In humanity’s ceaseless quest to lose weight, the search for a secret weapon continues. Over the course of history these have ranged from laxatives to soap to Lord Byron’s curious combination of copious amounts of vinegar with water alongside a cup of tea with a raw egg in it.
In more recent years, a lot of focus has been placed on medication and supplements. Garcinia Cambogia is in the midst of a surge of popularity, and many manufacturers of sports supplements include all number of weight loss concoctions.
However, in recent months Duromine has leapt to prominence as the weapon of choice for those seeking to shrink their waistline. Marketed in South Africa and many other countries as Duromine, the active ingredient in question is phentermine.
Phentermine is an anti-obesity drug that functions by targeting the part of the brain responsible for the sensation of hunger, as described by the American Society of Health-System Pharmacists.
The hypothalamus, as this area is known, is considered to be one of the most “primitive” parts of the brain because it exists in virtually all vertebrate mammals, but the functions it carries out are actually essential for maintaining life, prompting concern that messing with such an important structure could have serious repercussions.
Read: Exercise not effective for appetite suppression
How it works
The mechanism of action of phentermine is very similar to amphetamine, as the two compounds are pharmacologically similar. This also means that the medication shares much of its features with infamous methamphetamine, or crystal meth/tik.
It is worth noting, however, that the doses delivered through medicines like Duromine (typically 15 or 30mg) are far lower than is required for a drug-like high. Ritalin, commonly used as a treatment for ADHD, is another form of amphetamine in common circulation.
Phentermine specifically focuses on a compound known as TAAR1, the production of which is essential for regulating many important chemicals in the brain. In this case, the important response is the increased production of noradrenaline which is responsible for the body’s “fight-or-flight” response.
This response is the same you experience whenever you feel you are in danger, and puts the body in an altered state that is better able to react to the threat. Specifically, it increases the heart rate, lung activity and general readiness of the muscles.
Additionally, it decreases the function of certain bodily systems that it deems unnecessary, crucially, this includes the digestive system.
In other words, Duromine puts your body in a mild state of “fight-or-flight” in order to capitalise on the appetite suppression that comes with it while avoiding the, potentially severe, consequences that can result from your body being fully alert for long periods of time. In capsule form, the phentermine is mixed with a resin which ensures it is released slowly over the course of an entire day. Capsules are usually taken first thing in the morning so the alertness brought on by it doesn’t affect one’s sleep.
People taking phentermine typically eat just a fraction of the amount of calories they might have without the medication, though it's important not to go below the recommended minimum requirement of 1200 calories a day.
Read: 10 ways to suppress your appetite naturally
The drug has become a key topic in weight loss circles with several dedicated forums available online to discuss the impact and side effects of the drug.
Below are some before and after photos from a Duromine facebook page. However it is difficult to determine whether these are legitimate pictures or used by those looking to peddle the drug online, as is very common.
Medicines that alter a person’s basic brain chemistry should always be approached with caution, but phentermine appears to be relatively well tolerated according to research published in the journal Endocrine.
Indeed, the side effects are very similar to the aforementioned Ritalin. This has helped phentermine-based drugs proliferate in the notorious diet-pill market. Over the years regulatory boards have banned many different brands of diet pill due to the serious health risks they pose, though this has lead to a thriving online black market for them.
The potential for problems is always present however, especially if one exceeds the dosage instructions and abuses the medication. Taking a stronger dose than necessary or taking additional doses later in the day can increase the strength of the fight-or-flight response beyond what the body can safely tolerate for long periods.
In this case, common side effects include insomnia, psychosis, heart palpitations and withdrawal symptoms.
Amphetamines have the potential to be extremely addictive in high doses, a problem compounded by the body’s tendency to increase the tolerance to amphetamines rapidly, forcing abusers to constantly seek stronger and stronger doses, describe Malenka et al in their 2009 book Molecular Neuropharmacology: A Foundation for Clinical Neuroscience.
For this reason, Duromine is not available over the counter in South Africa, requiring a doctor’s prescription. Your doctor will assess whether or not the drug is the solution to your weight problems and whether you are indeed overweight enough to need it.
Futhermore, Duromine is intended as a short-term solution and cannot be taken for over 3 months, as such it is recommended that in the time during which you are taking Duromine you also work to develop healthier eating habits and a more active lifestyle, otherwise you are highly likely to regain the weight as soon as you stop taking the medication.
Readers ask about Duromine in our Expert Forum
Dozens of users have posted questions to our DietDoc regarding Duromine and it's efficacy and safety. DietDoc states in this post:
"The following side-effects can occur with Duromine (which contains phentermine as its active ingredient), as listed in my copy of MIMS: pulmonary hypertension, central nervous system effects including psychotic episodes and hallucinations, cardiovascular effects, gastrointestinal disturbances, problems with urination, rash, impotence or changes in libido, facial oedema and blurred vision.
I would really recommend that you rather use a good diet and exercise to lose your weight. However if you do lose at least 14 kg so that your BMI is back in the normal range, then you should not regain the weight you have lost."