Diet drugs pose hidden dangers

Maria Endah Hulupi, The Jakarta Post, Jakarta

Slim might be everything to some people, but taking too many diet drugs can cause heart problems since some contain health- threatening substances.

A wide range of hard-to-resist diet drugs -- both local and imported -- are not only available on prescription but can also easily be found at supermarkets or street-side drug stalls. Diet drugs are available in all forms: traditional concoctions, pills, tablets and powder.

Some diet drugs claim to offer a significant weight loss within a short period of time and attract overweight people, who are increasing in number thanks to today's urban lifestyle.

Behind the "sweet promises", however, lurk potential danger.

A cardiologist at Siloam Gleneagles Hospital in Karawaci, Tangerang, Hafil B. Abdulgani, warned that illegally imported diet drugs may contain health-threatening substances, namely phentermine and fenfluramine, known as phenfen.

One of his female patients who came in with heart problems had been taking diet pills made in China. The diet pills were bought at a street-side drug stall. The little yellow pill was rumored to be effective, but after further examination, it was found the drug contained fenfluramine.

"Such diet drugs are effective as appetite suppressants. However, some of the weight loss achieved may be attributed to the disorder it causes," Hafil said.

Fenfluramine alone, he said, is hazardous and a combination of the two -- fenfluramine and phentermine, is even more dangerous.

"The sad part is, the imported diet pills she showed me are not accompanied with information on the dosage or a warning of possible side effects. There is only a Chinese inscription on the back, which she didn't understand at all," Hafil explained.

Among the health complaints that may occur include shortness of breath, insomnia and fatigue.

Drugs containing phenfen, Hafil said, can cause other very serious health problems like valvulopathy or valve disease due to leakage or regurgitation at the heart's left valve as well as causing increased pressure in the lungs, or pulmonary hypertension.

The symptoms, he said, would show within five to six months, or even sooner.

"It depends on the dosage and how many pills a person takes every day," Hafil said.

When a person has developed heart valve problems, they need to undergo surgery to replace the damaged valves with artificial ones.

"The reported side effects prompted the withdrawal of diet drugs containing fenfluramine and dexfenfluramine from market shelves in the United States several years ago," Hafil said.

According to a report at www.fda.gov, the Food and Drug Administration has asked manufacturers to withdraw products containing fenfluramine and dexfenfluramine. However, the administration has not requested the withdrawal of phentermine, the third widely used medication for obesity.

Hafil said that women, especially those between 30 and 40 years old, are prone to fall victim to such diet drugs.

"Usually those who have just given birth want to regain their old shape. A few of them, still considered to be of average body weight, take (potentially hazardous) diet pills to shed a few kilograms," he added.

Given the seriousness of the possible health problems caused by consuming such drugs, Hafil warns overweight people wanting to lose weight against taking unprescribed diet drugs, let alone buying drugs that offer attractive but unproven claims.

Instead, the cardiologist advises overweight people to watch their eating habits and start living a healthy life.

"I believe that a balanced diet -- three meals a day -- with adequate exercise will help. But just to make sure you adopt a healthy weight loss program, consult a dietitian who will design a diet program."