They can help control obesity, but also promote the accordion effect
The Senate approved the bill that frees sale of appetite suppressants. The decision allows the sale of diet pills based on substances produced amfepramone femproporex and mazindol. The proposal also frees the sale of medicines containing sibutramine substance, its salts and isomers, as well as intermediates. The news has doubts about these medications tripled.
On one side, experts argue that the drugs are still an effective weapon against obesity. The other, there's the team that condemns the indiscriminate use and the harms that drugs can cause. According to a recent report released by the UN Office on Drugs and Crime, the diet pills should be used, but only medical treatments. The report by the INCB (International Narcotics Control Board) encourages Brazil to continue to take "all necessary measures so that anorectics are used solely for medical purposes as well as to prevent them being misused and prescribed indiscriminately."
The first step to understanding the controversy of weight loss is to know more about them. Then My Life, along with endocrinologists Glaucia and Vania Duarte dos Santos, clarify key questions about such controversial remedies.
1. What are the types of diet pills? How they act in the body?
There are three main groups of diet pills: anorectics, the sacietógenos inhibitors and absorption of fats. The first group of drugs inhibit the appetite, and has in its composition of substances known as amphetamines. Examples of them amfepramone, femproporex and manzidol are. "Currently, experts use this class only when the other two were not successful, as it presents more risk of side effects," says endocrinologist Gláucia Duarte, a member of the member of the Brazilian Society of Endocrinology and Metabolism.
The second group (sacietógenos) meets drugs that act in stimulating satiety, that is, the individual feels hungry, but with a smaller portion of food is satisfied, stopping eating earlier. Sibutramine is the best known of the group, and may have secondary action for weight loss, increased energy expenditure.
The third group is composed of fat absorption inhibitors, orlistat and represented only by the Cetilistate. Does not restrict the appetite, they do not act in the brain or nervous system. "They act by inhibiting intestinal absorption of about 30% of ingested fat. With good control of fat intake, may represent a significant help, but to overeat, the tendency is to lose weight, because 30% of fats that are no longer absorbed may not be sufficient for weight loss calorie deficiency, "says endocrinologist.
2. In what circumstances should they be used? They are valid for both overweight and obesity?
All types of weight-loss drugs should only be used when adopting a healthier diet and physical exercise showed no results in weight loss. "When the body mass index (BMI) remains above 29.9 after treatment with nutritional education, the use of medicines to aid in weight loss process is indicated," says Vania Santos endocrinologist. To discover the body mass index, simply divide your weight in kilograms by the square of your height. Calculate your ideal weight here.
Table of BMI according to World Health Organization
Underweight - less than 18.5
Normal - 18.6 to 24.9
Overweight (pre-obese) - 25 to 29.9
Take it Obesity 30 to 34.9
Moderate obesity - 35 to 39.9
Severe or morbid obesity - over 40
3. What are the possible side effects?
Even if these drugs are safe if used properly, they can cause a number of side effects. "Each type of medication against obesity has specific side effects that also vary according to each individual metabolism," explains endocrinologist Glaucia Duarte.
The anorectic (amfepramone femproporex, mazindol) may cause irritability, sleeplessness or shallow sleep, tremors, depression or alternate periods of stimulation with periods of depression, increased blood pressure and heart rate. "All of these effects are related to the nervous and cardiovascular system, have areas where the anorectic effect," says Duarte Glaucia.
Already sacietógenos that increase the feeling of satiety, usually have milder side effects than amphetamines, causing insomnia or light sleep, agitation, irritability (which is not a common symptom). Still sibutramine, which falls in this group, was banned from being sold in the United States and Europe by the responsible agencies have claimed that the drug accelerates the heart rate, causing arrhythmias in those who already have a propensity for heart disease. In Brazil, sibutramine was framed in the category of controlled drug.
The fat absorption inhibitors have side effects especially if fat intake is exaggerated. It's like a red light. "The person will present with diarrhea pasty or liquid stool and may even eliminate fat droplets after more heavy meals. So even taking diet pills, you need to have a balanced and healthy diet," says Vania Santos Nunes endocrinologist.
4.Crianças with signs of obesity can take diet pills?
The indication of diet pills must be restricted, being indicated where obesity has become a risk factor. According to Vania Santos, nourishing education and the practice of physical activities usually alone can bring a considerable improvement in the health of obese children and adolescents under 16 years. However, sometimes the use of drugs is needed. "The use of oslistat, a type of drug that decreases fat absorption by the intestine, has been tested and approved for children. Since the drugs that act on the central nervous system does not yet have full approval in children and adolescents," says Duarte Gláucia . And no wonder. If they have cause unpleasant effects in the body of an adult, imagine for children.
5.Esse type of remedy has any contraindications?
By causing alterations in the functioning of the nervous system and cardiovascular system, and sacietógenos anorectic drugs should not be used by those with decompensated hypertension, cardiac arrhythmias, type 2 diabetes, psychiatric disorders (depression and mood disorders, compulsive drives) and glaucoma.
"Even though the main contraindications fab sacietógenos and anorectic, medicines that decrease absorption of fats are also at risk group who are the patients with inflammatory bowel diseases," says Vania Santos endocrinologist.
6.The prolonged use can cause dependence (physical or psychological)?
Even though the degree of dependence is low (with level one on a scale that goes up to four), the weight-loss drugs can cause physical and psychological dependence if used for an extended period (more than four months without new assessments). "Because these drugs should be used only as a last resort and still like to support a program of reeducation food and physical activity, after the patient is no longer in a context of obesity, the use of drugs should be stopped" says Vania Santos
7.Eles must constantly be taken to keep the weight under control?
"In fact, they should be used for a short period, (the doctor makes a new monthly evaluation is the remedy remains necessary) not to cause any degree of dependence," says Vania Santos. Medications for weight loss should be part of treatment to lose weight, and not to keep it down. According to the endocrinologist, the maintenance of good order should be made from healthy eating and physical exercise. Otherwise, the chances of regaining the weight again are huge. It is the famous accordion effect.
8.Se stop taking fattening twice?
According to endocrinologists, who lose weight with the help of drugs that act on the central nervous system actually recover all the lost fat if you do not care about the food and the practice of physical activities after the end of treatment.
9.It is dangerous to take them and do intense exercise because the heart rate?
Just like food, physical exercise should be controlled after prescription diet pills "Usually physical educators suggest the stress test before starting physical activity. The ideal is to keep a monitoring of heart rate variability to diagnose any changes, "says Duarte Glaucia.
10.Eles cause excessive sweating?
The thermogenic drugs, a type of substances that act primarily by increasing the energy expenditure of the body can cause this side effect in some people. But for reasons of safety and side effects (increased heart rate, increased blood pressure, increased thermogenesis), this kind of remedy has been little used.
11.Seus results are better than dietary reeducation and physical exercise?
The use of medication can only facilitate weight loss, but if there is no change of lifestyle chances of recovery of the lost weight. "The remedy alone will not bring positive results. We need to control the feeding and physical activities along with medication to successfully lose weight," says Vania Santos.
12.Eles speed up metabolism?
According to Vanya, people with obesity tend to have a slower metabolism, and therefore, the body takes to consume all the energy that has been accumulated for meals. What are some remedies cause as a side effect, is to increase caloric expenditure. Unless remedies for thyroid, which are not indicated for cases of obesity, weight-loss drugs do not affect the functioning of our metabolism.
13.How do ensure that the prescription of medicines is the most suitable for "my" case?
According to nutritionists, the best way to protect yourself from an error of only prescription is seeking qualified and nominated by other doctors trust. Another tip is to always seek a second opinion.
14.Qual the danger of taking those manipulated formulas that make a cocktail of drugs? In this case, the most appropriate remedy is bought at the pharmacy?
As these drugs can have many side effects, doctors prefer medications laboratories, which are sold in public pharmacies. "The doctor has no way to predict which side-effects that a manipulated formula can bring to the patient. Therefore, good doctors always prescribe medications for weight loss by renowned laboratories that pass quality testing," says Vania Santos.
15.Eles are diuretics?
"Most remedies for slims also have diuretic to increase fluid loss in the body, and thus increase the sensation of weight loss," says Gláucia.
16.The weight loss is illusory, or more lean mass than fat is lost?
A fast weight loss process without concern for physical activity or nutrition to maintain lean mass tend not to sustain. In this case, there is loss of muscle yes. "Weight loss scaled a full treatment, with food and exercise rehabilitation, guarantees the exchange of fat mass by lean mass," explains Duarte Glaucia.
17. In course of time the body gets used to the medication and the dosage? Who takes medication for a long time is more difficult to lose weight without it then?
Over time, especially with amphetamines, the organism can develop tolerance, ie increasing the dose needed for the purpose is the same. "Probably whoever becomes an addict of amphetamines, expect an easy to lose weight, without a commitment to food and exercise rehabilitation, hindering the sustainability of weight lost way," says Duarte Glaucia.
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