Easy weight loss is risky

The newcomers on the diet drug scene are the subject of an article in the July Allure. Diet aids fen-phen, a combination of the drugs fenfluramine and phentermine, and its newer version, dexfenfluramine, or Redux, have been a sensation in more ways than one. When the U.S. Food and Drug Administration (FDA) approved these drugs, they did so with the stipulation that they be used only by people who are 30% or more above their ideal body weight. However, since their approval, fen-phen and Redux have become the newest, fastest ways to lose those last 15 pounds.

The problem with these drugs, which suppress the appetite by affecting levels of serotonin in the brain, is their potentially serious side effects, including a rare, life-threatening condition, primary pulmonary hypertension. The FDA considered the benefits worth these risks for seriously obese people, whose weight could lead to health problems. But now there seems to be no practical way of controlling the drugs’ distribution by physicians. Citing her own experiences in three Dallas clinics, the author maintains that many weight loss centers do not screen adequately before distributing the drug. Fen-phen and Redux simply were not intended for cosmetic weight loss, but the easy route is making huge inroads on more established programs such as Jenny Craig and Weight Watchers, which have long been advocates of behavior modification as the key to weight loss.

-An article in the August McCall’s discusses the horrors of drug errors and recommends several ways to avoid this problem. Drug errors can occur for many reasons, the article says. Some physicians do not have adequate knowledge of the ways in which new drugs interact, and this problem can lead to serious side effects. Frequently, however, the problems are basic. For example, a pharmacist misreads a doctor’s handwriting, or a hurried mother assumes the medicine for her child’s ear infection is applied directly to the ear rather than taken orally.

The article suggests that much of this confusion can be avoided if patients are more assertive with their doctors. Readers should tell their doctors of all drugs they’re taking, including birth control pills and over-the-counter products, before accepting a prescription. They should ask about side effects of the drug and the correct administration procedure. Readers are told to double-check the name on the bottle they receive from their pharmacists before taking the drug. And if they are in the hospital, they should make sure each nurse administering medication has looked at their charts and is aware of any drug allergies.

-In the August Mademoiselle, "How to save your own life," gives readers some advice on surviving a trip to the emergency department (ED). The article recommends going to a private hospital when the problem is not severe but does require immediate ED assistance. Because public hospitals prioritize patients according to the severity of the injury, a person with a milder problem might be forced to wait hours to get treatment. For serious problems, the article explains, the nearest public hospital is the way to go. For mild injuries, such as a twisted ankle, a freestanding urgent-care center is suggested. The article also advises patients to try to go to their own doctor’s hospital if at all possible, to avoid complications with medical records, insurance companies, and continuing treatment.

Patients are advised to call an ambulance immediately for serious problems. For less severe ones, it is wise to have a friend drive you to the hospital or take a cab. It is never a good idea to drive yourself to an emergency department. In addition, Mademoiselle recommends being assertive and descriptive about your problem to doctors and triage nurses once you are in the ED. Finally, to expedite the ED visit, patients are advised to call their own doctor and insurance company from the ED to inform them of the problem and to get a copy of their ED report on leaving the hospital.

-"Are the treatment options for PMS leaving you bloated, irritable, and crampy?" in the July/August Ms. discusses premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). The article describes some improved treatment options now available.

In 1994, PMDD was included in the Diagnostic and Statistical Manual as a psychiatric disorder, and doctors began exploring treatment options for symptoms that include a combination of severe depression, anger, anxiety, mood swings, and lethargy. Since then, several psychotropic drugs such as Prozac and Xanax, as well as more risky synthetic hormone treatments, have been found effective in combating the effects of PMDD. However, some women are objecting to the treatment of PMDD as a psychiatric disorder, rather than a purely medical one, on the grounds that it supports the "it’s-all-in-your-head" assertion.

As for the more common PMS, there are still few treatments, the article explains, and those that do exist manage rather than prevent PMS symptoms. Sufferers are advised to try vitamin B6, magnesium, and calcium supplements and to decrease their caffeine intake before trying prescription drugs. A high-carbohydrate diet and aerobic exercise also are suggested to combat mood problems, fatigue, and depression.