Ephedra and phentermine are two drugs commonly used as weight loss aids. Ephedra is an herbal drug that contains ephedrine, a stimulant used in the medical field to treat certain respiratory conditions. Phentermine is a pharmaceutical drug that has been FDA approved for the treatment of obesity. While both drugs are relatively effective, there are major differences in their accessibility, the way they work, how effective they are and what kind of side effects they produce.
Availability
Ephedra was banned in the United States by the FDA in April 2004 and is no longer available for use. Its pharmaceutical-grade cousin, ephedrine, is available as an over-the-counter decongestant for the treatment of short-term asthma and bronchitis. In most states, you must be over the age of 18 to buy medicine that contains ephedrine. You may buy only 3.6 grams, roughly one to three boxes depending on the size of the box, within a 24-hour period, and you must show the pharmacist a state-issued ID and sign a logbook. Phentermine is a controlled substance, which means it is strictly regulated by the Drug Enforcement Administration, or DEA. It is only available through a prescription from your doctor and carries a limitation on the amount of times you can refill it.
Mechanism of Action
Ephedra is a stimulant, similar to methamphetamine, and produces weight loss through a combination of appetite suppression and thermogenesis, according to a review published in the January 1992 issue of "The American Journal of Clinical Nutrition." It stimulates the body, forcing it to use more energy. Phentermine is a strong appetite suppressant. It reduces your desire to eat, which results in a greater caloric deficit, leading to greater weight loss.
Efficacy
Both ephedra and phentermine have been proven effective at producing a greater weight loss than can be achieved through diet and exercise alone. An evidence report published in the March 2003 issue of "Agency for Healthcare and Quality" noted that in a six-month period, people taking ephedra lost an average of 12 pounds more than those not using weight loss supplements. The efficacy is increased when caffeine and aspirin are taken at the same time. A review of common drugs used in the treatment of obesity published in the August 2001 issue of "Archives of Internal Medicine" found that phentermine causes three times more weight loss than dieting and exercise alone.
Adverse Effects
Ephedra carries with it myriad adverse effects. Nausea, vomiting and changes in mental status --- like agitation and paranoia --- are most common. Occasionally, you can experience psychosis, headache and dizziness. Life-threatening conditions, such as heart attacks, strokes and seizures, can result if you misuse ephedra or are sensitive to its effects. Taking caffeine with ephedra increases the likelihood that you'll experience these side effects. Ephedra was banned because some people died as a result of taking it. You should not take it for weight loss.
Phentermine most commonly causes vomiting, dry mouth and diarrhea or constipation. In some people, it causes more serious symptoms, which include heart palpitations, chest pain, shortness of breath and dangerously high blood pressure. If phentermine is taken with other weight loss medications, particularly fenfluramine, you may develop a condition called pulmonary hypertension, which can be fatal. Rarely, pulmonary hypertension is caused by phentermine alone. Take phentermine only if you are prescribed it by a doctor, and avoid taking other weight loss supplements without doctor approval.
References
- University of Maryland: Ephedra
- PubMed Health; Phentermine; January 2011
- "The American Journal of Clinical Nutrition"; Pharmacology of Thermogenic Drugs; Arne Astrup, et al.; January 1992
- "Agency for Healthcare Research and Quality"; Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement; Paul Shekelle, MD, PhD, et al.; March 2003
- "Archieves of Internal Medicine"; Long-term Pharmacotherapy of Obesity 2000; Gary Glazer, MD; August 2001
- "Yonsei Medical Journal"; Pulmonary Hypertension Associated with Use of Phentermine; Woo-Dae Bang, et al.; November 2010
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