A banana. A Pop-Tart. A pill.
It's the breakfast of cham
pions!"" quipped UW-Madison sophomore Sarah. ""I desperately want to lose weight, and these pills are my last attempt.""
Fellow UW-Madison sophomore Megan, who ingests these pills at least twice a week, understands - and, like Sarah, wished her last name witheld.
""I think of them as 'anorexic' pills,"" she said. ""They are giving me the will to be anorexic for a day.""
Along with brushing teeth, deciding on an outfit and examining themselves in the mirror, Americans are increasingly adding diet-pill popping to their morning routine.
According to pharmaceutical company GlaxoSmithKline, Americans spend $23 billion a year on diet pills. Teenage girls in particular have experienced a dramatic leap in diet-pill consumption; a recent University of Minnesota study revealed that their use has doubled over the last five years.
Since the National Alliance for Nutrition and Activity found that 65 percent of the American population is overweight or obese, it's no wonder people are scrambling to plastic bottles for some assistance.
""[Obesity is] a very sad fact for our public health,"" said Pete Anderson, a professor in UW-Madison's nutritional science department. ""It's going to contribute to a lot of heart disease, cancer and diabetes.""
Today, there are two kinds of weight-loss drugs available: drugs that require a prescription and drugs that can be found over-the-counter. The latter is a new addition to the weight-loss grab-bag, thanks to the recent introduction of Alli.
With its debut in June 2007, Alli earned a coveted spot in pharmaceutical history: It stands as the first and only weight-loss drug that is approved by the Food and Drug Administration and offered over-the-counter.
According to the drug's website, Alli can help users lose ""50 percent more weight than dieting alone"" with the help of a compound known as orlistat.
Orlistat binds to enzymes in the digestive tract, preventing them from absorbing one-quarter of the fat consumed. The undigested fat, since it cannot be broken down, is eventually excreted.
""The side effects are pretty horrendous,"" said John W. Beasley, professor emeritus and chair of UW-Madison's family medicine department. ""People get a lot of fecal incontinence and greasy stools because it really does block fat absorption.""
Consequently, Alli's manufacturer,
GlaxoSmithKline, recommends eating no more than 15 grams of fat per meal if taking the drug. To put the restriction into perspective, the average slice of pizza contains 20 grams of fat.
Although they've made sacrifices, Alli consumers have seen results. According to a study conducted in 2006 by the UK College of Medicine Metabolic Research Group, overweight individuals who followed a low-fat diet and took Alli lost seven to 15 pounds over four months.
Another weight-loss pill has had comparable effects. Xenical, a pill that requires a prescription, is also available. Like Alli, Xenical contains orlistat.
However, Xenical contains double the dosage: while Alli has 60 mg, Xenical boasts 120 mg.
According to a study in 2006, researchers in Brazil found that Xenical helped obese individuals lose, on average, up to 11 pounds a year. In addition, the study discovered that the drug reduced diabetes in the participants and also improved their cholesterol levels and blood pressure.
However, the significance of those benefits is questionable.
""Anything that helps people lose weight is going to help diabetes,"" Beasley said. ""But good exercise programs are actually going to help more.""
Although pill consumers have reported weight loss, they've also reported more unpleasant - and dangerous - results. In 1997, more than 100 people notified the FDA when they were diagnosed with heart valve disease, a condition in which the valves of the heart leak or tighten. All of the individuals had one thing in common: Each had been taking a combination of two FDA-approved weight-loss drugs, fenfluramine and dexfenfluramine. The two drugs, commonly referred to as ""Fen-Phen"" when combined, were hurriedly withdrawn from the market.
In an effort to bypass hazardous complications and lose weight, people are turning to drugs that, although not intended for weight loss, still produce results.
A drug that treats epilepsy, Zonegran, and a drug that treats migraines, Topamax, have yielded surprisingly substantial amounts of weight loss.
According to a 2003 study published in the Journal of the American Medical Association, researchers found that Zonegran, on average, helped obese people lose up to 20 pounds in eight months - about 10 percent of their body weight.
Topamax has left a similar impact on consumers.
According to an experiment in Obesity Research, ""80 percent of patients recorded weight loss, even though patients were encouraged not to change their diet or exercise regimens.""
Although these drugs can help trim the unwelcome pounds, they are not without their flaws.
Beasley contends that he has yet to hear of any long term controlled studies that say Topamax helps people lose weight.
In addition, a 2003 study conducted at Georgetown University Hospital found that patients taking Topamax experienced poorer cognitive abilities.
They had difficultly finding words, memorizing them and putting together sentences.
With all of the benefits, risks, dangers and surprises embedded in the diet-pill culture, Beasley urged students to avoid taking drugs and opt instead for a healthy diet and exercise routine.
""By diet, it doesn't mean you never look another piece of pizza in the eye again,"" Beasley said. ""But it does mean that you be reasonable in your caloric consumption.""
Sarah, however, has hatched an alternate plan.
""I'm going to keep taking these pills. But instead of driving in my car to class, maybe I'll walk.""
