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While not absolutely necessary, utilizing
the important prong of medication greatly speeds results. Medications
correct the underlying biochemical mechanisms driving weight gain
They also control intense food cravings and binges. For those who
feel "tired all the time" certain medications can increase
metabolism and boost energy. Other medications ease stress and depression
(chief contributors to weight gain).
There is a definite art to prescribing and using
anti-obesity medications. Dr. Piatek is a specialist in that art,
personally tailoring dosages for thousands of patients. Under his
guidance, the vast majority find the experience to be an easy and
enjoyable one.
While researching medications and weight loss
products, Dr. Piatek has also examined natural products commonly
found in drug stores, health food stores, or offered through other
programs (products like Chromium, Metabolife, herbal phen/phen,
etc.). Unfortunately, he's been disappointed by most of them, finding
that the claims made are advertisers claims only and are not supported
by research. One major exception, however, is the natural product
5-HTP. 5-HTP is the precursor to serotonin. Working in the hypothalamus,
it curbs cravings for sweets and carbohydrates. (If you would like
detailed information on 5-HTP. it is available in pamphlet form.)
Another exception is the fiber Glucomannan. Glucomannan
is a natural product, highly effective, and void of serious side
effects. Its fibrous characteristics allow it to expand slowly in
the stomach. Taken prior to meal time, it produces a feeling of
fullness thereby decreasing intake. Another benefit of Glucomannan
is that it lowers cholesterol, decreases chances for constipation,
and helps to prevent hypoglycemia.
Vitamins, too, have become an essential part of
weight management in the program, not only to prevent the vitamin
deficiency associated with obesity and weight loss, but also to
bolster metabolism, taking advantage of the latest research in nutrition.
Dr. Piatek will be discussing this topic in detail with you.
DRUG
SIDE EFFECTS
As with all prescription medications, individuals
must weigh the risks versus the benefits of taking a particular
pharmaceutical. You should know that the risks of untreated obesity
are great, causing many serious health problems as well as compromising
longevity. So when comparing obesity to possible drug side effects,
these side effects become fairly negligible. The anti-obesity medications
used in the program are not amphetamines and have little or no abuse
potential. Although side effects are experienced by less than 10%
of patients, here are some you could experience (most common in
italics):
For Phentennine (Adipex, Ionarnin, Fastin): Dry
mouth, insomnia, dizziness, blurred vision, heart palpitations,
behavioral changes, mood swings, irritability, stomach upset or
constipation, jitteriness.
For Phendimetrazine* (PDM): Same as phentermine
For Tenuate* : Same as phentermine
For Sibutramine (Meridia): Same as phentermine,
rarely hypertension
For Effexor: Nausea. sleepiness
For Prozac: Insomnia. Fatigue, loss of sex drive
For Xenical (Orlistat): Loose stools, leaking
For Glucomannan: Loose stools, nausea.
For 5-HTTP: Nausea, tiredness
Most side effects subside after two weeks of use.
Patients rarely quit treatment due to side effects. If any side
effect becomes bothersome, notify Dr. Piatek immediately.
* Has been rarely associated with primary pulmonary
hypertension (PPH). Chances of contracting PPH from this medication
has been estimated to be less than 18 in 1,000,000.
DRUG
SAFETY In the hands of a skilled
physician, these medications are safe. However, they are not over-the-counter
diet pills. They are significant anti-obesity drugs for the purpose
of treating the disease of obesity. For this reason, here are some
simple rules and guidelines. Patients of the Piatek Institute are
expected to follow them or will be released-from the program.
1. You should not take anti-obesity medications
if you are pregnant or become pregnant while receiving treatment.
The drugs should not be taken if you are breast feeding.
2. You should notify Dr. Piatek immediately if
you are already taking anti-depressants or your family physician
wishes to start you on anti-depressants. A group of anti-depressants
referred to as MAG inhibitors can have harmful interactions with
anti-obesity medications. This needs to be carefully monitored by
Dr. Piatek.
3. Most medications can be safely taken with anti-obesity
drugs. However, notify Dr. Piatek if your family physician starts
you on any new medications. This includes over-the-counter panaceas.
For example, decongestants should be avoided while taking phenterrnine
as both are stimulants. All antibiotics are safe with anti-obesity
drugs.
4. Anti-obesity medications are to be respected,
just as you would any prescription drug. You are not to alter your
drug dosage in any way. Take them, and all of your medications,
exactly as prescribed. Please note: It is a Federal crime 10 share
prescription medications with family, friends, etc.
5. If you are taking a diuretic (such as Maxide),
take it only on the days that you are swollen. Do not use diuretics
to aide in weight loss as this can be dangerous. Let all of your
attending physicians (family physicians, surgeon. anaesthesiologist,
etc.) know which anti-obesity medications you are taking.
6. Do not stop anti-obesity drugs abruptly. Although
the drugs are not addictive, they must be weaned off slowly just
like many other common drugs.
7. If planning to have major surgery, let Dr.
Piatek know immediately. Anti-obesity medications must be weaned
off 14 days prior to the procedure.
8. Do not alter any special diets advised by your
primary care physician (such as a "no salt" diet).
9. If you are submitted to a urine drug screen
for your employment, taking anti-obesity medications can result
in a false ( + ) reading. A clarification will be provided for your
employer if necessary. (See a staff member to obtain this information.
)
10. In case of any health emergency, page Dr.
Piatek (317-906-3669) and then go immediately to the nearest emergency
room. Report all medications you are taking to your attending physician.
11. Please feel free to ask Dr. Piatek about any
and all weight loss concerns. It is important that you keep all
check-up appointments. The first two-week check-up is not to establish
weight loss or gain, but to fine tune the program, medication dosages,
and to evaluate side effects. (Keep this hand-out for future reference.)
HOW WILL ANTI-OBESITY MEDICATIONS EFFECT...
Hypertension: Dr. Piatek has found that those
with hypertension can be safely managed while taking anti-obesity
medications. Studies have shown that a 5-10% weight reduction can
significantly and positively affect hypertension. Many enrolled
in this program have experienced dramatic changes in improved blood
pressure control, along with the discontinuation of their hypertensive
medications.
Diabetes: This program does help improve blood
sugar control. A 5-10% reduction in weight usually results in a
discontinuation of Type 2 diabetic medications. If you take medication
for diabetes you need to continue to follow your blood sugar levels
closely. It is not uncommon for blood sugars to drop up to 50 points
during the first month of this program. Keep some sugar on hand
(such as hard candy or juice} should an episode of low blood sugar
occur. Also, let the physician managing your diabetes know what
anti-obesity medications you are taking.
High Cholesterol: Most patients will experience
an improvement in high cholesterol levels.
Coronary Artery Disease: Because weight loss reverses
most risk factors for obesity, it is felt that coronary artery disease
will also improve.
Arthritis: Those with severe lower extremity arthritis
improve markedly from this program. The knees carry the force equivalent
of 6 times your body weight. A small loss in weight can make a dramatic
improvement in joint discomfort.
Previous Heart Attack: Patients should wait approximately
6 months after a heart attack before starting anti-obesity medications.
Dr. Piatek may consult with your cardiologist to insure safe treatment
once started.
Caffeine Use: Because phentennine and caffeine
are both mild stimulants, caffeine intake should be curtailed- preferably
no more than 2 servings a day. More than this amount can actually
cause fatigue, jitteriness, and an increase in the hormone cortisol
(a stress hormone which as been linked to weight gain). Do not stop
caffeine use abruptly.
Tobacco Smoking: Weight gain (as much as 20 lbs)
is associated with smoking cessation. Studies show that, coupled
with anti-obesity drugs, smoking cessation results in only a 1-2
lbs weight gain. In addition, Dr. Piatek has had success with the
prescription drug Zyban which increases smoking cessation rates
by 50%. Ask him about quitting tobacco use.
Alcohol Use: While on anti-obesity medications,
alcohol intake should be curtailed. |
