How to Lose Weight: Drugs in Obesity

Doctor can you give me something to lose weight?

Every doctor is familiar with the obese patient who comes into the clinic with a request for “something to get my weight down , doctor!”
“No drugs can reduce the weight”, says Dr. O.P. Kapoor, Profession of Medicine, J.J. Group of Hospitals, Bombay.

Drugs for treatment for obesity fall into four classes :

Appetite -depressants – Amphetamine group of drugs.
Hormones
Diuretics.
Laxatives and Purgatives.

I eat less, I lose weight. So what is the harm in taking amphetamines to reduce hunger ?

The Amphetamine group of drugs have a powerful stimulant action on the central nervous system. The drug postpones sleepiness and fatigue, stimulates mental and physical activity energy expenditure and well-being. It also diminishes appetite when taken before meals. And this effect is sought after to keep the reduce satisfied with less quantity of food.

There is no doubt that amphetamine group of drugs reduce appetite, for a time, in many cases. But in doing in so may lead to partial starvation and loss of vital tissues, muscle and organs from the body, thus leading to weight loss – a dangerous consequence. Its stimulant action may cause extreme irritability, sleeplessness and the patient becomes tired and ill- looking.

In many patients drug tolerance occurs. This means that the drug in given doses fails to reduce appetite in the patients after a few months. This requires that the dose of the drug be increased. But whether any drug should be used for months to prevent such a fundamental feeling as hunger is a debatable point.

There are often clear reasons against these drugs as they can cause :

Increase in heart rate-tachycardia or even heart block.
High blood pressure.
Abdominal pain and spasms of bladder and rectum.
Addition, chronic restlessness and hyper excitability alternating with melancholia – a mental state characterized by extreme-sadness.

Dr.Sir Adolph Abraham, honorary medical officer to the British Olympic team, in the “News Chronicle ” slimming series, writes, “The employment of amphetamine group of drugs in treatment of obesity is by no means without danger. ”

My own advice is a reminder that amphetamine group of drugs, or for that matter any other drugs, taken without medical advice is dangerous, and that as yet there is no valid drug or medicine that can make you lose weight naturally and just as important -keep you at the proper weight level.

What is the role of thyroid hormones in the treatment of obesity ?

This vital hormone produced by the thyroid gland fans body fire to a brighter glow. That is, the thyroid hormone has the property to raise the basal metabolic rate which is the rate at which food (fat) burns. If the patient’s own thyroid gland does not produce enough hormone – a condition called hypothyroidism, supplements can make up for the deficiency. But the majority of the obese persons have a basal metabolic rate that is normal or higher than normal, and a normally functioning, thyroid gland. Use of thyroid hormone in the treatment of simple obesity can elevate blood pressure and can worsen a heart condition. If you suffering from circulatory disease, or from diabetes and you take thyroid extract pills without consulting your doctor, you actually are endangering your life.

Take the case of S.K. a young man twenty kilos over his ideal weight. His marriage has been fixed. He wished to shed off his excess weight as quickly as possible. A well-wisher advised him to take thyroid pills and convincingly illustrated a case where dramatic results had been achieved with thyroid pills.

Desperate and foolish, S.K. resorted to thyroid medication without consulting a doctor. S.K. soon developed diarrhoea, generalized shakiness and increased nervousness.

At the onset of these symptoms the young man was referred to me. I immediately took him off thyroid medication. Blood tests showed that ” he was not a hypothyroid.” He was anemic due to loss of nutrient material from the body resulting from constant diarrhoea. He was placed on proper treatment for obesity and advised to eat nutritionally balanced meals. He lost his excess weight in ten months and has been able to maintain his ideal weight since four years.

There is simply no scientific evidence that thyroid extract will help cure obesity, unless the obesity is caused by thyroid defect. Thyroid preparations must never be used without proper blood tests and without the consent of your doctor.

What is a diuretic? How do they act?

Kidney is an unique organ of excretion. It holds back useful elements in the blood and allows only waste material to pass out of the body in the form of urine. This property of the kidney is called selective filtration.

Drugs belonging to the diuretic group, when taken by an obese person ( or even non obese person), lead to diuresis, a forceful expulsion of water in the form of urine, by inhibiting the Selective Filtration action of the kidneys. This forceful removal of water leads to weight loss obviously water, not fat and the weight is regained once water is drunk.

The Diuretics, along with forceful removal of water also cause loss, of vital elements (K+) potassium, (Na+) sodium etc. Causing harmful side effects similar to dehydration.

Is it safe to use Laxatives or Purgatives for treatment of obesity ?

These group of drugs act by speeding the movements of the intestines thereby preventing absorption of digested food in the gastro-intestinal tract. This causes frequent passage of stools (diarrhoea ) with water resulting into weight loss. Unfortunately the weight loss is fluid and nutritive material from the intestines and not fat loss. The resulting thirst soon leads to drinking more water and lost weight is quickly regained.

Continual abuse of laxatives and purgatives for weight loss can seriously interfere with digestion and absorption of food, and will eventually cause loss of weight through malnutrition.

Could you explain the Ayurvedic theory on the cause of obesity in detail ?

The Science of Ayurveda in India is in practice for more than 2000 years. Ayurveda has discussed at length the factors responsible in achieving not only a long life, but a healthy long life. Ayurveda gives importance to nutrition, physical activity and positive thinking for living.

The first question an ayurvedic doctor asks is not “what disease does my patient have ?” but ” who is my patient?” By “who ” he does not mean your name but how you are constituted. He looks for the tell-tale traits that disclose your body type, also known as your “PRAKRITI”. This Sanskrit term means ” nature” It is your basic nature he wants to uncover before he turns to your problem of obesity.

Your body type – “PRAKRITI” – essential nature is, your biochemical individuality expressing innate tendencies that have been built into every aspect of your body.

Your body type whose tendencies you inherited at birth, is the most natural guide to how you should eat, exercise and make decision in every area of your life. Where do the body types come from? Every one has essentially same kind of cells and organs occupied by three operating principles called “DOSHAS”

The three doshas are called Vata, Pitta, and Kapha. Depending on the predominance of a dosha there are ten body types.

Although the doshas regulate thousands of separate functions in the body, they have three basic functions :

VATA DOSHA – Controls movements.
PITTA DOSHA – Controls metabolism.
KAPHA DOSHA – Controls structures.

VATA DOSHA : helps to breathe, circulate blood, pass food through digestive track, send nerve impulses between brain and the rest of your body.

VATA TYPES :- Are prone to insomnia, chronic constipation, nervous stomach, anxiety and depression, muscles spasm or cramps, irritable bowls, chronic pain, high blood pressure and arthritis.

PITTA DOSHA :- Helps to process air and water and allow proper intellectual function.

PITTA TYPES :- Are prone to rashes, acne, heart burns,peptic ulcers, early balding and premature grey hair, poor eye-sight, hostility, self criticism and heart attack -related to stress.

KAPHA DOSHA :- Help to hold cells together and forms connective tissues.

KAPHA TYPES :- Are prone to obesity, congested sinuses, chest – colds, painful joints, asthama, and/or allergies, water retention , depression, diabetes, high cholesterol, and sluggishness in the morning. This simply outline the broad shape of things. There is no simple one-to one relationship between a disease and body type. Being a Vata does not mean that nature has doomed you to get arthritis nor does being a PITTA or KAPHA automatically protect you from it. Illness is individual and depends on the overall pattern of your life. With the body type serving as an important influence, not a cause.

According to Ayurveda, there are seven body nutrients (Dhatus) 1. Body fluids (rasa), 2. Blood, 3. Flesh, 4. Bones, 5. Bone Marrow and nervous system, 6. Fat (Meda), 7. Generative Tissue. A healthy body means a balance or equilibrium in the proper proportion of these seven body nutrients. An increase or decrease in any one of the seven nutrients results in disease of the body when any of the seven nutrients reach saturation points and are non -transformed into other vital stages “Fat” starts accumulating.

The Ayurvedic doctrines and philosophy laid down by eminent Ayurvedic physicians “CHARAK” “SHUSHRUT” and “VAGBHAT” say :

Once a Dosha becomes unbalanced the others follow suit, unless balance is restored. In a person prone to obesity, once the Doshas, commonly, Kapha gets imbalanced, the persons appetite increases and becomes irregular. When this is followed by VATA aggravation, the person suffers from false hunger pangs, craves for more food, eats plenty and irregularly, thus upsetting the digestive system. An increase in the “VAYU” factor, also slows down the “PITTA” Dosha or metabolic process of the body, and this in turn adds to the problem faced by an already over-taxed digestive system. The overall result is an accumulating of fat in the fat cells. A person, thus affected, suffers from urinary disorder, diabetes, (MADHU MEHA), heart disease (Hrid rog). His fat increases so much that the buttocks, hips, breasts and chest become flabby and hang loosely. He gets lethargic, is drowsy, lacks enthusiasm. This person is called ‘STHOOLA” (OBESE).

COULD YOU GIVE A GENERAL IDEA ABOUT THE AYURVEDIC – TREATMENT OF OBESITY ?

In our Ancient books of Ayurvedic medicine, we find reference to obesity, and its treatment. The text of Bhava Prakash devotes chapters to this problem – they mention certain herbs i.e. plants and their products, that can successfully combat obesity. Haritaki: Which reduces accumulated Vata. Although overweight is usually as a result of Kapha imbalance, accumulated Vata in addition to obesity can cause problems of the digestive system such as bloating, gas, constipation.

“Amalaki”: which rejenuvates tissues, relieves irritation of digestive system and helps reduce unhealthy food cravings.
“Bibhitaki” : which liquiefies and expels kapha accumulation in the digestive system.
“Trikatu” : an aggregate of three common spices “black pepper”, ‘long piper’and ‘dry ginger’ promotes digestion.
“Guggul” : which reduces fat and toxins and helps to check obesity.

Thus, we find , in India since ancient times, physicians were aware of the problem of obesity and had taken measure to control it. Although herbs are far more effective and less harmful than conventional diet drugs for controlling obesity, they must only be taken under supervision of a qualified doctor.

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