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Almost All Weight Loss Drugs (Good, Bad and Awful) Ever Used in the United States

Welcome to an extensive compilation of nearly every weight loss agent ever utilized in the United States. The term 'drug' is employed here to encompass any substance administered through various routes, including oral ingestion, insufflation, suppository, injection, or intravenous infusion. The American journey through the landscape of weight loss drugs is marked by a myriad of experiences, where moments of triumph are entwined with phases of turmoil. For each effective weight loss agent listed here, one might encounter three or four others that proved to be either harmful, impractical, or simply unattractive. Nevertheless, this chronicle is a testament to our nation's continuous quest for effective weight management solutions. This comprehensive collection is presented not only for its rarity but also for its educational value, offering a unique perspective on a significant aspect of American medical history that remains largely unexplored.

Tapeworm Eggs

Tapeworm Egg: While not actually a drug, a tapeworm egg in a sugar cube was sold and ingested as if it was a drug and so I will list it here. Tapeworm eggs were used in the early 20th century as a weight loss aid. The eggs were ingested, and the tapeworms would grow inside the host's intestines, consuming nutrients and calories. This method is not only dangerous but also illegal in the US. Side effects include abdominal pain, malnutrition, and in severe cases, organ damage and death.

Era in History

Early 20th century

Mechanism of Action

Ingested eggs hatch and grow inside host, consuming nutrients and calories

Used as weight loss aid in early 20th century

Side Effects and Problems

Benefits

Weight loss due to tapeworms consuming nutrients and calories

Side Effects and Problems

Abdominal pain, malnutrition, organ damage, and death in severe cases

Current Status in US

Illegal. Occasional claims that clinics in certain Latin American countries are infecting people.

Dinitrophenol (DNP)

Dinitrophenol (DNP): DNP is an industrial chemical that was discovered in the 1930s to cause rapid weight loss by uncoupling oxidative phosphorylation in cells, increasing metabolic rate. It was banned in the US in 1938 due to its severe side effects, including cataracts, skin lesions, and fatalities due to hyperthermia. DNP remains illegal and is not used in medical practice.

Era in History

1930s

Mechanism of Action

Uncouples oxidative phosphorylation, increasing metabolic rate

Used briefly in the 1930s, banned in 1938

Side Effects and Problems

Benefits

Rapid weight loss

Side Effects and Problems

Cataracts, skin lesions, hyperthermia, and fatalities

Current Status in US

Illegal for human consumption. Industrial chemical.

Amphetamines

Amphetamines: Amphetamines were widely prescribed as appetite suppressants in the 1950s and 1960s. They work by increasing the release of certain neurotransmitters, such as dopamine, which suppress appetite. However, their use declined due to the risk of addiction and side effects like insomnia, increased heart rate, and high blood pressure. Currently, amphetamines are not approved for weight loss in the US.

Era in History

1950s and 1960s

Mechanism of Action

Increase release of neurotransmitters (e.g., dopamine) that suppress appetite

Widely prescribed as appetite suppressants in the 1950s and 1960s

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

Insomnia, increased heart rate, high blood pressure, addiction

Current Status in US

Not approved for weight loss

Phentermine

Phentermine is the most widely prescribed weight loss drug on Earth. Since it was first approved by the US FDA in 1959, phentermine is estimated to have been prescribed to over half a billion people on Earth. Phentermine is a mainstay of what we call "classic" weight loss drugs. It works very well for most people and extremely well for some. Phentermine is a stimulant and therefore may cause related side effects but these are usually mild and easily managed through dose modulation.

Era in History

1959

Mechanism of Action

Stimulates central nervous system, increasing heart rate and blood pressure while decreasing appetite

Approved by FDA in 1959 and still in use

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

Dry mouth, insomnia, constipation

Current Status in US

Available by prescription

Phendimetrazine

Phendimetrazine: Phendimetrazine is another sympathomimetic amine approved for short-term use as an appetite suppressant. It works similarly to phentermine and was approved by the FDA in 1961. Side effects include dizziness, dry mouth, and increased heart rate.

Era in History

1961

Mechanism of Action

Sympathomimetic amine that suppresses appetite

Approved by FDA in 1961 and still in use

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

Dizziness, dry mouth, increased heart rate

Current Status in US

Available by prescription

Diethylpropion

Diethylpropion: Diethylpropion, approved in 1959, is a sympathomimetic amine used for short-term treatment of obesity. It reduces appetite and boosts metabolism. Side effects include dizziness, headache, and insomnia.

Era in History

1959

Mechanism of Action

Suppresses appetite and boosts metabolism

Approved by FDA in 1959 and still in use

Side Effects and Problems

Benefits

Weight loss due to appetite suppression and increased metabolism

Side Effects and Problems

Dizziness, headache, insomnia

Current Status in US

Available by prescription

Preludin (phenmetrazine)

Preludin (phenmetrazine): Preludin was an amphetamine-like drug used as an appetite suppressant in the 1960s. However, it was discontinued due to its potential for abuse and addiction.

Era in History

1960s

Mechanism of Action

Amphetamine-like drug that suppresses appetite

Used as appetite suppressant in 1960s

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

Addiction and potential for abuse

Current Status in US

Discontinued

Didrex (benzphetamine)

Didrex (benzphetamine): Didrex, an anorectic drug, was approved in 1960. It stimulates the central nervous system, suppressing appetite. Side effects include elevated blood pressure, dry mouth, and constipation. Didrex is available by prescription in the US.

Era in History

1960

Mechanism of Action

Stimulates central nervous system, suppressing appetite

Approved in 1960 and still in use

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

Elevated blood pressure, dry mouth, constipation

Current Status in US

Available by prescription

Fenfluramine (Pondimin) and Dexfenfluramine (Redux)

Fenfluramine (Pondimin) and Dexfenfluramine (Redux): Fenfluramine and its enantiomer dexfenfluramine were approved in the 1970s and 1990s, respectively. They worked by increasing serotonin levels, reducing appetite. However, both were withdrawn from the US market in 1997 due to their association with serious heart and lung issues, including primary pulmonary hypertension and valvular heart disease.

Era in History

1970s and 1990s

Mechanism of Action

Increase serotonin levels, reducing appetite

Used in the 1970s and 1990s, withdrawn in 1997

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

Primary pulmonary hypertension, valvular heart disease

Current Status in US

Withdrawn from the market

Phenylpropanolamine (Dexatrim)

Phenylpropanolamine (Dexatrim): Phenylpropanolamine was an over-the-counter weight loss ingredient found in products like Dexatrim. It was removed from the US market in 2000 due to its association with an increased risk of hemorrhagic stroke.

Era in History

1980s-1990s

Mechanism of Action

Over-the-counter weight loss ingredient

Used as an OTC weight loss ingredient until 2000

Side Effects and Problems

Benefits

Weight loss

Side Effects and Problems

Increased risk of hemorrhagic stroke

Current Status in US

Removed from the market

Sanorex (mazindol)

Sanorex (mazindol): Sanorex, approved in the 1970s, is a sympathomimetic amine that suppresses appetite. It is rarely prescribed due to concerns about its potential for abuse and side effects, including high blood pressure, dry mouth, and constipation.

Era in History

1970s

Mechanism of Action

Suppresses appetite

Approved in the 1970s

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

High blood pressure, dry mouth, constipation

Current Status in US

Rarely prescribed

Rimonabant

Rimonabant: Rimonabant is a selective cannabinoid-1 receptor antagonist that was never approved in the US. It was used in Europe for a short time but was withdrawn due to its association with psychiatric side effects, including depression and suicidal thoughts.

Era in History

2000s

Mechanism of Action

Selective cannabinoid-1 receptor antagonist

Never approved in the US, used briefly in Europe

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

Psychiatric side effects, including depression and suicidal thoughts

Current Status in US

Not approved in the US

Xenical (orlistat) and Alli

Xenical (orlistat) and Alli: Xenical (prescription) and Alli (over-the-counter) are FDA-approved weight loss medications that work by inhibiting the absorption of dietary fat. Side effects include oily stools, gas, and abdominal pain. Alli and Xenical are available in the US.

Era in History

1999 and 2007

Mechanism of Action

Inhibit absorption of dietary fat

Approved in 1999 (Xenical) and 2007 (Alli)

Side Effects and Problems

Benefits

Weight loss due to reduced fat absorption

Side Effects and Problems

Oily stools, gas, abdominal pain

Current Status in US

Available in the US (Xenical by prescription, Alli OTC)

Meridia (sibutramine)

Meridia (sibutramine): Meridia was approved in 1997 and worked by increasing serotonin, norepinephrine, and dopamine levels, reducing appetite. It was withdrawn from the US market in 2010 due to an increased risk of cardiovascular events.

Era in History

1997

Mechanism of Action

Increases serotonin, norepinephrine, and dopamine levels, reducing appetite

Approved in 1997, withdrawn in 2010

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

Increased risk of cardiovascular events

Current Status in US

Withdrawn from the market

Topiramate

Topiramate: Topiramate is an anticonvulsant medication that is sometimes prescribed off-label for weight loss. It works by suppressing appetite and increasing feelings of fullness. Side effects include dizziness, fatigue, and memory problems.

Era in History

1990s

Mechanism of Action

Anticonvulsant medication with appetite-suppressing effects

Used off-label for weight loss

Side Effects and Problems

Benefits

Weight loss due to appetite suppression and increased fullness

Side Effects and Problems

Dizziness, fatigue, memory problems

Current Status in US

Available by prescription (off-label for weight loss)

Qsymia (phentermine/topiramate)

Qsymia (phentermine/topiramate): Qsymia, a combination of phentermine and topiramate, was approved by the FDA in 2012. It helps patients lose weight by suppressing appetite and increasing feelings of fullness. Side effects include dizziness, dry mouth, and constipation.

Era in History

2012

Mechanism of Action

Combination of appetite-suppressing drugs

Approved by FDA in 2012

Side Effects and Problems

Benefits

Weight loss due to appetite suppression and increased fullness

Side Effects and Problems

Dizziness, dry mouth, constipation

Current Status in US

Available by prescription

Belviq (lorcaserin)

Belviq (lorcaserin): Belviq was approved in 2012 and worked by activating serotonin 2C receptors in the brain, reducing appetite. It was withdrawn from the US market in 2020 due to an increased risk of cancer.

Era in History

2012

Mechanism of Action

Activates serotonin 2C receptors in the brain, reducing appetite

Approved in 2012, withdrawn in 2020

Side Effects and Problems

Benefits

Weight loss due to appetite suppression

Side Effects and Problems

Increased risk of cancer

Current Status in US

Withdrawn from the market

Contrave (naltrexone/bupropion)

Contrave (naltrexone/bupropion): Contrave, approved in 2014, is a combination of naltrexone, an opioid antagonist, and bupropion, an antidepressant. It helps patients lose weight by suppressing appetite and reducing cravings. Side effects include nausea, headache, and constipation.

Era in History

2014

Mechanism of Action

Combination of opioid antagonist and antidepressant

Approved by FDA in 2014

Side Effects and Problems

Benefits

Weight loss due to appetite suppression and reduced cravings

Side Effects and Problems

Nausea, headache, constipation

Current Status in US

Available by prescription

Metformin

Metformin: Metformin is a diabetes medication that can cause modest weight loss in some patients. It works by decreasing the absorption of glucose and reducing insulin resistance. Side effects include gastrointestinal symptoms such as diarrhea, abdominal pain, and bloating.

Era in History

1950s

Mechanism of Action

Decreases absorption of glucose and reduces insulin resistance

Used as a diabetes medication, sometimes causes weight loss

Side Effects and Problems

Benefits

Modest weight loss in some patients

Side Effects and Problems

Gastrointestinal symptoms, such as diarrhea, abdominal pain, and bloating

Current Status in US

Available by prescription

Ephedra and Ephedrine

Ephedra and Ephedrine: Ephedra, a plant containing ephedrine alkaloids, was a popular weight loss ingredient in the 1990s and early 2000s. It was banned in the US in 2004 due to its association with serious side effects, including heart attacks, seizures, and strokes.

Era in History

1990s-early 2000s

Mechanism of Action

Plant containing ephedrine alkaloids

Popular weight loss ingredient until banned in 2004

Side Effects and Problems

Benefits

Weight loss

Side Effects and Problems

Heart attacks, seizures, strokes

Current Status in US

Banned in the US

GLP-1 Agonists

GLP-1 Agonists: GLP-1 agonists, such as liraglutide (Saxenda), are medications originally developed for diabetes but also approved for weight loss. They work by mimicking the effects of the hormone glucagon-like peptide-1, increasing satiety and delaying gastric emptying. Side effects include nausea, vomiting, and diarrhea. Saxenda is available by prescription in the US.

Era in History

2010s

Mechanism of Action

Mimic the effects of glucagon-like peptide-1, increasing satiety and delaying gastric emptying

Approved for weight loss (e.g., liraglutide/Saxenda)

Side Effects and Problems

Benefits

Weight loss due to increased satiety and delayed gastric emptying

Side Effects and Problems

Nausea, vomiting, diarrhea

Current Status in US

Available by prescription (e.g., Saxenda)

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