NEW ORLEANS -- Everyone knows that eating less and exercising more is the way to lose weight. But shutting off the behavior to overeat is not easy.
Now a new study shows that there is a drug that can help, but there are pros and cons.
A local women and mother says no matter how successful she has been in life, she could never keep weight off after losing it, causing her emotional pain. She asked that we conceal her identity to keep her treatment part of her private medical history.
"There is a lot of shame associated with being overweight, even though I know I'm a strong person and have will power," said the patient.
She has been to the popular weight loss programs, asked doctors and nutritionists for help, gotten hypnotherapy, acupuncture and a trainer, but still there was the yo-yo effect.
"My family did, they saw me struggle with weight and they wanted to help me, but there was nothing they could do. They couldn't do it for me," she added.
But today she is 50 pounds lighter than her top weight. And she is not only having an easy time keeping off the 30 pounds she lost with dieting and walking, but another 20 pounds have easily come off as well. Now she owes her size 6 jeans to a prescription drug called Tenuate.
"When I'm not on Tenuate, I'm hungry all the time and even after a meal, you know, I prepare a meal and I know that that's enough, I'm still hungry. I'm never full and now the Tenuate helps me be full," she said.
Doctors say Tenuate has been on the market for years, approved as an appetite suppressant. It is not as potent as an amphetamine and works by increasing two of the pleasure chemicals in the brain, which also play a role in concentration, memory, logical thought, being social, more motivated, setting and following goals.
Dr. Rob Dahmes, LSU Health Sciences Center clinical pharmacologist and psychiatrist, said it's not as easy for some people to just eat less when their brains are driving them to eat more.
"When you sit back and just say, 'It's just simply mind over matter,' I wished it were that easy. Well you know what your mind is? Of course it's your brain. Well guess what's in your brain, all of these incredibly potent neurotransmitters that have things to do with how you act, how you behave when you're hungry, when you're not hungry, whether you're going to burn the calories off, whether you're not going to burn the calories off. So genetics plays a tremendous role," said Dr. Dahmes, who is also the principal investigator at Louisiana Research Associates.
Dahmes said he uses Tenuate in his practice and a new study showing it's success may make this drug more popular.
"The thing that is really bringing Tenuate back is that there was a very good study, long term, 12-month study, to see whether or not this drug lost efficacy like many of them do after a few weeks. It turned out that Tenuate did not lose efficacy after 12 months. It was still helping people lose weight," Dahmes said.
But Dahmes cautioned that while this medication is well tolerated by most people, boosting mood and interests, some people can have mild side effects such as insomnia, headaches, gastric problems, raising blood pressure, heart rate and anxiety. And he said its best use is not by itself, but rather to get someone started on a lifestyle of eating fewer calories and burning more.
Other doctors, who are not advocates of Tenuate, agree.
"If it's monitored properly, which shows continued weight loss, then that's fine," said Dr. Kim Edward LeBlanc, head of the Department of Family Medicine at LSU Health Sciences Center. "But still there should be strict instruction on diet and exercise and if someone doesn't follow that they are not really modifying their behavior and ultimately they are going to fail."
"What it will do, again, is increase the metabolic rate. So from that point of view, it can be useful for short term weight loss, but again, when you take it away and in all likelihood if a new behavior has not evolved, then all of the weight will come right back," said Dr. Henri Roca, a specialist in Family and Integrative Medicine at LSU Health Sciences Center.
Dahmes said his patients who have formed new behavior, healthful diet and exercise habits, have not gained weight back after stopping the Tenuate. And so far, it is not showing that it is addictive like amphetamines.
"Is it physiologically addictive? No, it's not physiologically addictive. But if I told you that you were going to take a medication that would really help you lose weight and maintain a lower weight, it could potentially become psychologically addictive," Dahmes said.
"It has long-term data to say that it was used safely and with apparently no addictive problems, but you always have that worry in the back of your mind," LeBlanc said.
For this patient, it's meant freedom from thinking about the next meal or food all day long. That's why she is sharing her story in hopes of helping others.
"It's great to wake up in the morning and know that you're at your goal weight," said the Tenuate Patient. "Your clothes are going to fit and it's not an issue and just get on with the day."
Tenuate must be used and monitored under the supervision of a doctor. And your doctors need to make sure it won't interact with the other medications you're taking.
Tenuate should not be used by people with diabetes, heart problems, high blood pressure, insomnia, anxiety, overactive thyroid disease or those who abuse alcohol or drugs.