Obesity is a chronic disease that requires long-term management. Comprehensive interventions, including diet and exercise, are the cornerstone of treatment. However, these programs don't work for everyone. Weight-loss medications can help more people achieve larger, longer-lasting responses to lifestyle interventions. Phentermine, also known as Adipex, is a commonly used anti-obesity medication that can support the weight loss journey.
What is Adipex?
Adipex is a brand name for phentermine, an FDA-approved medication for obesity. It is an anorectic drug that works by suppressing the appetite. It is believed to increase brain chemicals such as dopamine, serotonin, and norepinephrine, which reduces hunger. By stimulating the central nervous system, it increases blood pressure and heart rate. This prescription medication helps patients achieve a calorie deficit, leading to weight loss over time.
How Adipex Works
While the exact mechanism of how Adipex suppresses appetite isn't fully understood, it's believed to increase levels of certain neurotransmitters in the brain, such as dopamine, serotonin, and norepinephrine. These chemicals are associated with mood regulation and appetite control. By increasing their levels, Adipex can help reduce hunger and cravings.
Adipex is not a replacement for diet and physical exercise. Clinical studies have proven that this medication is effective for weight loss in obese individuals and is a safe option when used under medical supervision in combination with lifestyle changes.
Who is an Ideal Candidate for Adipex?
Adipex is a good weight loss pill for adults over 16 with a BMI over 30. It can be prescribed to patients over 16 years of age who have tried lifestyle changes such as diet and exercise but haven't lost weight. The medication is used in addition to lifestyle changes to reduce the health risks associated with obesity. It is recommended for patients with a BMI of 30 or higher, and for those with a BMI of 27 who suffer from a chronic obesity-related condition.
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Dosage and Administration
Phentermine should be taken 1 to 2 hours before breakfast. Follow the dose recommended by your doctor and their guidelines. The body gets used to the medication, so your doctor can increase the dose.
Many doctors prescribe phentermine, on its own, to patients for more than 12 weeks. Some doctors cycle patients on for 5 days and off for 2 days to keep the body from building up a tolerance to the medication. Taking a month break every few months along with cycling on/off each week may also be recommended.
If you plan to stop the treatment, consult with your doctor first. A sudden stop can result in unpleasant withdrawal symptoms. Your healthcare provider will inform you on how to terminate the therapy safely. Don't consume alcohol with Adipex since it can result in adverse effects. If you're at the beginning of your treatment and don't know how this medication will affect your reactions, avoiding driving or hazardous activities would be better.
Expected Weight Loss
The average weight loss with Adipex is 5%. Patients will lose 3% of their initial body weight in three months and 5-7% after six months. Some can even lose 10% of their body weight in 12 weeks. A patient weighing 200 pounds can expect to lose 10 to 20 pounds. It is important to note that everybody responds differently to this medication. If you don't notice an improvement in three months of taking Adipex, your doctor will discontinue the therapy.
Benefits of Adipex
A real-life example shows the potential benefits of Adipex when combined with lifestyle changes and professional support. One individual's weight ballooned up after having kids, then a divorce, and other life events. After gastric bypass surgery in 2008 followed by a stressful period marked by personal losses and anxiety, they turned to food for comfort. After deciding that their life was worth it, they looked up Journey Lite and made an appointment.
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In October, they tried to go it alone, weighing 245 pounds at that time. In November 2023, they started on Adipex, weighing 240.2 pounds. The NPs, dieticians, and staff were supportive, teaching them how to make good food choices for life, read labels, and understand carbs, fat, protein, and macros. The dieticians helped them find good recipes, and they learned how to make foods they love with good ingredients. They also found ways to have a tiny desert every now and then, and started working out, walking 5 miles a day 5-6 days a week and including HIIT and strength training. By May 30, 2024, they were down to 184.6 pounds, feeling good, having more energy, sleeping better, and eating healthier. They lost inches and went from a size 24 to a 14. This individual emphasized that Adipex is only the tool, and the decision to make this a lifestyle is up to them.
Potential Side Effects and Risks
Adipex is a safe medication for short-term use, and serious adverse reactions are rare. Common side effects include dry mouth, sleeping problems, fatigue, dizziness, irritability, and heart palpitations. If you notice signs of an allergic reaction such as difficulty breathing, hives, and swelling, get emergency medical help.
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and does not cause any unwanted effects.
This medicine may cause pulmonary hypertension (increased blood pressure in the lungs). Serious heart or blood vessel problems (eg, valvular heart disease) may also occur if you take more of it, if you take it for a longer time, or if you are taking other medicine that reduces appetite (eg, dexfenfluramine (Redux®), fenfluramine (Fintepla®)). Check with your doctor right away if you have chest pain, decreased ability to exercise, fainting, swelling of the feet or lower legs, or trouble breathing.
This medicine may cause some people to become dizzy, lightheaded, or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. This medicine may affect blood sugar levels. Patients with diabetes may notice a change in blood or urine sugar tests. Check with your doctor if you have any questions. Avoid drinking alcohol while you are using this medicine.
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Contraindications and Precautions
As with other drugs for weight loss, Adipex isn't a good choice for everyone. Patients with high blood pressure, heart disease, hyperthyroidism, a history of drug abuse, and glaucoma shouldn't take this medication. Also, it isn't recommended for pregnant women and nursing mothers. Weight loss during pregnancy can harm the baby, so patients should inform their doctor if they conceive during the treatment. If you're taking diabetes medications, your dose might need to be adjusted when taking Adipex.
Do not use phentermine if you are also using similar medicines such as benzphetamine, diethylpropion, mazindol, phendimetrazine, Bontril®, or Didrex®.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription and nonprescription (over-the-counter) medicines, dietary supplements, herbal remedies, or medicines for appetite control, asthma, colds, cough, hay fever, and sinus problems.
Drug Interactions
Adipex can have drug interactions with monoamine oxidase inhibitors, a less commonly used antidepressant. It isn't recommended for patients that have taken MAO inhibitors in the past two weeks, such as isocarboxazid, methylene blue injection, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine. Also, Adipex shouldn't be taken with other weight loss pills. Your healthcare professional will assess your medical history and determine if you're the right candidate for this medication.
The Importance of Lifestyle Changes
Adipex is most effective when combined with lifestyle changes, including a healthy diet and regular physical activity.
- Choose Low-Fat, High-Fiber Foods: Foods that are low in fat and high in fiber are ideal for weight loss, as they help support digestion and blood sugar regulation. Opt for foods like fresh fruits, vegetables, whole grains, and legumes, which are high in fiber and low in calories. Avoid foods that are high in saturated and trans fats, such as fried foods, processed snacks, and fatty meats, and drink plenty of water.
- Opt for Whole Grains: Whole grains provide sustained energy and are a good source of fiber. Choose foods like brown rice, quinoa, and whole wheat bread instead of refined grains, such as white rice, which can cause blood sugar spikes and undermine weight loss efforts.
- Incorporate Lean Proteins and Vegetables: Lean proteins, such as chicken, fish, tofu, and beans, can help you feel full and satisfied while supporting muscle growth. Vegetables are also a great choice, as they are low in calories and high in nutrients. Aim to fill at least half of your plate with non-starchy vegetables like broccoli, spinach, and peppers.
- Consider Healthy Meal Plans: There are many healthy meal plans that are Adipex-friendly and can aid in weight loss. For example, the Mediterranean diet, which is rich in whole grains, lean proteins, fruits, and vegetables, is a great option. There are also many meal delivery services that offer healthy, low-calorie options.
By following these tips and making healthy food choices, you can support your weight loss goals while taking Adipex. Remember to talk to your healthcare provider or a registered dietitian for personalized nutrition advice and to adjust your diet plan as needed.
Longer-Term Use of Phentermine
While phentermine was initially approved for short-term use (12 weeks or less), some studies suggest that longer-term use may be safe and effective for some individuals. A study published in Obesity found evidence of better weight loss with longer-term use of phentermine (up to 2 years' follow-up). The study also found that systolic blood pressure was reduced at 24 months in long-term users of phentermine relative to short-term users, possibly due to sustained weight loss.
It's important to monitor patients for their response to phentermine treatment. About a third of people prescribed phentermine lose less than 3 percent of their weight within the first 3 months of starting the drug. These “non-responders” should not continue phentermine treatment, as they are unlikely to experience clinical benefit from it.
Phentermine in Korea
Phentermine has been widely applied in Korea since 2004. A randomized, double-blind, placebo-controlled study was performed in Seoul on 68 relatively healthy obese adults whose body mass index was 25 kg/m2 or greater. They received phentermine-HCl 37.5 mg or placebo once daily with behavioral therapy for obesity. The primary endpoints were the changes of body weight and waist circumference from the baseline in the intention-to-treat population. Mean decrease of both body weight and waist circumference in phentermine-treated subjects were significantly greater than that of placebo group. Significant number of subjects in phentermine group accomplished weight reduction of 5% or greater from the baseline and 10% or more.
Dry mouth and insomnia were the only statistically significant adverse events that occurred more frequently in phentermine group. Most side effects of phentermine were mild to moderate in intensity.