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Dietary Supplements
March 2000

Q. I have heard of Meridia and Xenical for weight loss. I also was thinking of trying Metabolife. What is your opinion?

A. Good question!

The diet drug market is a multi-billion dollar industry. Some of the diet supplements available haven't even been well tested before they make it to the market. Remember, a "dietary supplement" does not have to go through the vigorous screening and approval process that a FDA approved drug does. Therefore, the phrase "caveat emptor," "buyer beware" really has important meaning here.

Metabolife is a "dietary supplement" that in my opinion, has more risks than benefit. I could not find one study on a Medline search regarding Metabolife. I do know that it contains ephedrines and caffeine which can significantly elevate blood pressure and heart rate. I had one patient that presented to me with new onset severe hypertension after he began taking Metabolife. Upon discontinuation of the drug, his blood pressure normalized. I therefore would recommend sticking with the FDA approved drugs that have been carefully screened, studied and tested.

Meridia works by altering neurochemicals in such a way that are believed to help suppress appetite. It is taken as one tab each day for about one year. The most common side effects are dry mouth and insomnia. Less common is increase in blood pressure and heart rate. Most patients tolerate this medication well, but regular follow up with your physician is very important.

Xenical is an alternative med that works very differently. It inhibits an enzyme in the intestine that normally is responsible for breaking down fats. Therefore, one on Xenical does not absorb fats in food as much as usual, and the fats are excreted in the feces. Xenical, therefore does not suppress appetite. However, it is not known to cause hypertension or increase heart rate either. The main side effects are gastrointestinal, and include gas, bloating, diarrhea and occasional fecal incontinence. If one cheats on their diet, they pay the price in increase side effects. Xenical is taken one tab with the first bite of each meal.

Of course it is best to discuss these options with your personal physician. Hope this helps.

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