America has become a society obsessed with appearance, especially weight.

We are conditioned at a young age to believe the only way to be normal is to be
thin. This norm is projected to millions of Americans each day through
television, magazines, billboards and every other form of media and advertising.

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How are people to know acceptance and happiness with themselves and others when
our culture propagates what the perfect body should be.

It is the search for the elusive, perfect body that has created a thirty-
three billion dollars a year weight loss industry. Yet few reduce their body
fat and even fewer maintain their weight loss beyond two to three years. This
leads to yo-yo dieting and increased low self-esteem of people constantly
struggling to become what they see as a normal member of society.

A problem that lies within this problem, is the chronically obese person.

Obesity is when one’s body wieght is 25-30% above normal. While overweight is
20-30 pounds over normal. Most people, including health care providers see
the problem with obesity as eating too much and exercising too little. But in
truth, for many obese people the problem lies with genetic predisposition,
metabolic problems, binge eating or sometimes all. These factors make dieting
virtually impossible because these problems are not ones that can be solved by
simply cutting calories. Especially the problem of binge eating.

Compulsive “binge” eating in the obese is not caused by just wanting to eat.

The want to eat is caused by looking for a sense of security. A sense of
security wanted because there are poor or no coping skills for stress or
depression and low self-esteem. Therefore, when a compulsive overeater or binge
eater diet, the diet is doomed to fail because the weight returns when the
person resumes normal eating. Thus creating an even greater depression.

Now many obese people have medical research to turn to as to why the weight
they lost usually comes back. Recent research has strongly backed the set-point
theory, which says that when an individual loses weight, the body’s metabolic
rate adjusts in order to return to the baseline weight.

Research with animals has revealed a protein called leptin. Leptin
circulates in the blood and signals the set point mechanism in the brain, which
tells how much fat is present in the body. The protein is believed to be
produced by an obesity gene called ob. When leptin is injected into rodents, it
lessened appetite and increased calories being burned. However, leptin is still
very much in early experimental stages, because even though it may gauge how
much fat you have it does not at this point tell how much you want.

Another recent breakthrough was the discovery of unocortin. Unocortin
appears to suppress appetite when the body is under severe stress. It is a
cousin of the brain chemical that generates the body’s “fight or flight”
response. Unocortin was discovered at the Salk Institute, when a researcher was
studying a neuropeptide which activates body stress reactors. He noticed
receptors in parts of the brain where the chemical did not exist. However, it
may be a long time before unocortin is actually a consumer drug. At this time,
the only way unocortin works is to be directly injected into the brain. A
company called Neurocin Biosciences, is already researching the brain receptor
unocortin locks onto to work.

For now, the serotonin reuptake inhibitor drugs are the only diet drugs
being used in the U.S. These drugs work by affecting eating behavior. Eating
behavior is the result of a mixture of neurotransmitters. The link between
serotonin and eating disorders was discovered in the early 1980’s. The
serotonin inhibitors include Lovan, Redux and phen-fen (Phentermine and
Fenfluramine). Phen-fen is the drug combination currently recieving so much
attention. Phentermine is similar to an amphetamine and it works to increase
metabolic rate. Fenfluramine(brand name Pondimin) in-creases the serotonin
level, which decreases appetite. However, neither drug works alone. They only
have optimum effect together.

Phen-fen is how I became interested in the research of new obesity drugs.

I first learned of phen-fen in June. The article I read in the Knoxville paper
about people who had taken the medicine, showed it to be what I and many others
had been waiting for. I finally believed my real chance to lose weight had
arrived. So with real anticipation, I made the two and half hour drive to
Monticello, Kentucky. My first month on the medicine was great, I lost fourteen
pounds and completely lost any desire to eat. The compulsion I normally felt
late at night to snack was gone. My problem with phen-fen began the second
month, when I started experiencing depression. One of the possible side effects
mentioned was depression in people who had suffered clinical depression or were
prone to depression. I knew this when I started the medicine, but I thought
anything was worth risking if it meant losing weight. By the third month, the
depression was worse and I had to make a decision. Was it really worth losing
weight if it meant losing my mental stability?
I decided it was not worth it to me. When I made the decision, I could not
believe the choice I made. My whole life has been spent wishing I had a
different body. I thought that losing weight was somehow going to solve every
problem I had. But when I realized I did not want to be depressed again, I
realized that thin people have problems to and my problems would exist no matter
what the size tag in my clothes read.

After I quit taking the medicine, the urge to eat whether I was hungry or
not did return. But I have continued to fight the urges and so far have only
gained a couple of pounds back from what I lost. Perhaps the thing I most of
the medicine, was the energy and the feeling of motivation.

Other side effects of phen-fen are dry mouth, dizziness, short-term memory
loss, and in some the serious problem of pulmonary hypertension. The New
England Journal of Medicine presented an editorial on the benefits and risk of
phen-fen and other drugs in this class. The physicians who wrote the article,
wrote that considering the health risks of obesity for some, that the possible
risk for pulmonary hypertension did not outweigh the benefits of the drugs if
used appropriately.

Overall, I am glad I took the risk to try phen-fen. There was always the
posibility that the medicine might have worked for me. But I am also glad that
I have an understanding of the body’s metabolic nature and was able to recognize
my symptoms for depression. For many others, the lack of understanding of what
is going on in their body is why many who have tried phen-fen have not been
successful with their experience. Therefore, it is the physician’s
responsibility to completely inform clients of all possible side effects and to
thoroughly explain to them what is going on in their body while they are taking
the medication. It is also anyone’s responsibility who is serious about taking
any medication of this sort, to find out for themselves what is going on and
what could happen.

In this paper I have outlined various physical causes of obesity and
possible treatments for the physical factors. But medication, exercise, healthy
diet, none of these things will effectively cause permanent weight loss until a
person is ready to be happy with their body and their overall self. You cannot
successfully lose weight if you think your life is suddenly going to get better
after the weight is gone. You have to want to do it because you love yourself
and you want a healthier body. I think this is the most important thing I have
finally learned about life and about myself. I hope that in the future there
will be a time when people are not judged by their appearance, therefore those
that think a different body will make them happy, will finally be able to be
believe their worth is based on who they are and not what they look like.