do to cure a patient’s ‘neurologic’ ailment.) Now there are a few reasons to help a person lose weight. If you ignore the cosmetic benefits, we know t
subbes, I believe ikkyu2 is suggesting rightfully, that using a stimulant with the possible side effects of causing systemic and pulmonary hypertension, increased heart rate, and valvular heart problems in order to treat a condition associated with cardiovascular mortality and morbidity probably rubs doctors the wrong way. While weight loss has been demonstrated to reduce the risk of various maladies, there’s no reason to assume that it’s irrelevant how you lose weight. Moreover, phentermine is really only approved for short term use, and the consensus is that weight loss is a long-term lifestyle problem. In someone who admits to wanting to use it as a crutch because they are unable to calorie reduce or exercise more, that doesn’t really bode well for sustained weight loss. Bear in mind, the literature on phentermine is largely limited to a single prospective study over 36 weeks done in 1968. This study demonstrated improved weight loss (most would agree that it probably will help you
