Hi, everybody!
Does anyone know a safe replacement for phentermine?
I'm looking for something over the counter. My physician refuses to give me a prescription for phentermine as last time I had some unpleasant side effects.
An appetite suppressant is exactly what I'm looking for. Such pills help maintain my weight within the acceptable limits.
Please give me a hint if you know something.
Hi Rita,
Phentermine works by stimulating the hypothalamus to secrete neurotransmitters such as catecholamines (dopamine, norephinephrine, etc.), inhibiting the appetite-stimulating NPY neurons. As I wrote in my post on the
Hypothalamic Hypothesis, the NPY neurons are "orexigenic" because they inhibit the "anorexigenic" POMC neurons which normally secrete α-MSH and activate satiety and increased fat burning. In short, phentermine shifts the balance towards satiety and fat burning. So you eat less and become more active, shedding pounds.
The problem is that this only works as long as you continue to take phentermine. And there are two problems with that. The first problem is that you have to keep taking phentermine or even increasing it to maintain the results. The second problem is that a tolerance often develops and phentermine stops working as well. That's because the hypothalamus starts depleting your supply of catecholamines and down regulating receptors. The balance between NPY and POMC starts to shift back. Now if you stop taking the drug, you will actually get fatter than where you started. This new problem can in turn be temporarily dealt with by taking additional supplements like amino acids and "D5", as explained in
this linked article. But now you are adding bandaids to bandaids, treating side effects by creating new side effects.
This is the problem with taking any drug: you get a short term benefit, and long term you prune the neurons you need most in your hypothalamus -- the POMC/CART neurons (which enable satiety and increase your energy level) and dopamine receptors, which register an overall sense of pleasure and well being.
A better plan is to use hormesis! Apply a stress to stimulate the growth of new POMC receptors and dopamine receptors, and cut back on the activity of appetite stimulating NPY/AgRP receptors. You want to make a long term, permanent, change in your hypothalamus, not a short term change in neurotransmitters that will cause a backlash. This is laid out in my post, "
Change your receptors, change your set point". You can read the science there, but if you want to skip it and get to the punch line, just scroll to the bottom of that post and read the recommendations under "How to up regulate your receptors" and "The receptor control theory". I won't give away the secrets here, but will let you enjoy that article.
Isn't it better to go for a permanent solution by rewiring your brain to strengthen its ability to respond to food in a positive way?
Let me know what you think.
