The history of pharmaceutical treatment of obesity in the United States and internationally is in many ways inseparable from the history of a single compound: phentermine. Phentermine was not the first drug approved for the treatment of obesity by the FDA, as amphetamines had been approved previously.
When first approved in 1959, Phentermine was part of a group of drugs called amphetamine congeners that were intended to mimic many of the properties of amphetamines without as many of their potentially harmful side effects when used for obesity. None of the other drugs approved during this time have had either the popularity or the staying power of Phentermine and many of them have been removed from the marketplace.
Phentermine is an anorectic medication that is approved for the short-term treatment of obesity along with changes in lifestyle. Is currently available in two forms the first is phentermine resin while the second is phentermine hydrochloride. The reason why Phentermine hydrochloride tablets typically have a maximum dosage of 37.5 milligrams is because this is the equivalent to 30 milligrams of Phentermine resin.
Phentermine works by reducing the reuptake of norepinephrine in the brain. Initially after its approval, scientists believed that increased the levels of norepinephrine, but the current consensus is that it actually prevents norepinephrine from being removed from the body.
Phentermine may also inhibit the reuptake of dopamine as well. It is still unclear exactly how Phentermine works, as the FDA notes that it may work not only through potential reductions of hunger but also through the use of other neurological mechanisms, some of which are not fully understood at the present time. Phentermine is chemically similar to amphetamines, but it varies from them in significant respects.
Amphetamines such as Adderall or Methamphetamine – which are both prescribed for the treatment of Attention Deficit Hyperactivity Disorder – have a stimulating effect on the body’s central nervous system. Methamphetamine has a reputation as an illegal drug due to its widespread illegal production and use, as well as its addictive properties.
However, it is technically a Schedule II drug available with a prescription from a doctor, usually a psychiatrist although its addictive properties mean it is rarely prescribed. In other words phentermine has relatively few rivals in the same drug class.
Phentermine differs from these drugs because it lacks this stimulant effect. However, Phentermine does have a stimulant effect to the extent that taking it late in the day encourages insomnia. This is because it has a proven medical use and a potential for abuse that is less than its amphetamine counterparts.
The Practical effect for the patient with a prescription is related to the refills that they can receive from their Pharmacy. Phentermine is approved by the FDA for use during periods of up to 12 weeks meaning that a patient could theoretically receive a single prescription from their doctor for the entire twelve-week duration they are prescribed phentermine that they are supposed to be taking it.
Phentermine was initially approved by the Food and Drug Administration (FDA) for the short-term treatment of patients affected by obesity in 1959 and has been in continuous usage since that time. During the following decades, Phentermine and numerous variants and forms would come to be prescribed more widely by doctors in both the United States and around the world.
Currently, there are approximately four million (4,000,000) prescriptions written for Phentermine every year in the United States. Phentermine has even spawned an online community of users to discuss how they’re able to obtain a prescription and what doctors are most likely to prescribe it.
Phentermine is available in the United States only with a prescription from a doctor. It is recommend to be prescribed to patients with a Body Mass Index (BMI) of 30 or greater, although this can be dropped to 27 if a patient is suffering from another medical condition.
The typical dosage of Phentermine varies between different patients, and is determined by the doctor prescribing the medication. Patients may be prescribed one dose of 37.5mg to take in the morning, two separate doses of 18.75mg, or one dose of 18.75mg in the morning depending on the determination of the prescribing physician.
Typically, Phentermine is dispensed at brick and mortar pharmacies rather than through online pharmacies. However, the users of online pharmacies report a high degree of satisfaction when they order from a legitimate pharmacy that requires a prescription from a doctor. However, 86 percent of Americans have yet to order a prescription from a pharmacy.
One of the primary reasons why they have not done so is due to the perception that the online marketplace is not a trustworthy way to fill prescriptions. If the perceptions of the online marketplace were to change then it is likely that the proportion of Phentermine and other drugs ordered from legitimate online pharmacies would change as well.
One of the most significant challenges that the legitimate online pharmacy are the perception that the online pharmacy industry consists mostly of shady operators. The use of a search engine such as Google or Yahoo to find information about Phentermine in countries around the world clear numerous websites offering to phentermine from those countries to the United States and other developed nations.
These illegal online pharmacies are often located in offshore jurisdictions where they cannot be prosecuted by authorities from the United States or Europe who are concerned about the problem of illegal prescription drugs. If someone attempts to order drugs from one of these illegal online pharmacies there is a significant risk that their shipment will be seized by Customs or if they get it that it will be fake.
The shutdown of these illegal online pharmacies will benefit the legitimate online pharmacy industry greatly. The more it is important to note that obtaining a phentermine prescription is not difficult particularly if a patient knows the right doctor to visit. The ease of obtaining legitimate or apparently legitimate phentermine means that people are reluctant to attempt to purchase it online.
The potential for online pharmacies is very large, given the significant market for prescription drugs in the United States. According to a recent survey by pew research approximately 45% of Americans take prescription drugs regularly while another 27% take them occasionally.
This means that a total of 72% of Americans take prescription drugs either regularly or in the cases where the prescribed to them in a short term basis.
Obesity in the United States and how many people are prescribed
Obesity is a widespread public health problem in the United States in the contemporary period. The National Institutes of Health define obesity as a Body Mass Index (BMI) of 30 or greater, with a BMI of 40 or greater defined as extreme obesity. Meanwhile, a BMI of between 25 and 30 indicates that someone is overweight despite not meeting the definition of obesity.
According to statistics from the NIH, 35.7% (percent) of Americans suffer from obesity while approximately 6.4 percent of Americans are severely obese. These statistics mean that currently 40.1% (percent) of Americans are suffering from obesity with a BMI of 30 or greater, making them potential candidates for Phentermine prescriptions if their physician found it potentially beneficial.
In thirty percent of American states, there is a rate of obesity of at least 30 percent or higher, a percentage that has risen steadily over recent. It is worth noting the body mass index is not a perfect measure of weight or health because it only takes into account height and weight and not the composition of that weight. Muscle cells weigh more than fat cells so somebody with a high amount of muscle mass might have a BMI that renders them obese even though their health profile varies significantly.
It is therefore clear that obesity is one of the most serious public health challenges facing the United States in the present era. Conceivably an increase in the rate of obesity could trigger an increase in the number of a heart attacks strokes and other conditions related to obesity such as type 2 diabetes.
The most commonly recommended method of treating obesity involves increasing exercise and reducing calorie intake, but these methods are often difficult to follow on their own.
The results they produce in patients who do not maintain their vigilance often lasts for only a short period of time. It is not difficult to understand why many people who lose weight through changes and diet and exercise are unable to keep it off.
This has led to the use of drugs like Phentermine – which originated in the United States – for the treatment of obesity in the short term, although Phentermine is approved only for use along with changes in diet and exercise for a short-term period a maximum of twelve weeks. Use of Phentermine over a longer period of time can result in serious side effects as well as dependency on the drug. In rare cases the side effects from long term use of Phentermine can be fatal but this is uncommon for individuals who use the drug as prescribed.
The logic behind prescribing Phentermine along with a changed program of diet and exercise is that the patient will increase their physical activity without consequently increasing their appetite. This means that any calories that a patient burns during exercise will not be overcome by subsequent eating. In other words, this drug is intended to help patients keep weight off during a program of diet and exercise rather than to cause weight loss by itself.
Phentermine’s effectiveness has been demonstrated by the fact that there are approximately four million prescriptions for this medication that are written in the United States each year. This demonstrates the enduring appeal of Phentermine over the course of several decades as it continues to be a prescription drug of choice for physicians and their patients suffering from obesity.
There are also drugs in the US market both past and present that combine Phentermine with another medication. Fen-Phen was a drug combining Phentermine with Fenfluramine, but it was pulled from the market in the late 1990s because the Fenfluramine was found to cause substantial heart valve problems in its users.
Initially the drug was believed by medical practitioners to be a highly effective treatment for obesity. However, in the late 1990s suspicions began to develop regarding the safety of Fenfluramine. In one particular case, a woman who had taken Fenfluramine and Phentermine in combination for only 23 days developed and died from Fatal Pulmonary Hypertension.
A study published in 2002 indicated that the rates of pulmonary hypertension were as many as three times greater among users of Fenfluramine. Phentermine was not found to have contributed to these Health complications meaning it is still available on the market today. Currently, Qsymia – a combination of Phentermine and Topiramate – is marketed by Vivus Pharmaceuticals.
However Vivus Pharmaceuticals has had some difficulties in bringing Qsymia to market, leading to financial losses and a low stock price. In fact at the close of market on March 9, 2017 Vivus pharmaceuticals had a stock price of $1.04 per share, making it in danger of being delisted from the Nasdaq stock market. Unlike phentermine this drug is intended to be taken for a lengthy period of time or perhaps indefinitely, but for some reason it has not caught on with patients was actively seeking to lose weight. In fact in 2016 only about 9000 prescriptions for Qsymia were written each week, forcing Vivus to offer significant discounts on phentermine.
The widespread demand for Phentermine in the United States and the date of its first approval in 1959 means that it is now widely available in the generic form. The brand name “Adipex” is used by Teva Pharmaceuticals for the Phentermine that it markets and sells in the United States. Teva Pharmaceuticals is an Israeli company with a history dating back to 1901, which was established by Jewish Immigrant. In 1951 Teva became one of the first pharmaceutical companies listed on the Tel Aviv Stock Exchange.
In 1976 it was combined with several other Israeli drug firms to create the current incarnation of Teva. Currently Teva has a market value of over 30 billion dollars indicating its success in the generic drugs market. Teva has a significant presence in the American market with the Adipex brand, but it is far from the only company currently marketing and selling Phentermine in the United States.
Furthermore the brand-name Adipex is marketed only in the United States as Teva pharmaceuticals markets phentermine under its own generic name elsewhere in the world. One of these companies is KVK-Tech, a relatively new firm that has established a foothold in the Phentermine business, in addition to its generic versions of other popular drugs such as adderall.
KVK Tech is currently based in Pennsylvania. Other companies that produce and market generic Phentermine in the United States are Sandoz, Lannett, and Elite Labs (Top 100 Diet Pills). Sandos is a German based subsidiary of Novartis that produces Phentermine for both the American and European markets. Regardless of the manufacturer all forms of phentermine are chemically identical with the differences being found only in the inactive ingredients that are included in the pill. For example Adipex includes blue dots that distinguish it from its rivals.
Worldwide Information about Phentermine
Obesity is a serious problem not only within the United States but around the world as well. The World Health Organization (WHO) estimates that the problem is becoming more severe globally, with potentially serious financial implications in many countries. According to WHO statistics, in 2030 there will be substantial obesity and cardiovascular disease related costs in China ($555.7 billion), Russia ($303 billion), India ($336 billion) and Brazil ($50 billion).
This represents significant costs for many of the fastest growing economies in the world. In fact these countries collectively have been described as the BRICs, representing the largest and most significant emerging markets in the world. If obesity is a significant problem already in these emerging markets – the countries that are expected to have a significant influence on the future direction of international politics – it is clear that it is a significant challenge throughout the world.
Genetic factors affecting the populations of some of these nations may cause particular serious health consequences for them. For example, studies have demonstrated the presence of genes in much of the Indian population that causes them to carry fat in their abdomens, resulting in a high risk of cardiovascular disease even in the absence of obesity.
Visceral fat are fat located inside the abdomen is much more dangerous from a cardiovascular perspective than that located between the skin and the muscle despite the negative cosmetic effects of this type of fat. India is also a center of the production of counterfeit Phentermine, complicating the efforts of those within its population who are seeking to lose weight. However, India is also one of the largest manufacturing centers for legitimate Phentermine. Therefore, if people in India are vigilant then they may be able to obtain a genuine version of phentermine from a doctor with a prescription.
In many of the wealthiest nations around the world the problem can be particularly severe. For example, in the oil-rich states of the Gulf Cooperation Council, “obesity has reached near-epidemic proportions increasing the prevalence of chronic diseases and driving up health care costs”.
Of all the countries of the world, perhaps one of the most serious cases can be found in the Gulf region, with between 70 to 85 percent of men and 75 to 88 percent of women suffering from obesity respectively in Qatar, Kuwait, and Saudi Arabia. Of these three countries, Kuwait and Saudi Arabia had the worst statistics regarding obesity. Meanwhile, in the United Arab Emirates, the rate of obesity increased rapidly from 1995 to 2000.
No precise statistics are available for the use of Phentermine in the Gulf region, but it is notable that the drug is legal there for prescription use despite the restrictive drug laws prevailing within the country (Narcotic and Psychotropic Control Section). The gulf countries have some of the strictest laws in the world regarding the use of drugs that are controlled with hefty prison sentences and fines for offenders.
The fact that these countries allow the use of Phentermine with the prescription indicates its popularity around the world as well as the severity of the obesity problem that the countries populations are suffering from. This is particularly burdensome because in most of the gulf countries the governments undertake to provide healthcare for all of their citizens.
In Europe, the history of Phentermine is more complex. After the dangers of Fen-Phen (a combination of Phentermine and Fenfluramine) were uncovered in the late 1990s, phentermine was banned from the marketplace. It was only in 2003 that Phentermine became available for purchase again. This indicates a more cautious attitude towards anorectic drugs by European authorities compared to their American counterparts.
Another notable market for Phentermine is Australia, where it is manufactured by iNova Pharmaceuticals under the brand name Duromine. The market for phentermine in Australia is smaller than its American counterpart because Australia’s population of 23 million is less than one-tenth of the 300 or more million people currently living in the United States. New Zealand is also a significant marketplace for phentermine, and the government has sought to collect information about the number of patients being prescribed this drug although little data is available at the present moment.
One interesting fact about the New Zealand phentermine market is that the insurance schemes they’re do not cover it requiring patient to pay between NZ$160 and $200 for their prescription. There is also a significant illegal street market for phentermine operating in many areas of New Zealand, which further increases the government’s concern regarding drug. This does not mean the phentermine it is necessarily dangerous but merely reflects the differing attitudes of different governments towards this medication around the world.
One of the methods that people use to purchase drugs is over the internet, which has become increasingly important in the current global marketplace. This can include illegal online “pharmacies” that offer to sell drugs without a proper prescription, but it also includes legitimate pharmacies as well. Phentermine would be one of the drugs available through these legitimate online pharmacies provided the customer has a prescription.
The precise data for prescriptions of Phentermine both in the United States and worldwide are difficult to calculate, but clues can be found in the data for online searches regarding the drug, as well as from other sources. The only available statistic is a vague number from the National Institutes of Health saying that approximately 4 million Phentermine prescriptions are written annually in the United States.
The following data is available from CVS pharmacy regarding its patients searching for Phentermine:
According to the prescription search statistics, 82.8 percent of those who search for information about Phentermine online are women, and the remaining 17.1 percent are men. The online searches are concentrated in the age groups of 20-40 and 40-60. CVS Pharmacy reports that they fill a significant number of patients’ prescriptions with Phentermine.
As mentioned above, in the Gulf States the obesity rate for women is between 75 and 88 percent, while for men it is only 70-85 percent, meaning that it is conceivable that searches for weight control methods like Phentermine might follow a similar pattern there and in other regions of the world.
Obesity has been a problem that human beings to face throughout the entire history of civilization and before. The discovery of ancient figurines depicting of these people indicates that this is not a new problem but rather one dating back to before the foundations of civilization. The difference is the new drugs like Phentermine are available that can offer somebody the ability to enhance the weight loss that they would normally achieve through diet and exercise.
In essence phentermine when used properly ensures that somebody can gain even more benefit from changing their habits in a positive fashion for this reason the drug has endured four decades since its initial approval in 1959 and remains a staple of the American and international weight loss Market even if statistics for the precise number of prescriptions written in each country are not readily available, except for some relatively limited data available for the United States.
Why has phentermine remained the staple of weight loss medications in the United States and elsewhere around the world since it was first approved in 1959? The answer is that phentermine is an effective method of increasing the amount of weight someone would lose either by itself or as part of a larger pattern of lifestyle changes.
Phentermine status is the ultimate weight loss solution is shown in a recent study by the National Institutes of Health that demonstrates that the greater hunger somebody feels and the less discipline that they have in controlling their appetite the more they stand to benefit from using it. Phentermine literally has the ability to establish discipline and those who need it most ensuring it will remain any effective weight loss solution far into the future.
Obesity is a medical condition characterized by an increase in weight caused by the accumulation of fat (adipose) cells throughout the body. In patients suffering from obesity both the size of fat cells and the number of them both increase. Obesity can be measured using a patient’s waist and their Body Mass Index (BMI), with a result of 30 or higher indicating obesity. Obesity can cause potentially serious or life-threatening complications such as Type II diabetes or heart attack.
It is usually treated with a combination of changes to an individual’s lifestyle such as diet and exercise, but sometimes this is not sufficient. This is why doctors and their patients have turned to Phentermine to assist in weight loss, and why this drug is currently the most popular weight loss medication worldwide.
Obesity and weight loss is not a new problem that only affects human beings in the modern era who life sedentary lifestyles. In fact, the earliest record of individuals suffering from obesity may come from archaeological finds in the Golan Heights which date back 200,000 years, and were initially thought to be icons rather than depictions of human beings.
However, the presence of more recent artifacts depicting individuals in Germany dating back between 25,000 and 30,000 years ago, demonstrates that these figurines may indeed be representations of living people suffering from this condition during the Paleolithic period. Many of these early figures depicting obese individuals were women. More recent sculptures depicting obese individuals have been found at archaeological sites in Turkey.
There are also depictions of obese figures found in ancient Egyptian archaeology, and Queen Hatshepsut may have suffered from the condition, according to at least one researcher. This contradicts a commonly held belief that our ancestors typically 8 balance diets when left to their own devices and that modern civilization is solely responsible for obesity. However, just because obesity itself is not a new problem, it does not mean that the modern age has not made this problem much more serious.
There are also other reports about obesity from sources in the ancient world. In Ancient Greece Hippocrates noted the problem of obesity was prevalent among individuals who consumed too much food, particular among the Scythian tribe.
He was not the only figure from antiquity to describe obesity, as the historian Plutarch also noted individuals who were suffering from it. Obesity also attracted considerable attention from physicians, scholars, and other observers from the renaissance to the Victorian age.
One of the most noted observers of obesity was Dr. William Wadd (d. 1829) who conducted autopsies of obese individuals and published the results, and recommended a diet to help with the condition.
In order to properly understand obesity as well as medical treatment such as Phentermine that are intended to address it we need to understand that obesity itself is a very old problem. Obesity then is not a new problem but one that has been around as long as human beings have walked the earth. When phentermine was first patented it offered to solution to a problem that had plagued individuals for centuries in different societies around the world.
In the contemporary era, obesity is one of the most widespread and serious public health issues in the United States and in many countries around the world. As mentioned above, obesity has a long history in human societies, but its present prevalence among a large portion of the population if a feature of the contemporary period. Modern sedentary lifestyles are particularly conducive to the prevalence of this medical condition.
Obesity occurs when a person consumes more food than they take in, resulting in the body storing the excess energy from the food in additional fat tissue. In 2013, the World Health Organization decided to formally recognize obesity as a disease rather than simply a health condition caused by the excess consumption of food. That same year, the American Medical Association followed suit by recognizing obesity as a disease as well.
The historical prevalence of obesity throughout human societies during both the pre-modern and modern eras has led to a variety of methods for treating this condition. This essay will explore the history and background of Phentermine, an anorectic medication that is one method that is widely employed for treating obesity in the contemporary period.