Prime among health concerns for the 21st century is obesity. With 35.7 percent of adults in the United States ranking as obese and another two-thirds considered overweight, the health and indeed financial cost of excess weight is incalculable.
On the case are doctors, scientists, and healthcare professionals from around the world.
"Losing weight is hard, and we need more tools in our toolbox to help patients," Donna Ryan, associate executive director for clinical research at Pennington Biomedical Research Center in Baton Rouge, told USA Today.
But the truth is that finding an effective prescription diet pill is easier said than done. And while people are looking to the established presence of the U.S. Food and Drug Administration for direction, they're often left bereft.
It just takes looking at the thousands of years of history behind weight loss to see that there is no easy solution. From ancient Greece to modern day America, finding an effective weight loss drug has never been simple.
Soranus of Ephesus: 2nd Century A.D.
The Greek physician Soranus of Ephesus holds the distinction of being the first person whose attempts at producing weight loss were recorded. Operating in the second century, Soranus prescribed laxatives and other purgatives to reduce weight, alongside heat, massage and exercise.
Soranus' recommendations became the golden standard for treating weight loss for more than a thousand years.
Weight loss remedies resurfaced in the 1930s, when doctors began seeking an alternate approach to helping people lose excess pounds. They identified the importance of accelerating metabolism, and eventually started to prescribe the industrial chemical dinitrophenol.
While dinitrophenol was successful in speeding up patients' metabolism, it also carried the risk of fever, swelling, and dangerous toxicity levels. Twelve women in San Francisco were even reported by the New York Times to have gone blind after taking the drug.
In fact, the dangers of dinitrophenol were part of the spur to establish the FDA in 1938.
Amphetamines: 1950s and 1960s
Twenty years later, the drug industry tried again with amphetamines. These highly active substances proved useful in both boosting metabolism and suppressing appetite, but were also discovered to increase blood pressure and heart rate.
While some amphetamines-like phentermine-are still marketed in the U.S., they are usually not recommended for use beyond twelve weeks. In terms of the drug industry, amphetamines are rarely included.
Perhaps the drug that most rocked the prescription weight loss boat was Fen-phen. Fen-phen was born in 1992 when one weight loss researcher discovered that the combination of two existing drugs-the previously mentioned phentermine, and fenfluramine-produced a 10 percent weight loss that was maintained for more than two years.
The drug was dubbed "Fen-phen" and was marketed by the corporation Wyeth without FDA approval, yet it garnered more than 18 million prescriptions at the height of its popularity in the mid-90s.
However, a 1996 paper in the New England Journal of Medicine noted that Fen-phen was linked with adverse side effects. At first, Wyeth didn't quite believe the findings.
"Recognizing that both drugs have been available for many years and millions of patients have taken them, we were quite surprised to have this finding, but we take it very seriously," Wyeth medical director Marc. W. Deitch said that August.
By 1997, however, it was discovered that about a third of patients on Fen-phen were developing life-threatening heart disease. It was pulled from the market in September.
Ephedra initially became popular in the wake of the Fen-phen debacle because of its long-established use in traditional Chinese medicine. Ephedra stimulated the brain, increased heart rate, and caused thermogenic responses in the body. It was often used in combination with aspirin and caffeine.
However, in 2004, Ephedra was banned in the United States on clinically-proven risks of heart attack, stroke, and even death.
"Ephedra raises your blood pressure and stresses your system," FDA Commissioner Mark McClellan said at the time. "There are far better, safer ways to get in shape."
Today: Alli, Apidexin, Hydroxycut and Other Supplements
Today, the drug industry still seeks to find that silver bullet that will make excess weight and obesity a thing of the past. Having to jump through so many hoops and comply with strict regulations, however, makes the process slow going.
In its stead, the weight loss supplement and diet pill industry have stepped in. Subject to fewer regulations, the weight loss industry has been successful at both getting people energized about losing weight and actually helping them to obtain their goals.
You've probably heard success stories from people taking the FDA-approved Alli, or the popular supplement line Hydroxycut. Even some lesser-known supplements like Apidexin have raked in their share of awards and devoted customers.
Nevertheless, it's important to do some research on diet pills before you try them. Some supplements contain dangerous or ineffective ingredients, and others are simply too costly to warrant purchase.
There are a number of helpful reviews and analyses online. For example, if you're interested in Apidexin, you can find a well-rounded review at http://www.consumerpricewatch.net/apidexin.
Or for more general information, you can consult groups like WebMD or The Mayo Clinic. The Mayo Clinic website even has a chart of individual ingredients along with clinically-based analyses on whether or not they're likely to work without side effects.
The future of weight loss for now seems to be in the hands of the supplement industry. However, the search for prescription weight loss is still ongoing and industry officials are hopeful.
The trick, according to Louis Arrone of the Comprehensive Weight Control Center at the New York Presbyterian Hospital, is to tackle the root cause of obesity on an individual basis.
"We are going to need many different medications in order to treat obesity effectively in the same way we have many different drugs to treat high blood pressure," Arrone told USA Today. "Some people do better with one medicine, and some people do better with another."
He, like others, suggests that people may need multiple medications to treat multiple symptoms.
Until then, it seems that people seeking weight loss are best left to diet, exercise, and an effective diet pill.