Simply put, Americans are getting bigger. Regardless of social trends, factors in the entertainment world, and waxing and waning economic conditions, the average U.S. citizen is considerably heavier than in decades past, with some two-thirds of Americans now defined as overweight using body-mass-index criteria, i.e., 25.0 or greater. As a result, despite the warnings attached to various prescription weight-loss medications -- some of which have been pulled from the market in the past decade owing to safety concerns -- Americans continue to clamor for pharmacological help in slimming down, and many drugs remain popular and in high demand.
Phentermine
Phentermine is among the various sympathomimietic appetite suppressants, a class of drugs which act by mimicking the effects of adrenalin -- the body's "fight-or-flight" neurotransmitter. It is presently considered safe by itself but was the second of two components in Fen-Phen, a combination diet drug removed from the market in 1997.
Orlistat
Orlistat, a prescription drug with the proprietary name Xenical, works by decreasing absorption of fats by the small intestine. It is available both by prescription and over-the-counter, and is meant to be used in conjunction with exercise and dietary modifications. It is considered safe, with its side effects more annoying than serious.
Sibutramine
Sibutramine, marketed as Meridia, was approved in 1997 for the long-term treatment of severe obesity, but withdrawn from the market in October, 2010 due to its association with higher risk of heart attack and stroke. It is believed to work by inhibiting the re-uptake of stimulant neurotrasmitters in the brain, thereby increasing feelings of satiety or fullness. It has been linked to elevated blood pressure, constipation and headaches.
Diethylpropion
This drug, usually sold as Tenuate, is used in the short term only as it may become habit-forming. Like many diet drugs of the stimulant type, its side effects are predictable--dry mouth, anxiety, tremors and upset stomach. It comes in both regular and extended-release forms.
Phendimetrazine
Phendimetrazine, usually prescribed as Bontril, is a precursor to a chemical called phenmetrazine, once sold as Pondimin but removed from the market owing to safety concerns. Both are chemically and pharmacologically similar to amphetamines and should therefore be used with caution.
Metformin
Metformin, sold in the United States as Glucophage, is a drug commonly prescribed to Tye II diabetics so that they may gain better blood-sugar control. It is not a traditional weight-loss drug, but often results in weight loss in diabetics whose chronically high glucose levels play a major role in their overnourishment.
Alli
Alli is the trade name of a preparation of orlistat that has been sold over the counter in the United States since 2007. Like its more powerful sibling Xenical, it blocks the intestinal absorption of fats by blocking the activity of lipase, an enzyme needed for fat digestion.
Zantrex
This over-the-counter metabolism-booster reputedly helps immune function and raises energy levels. The primary ingredients are yerba mate, caffeine and green tea extract.
Dexatrim
Dexatrim is an over-the-counter pill that once contained two now-banned stimulant substances--phenylpropanolamine and ephedra. It now includes a mixture of vitamins and herbal ingredients, including caffeine and orange peel extract.
Guarana
This herbal supplement originating in the Amazon basin draws its weight-loss claims from its very high caffeine content. It is often used as a flavoring agent in soft drinks and should not be taken in conjunction with other stimulants.
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