weight loss and diet pills

Sometimes, I have new patients come in for a consultation for our weight loss program and when I explain that we use a prescription appetite suppressant, the person will tell me they have to clear this through their physician. Almost 100% of the time, I will never see that patient again. As soon as they mention the word "phentermine" to their doctor, usually that physician will give grave warnings about using appetite suppressants...."they are dangerous". Where does that come from? I have to be honest. I was the same up until I started this program over 6 years ago and heavily researched these medications. In medical school and residency training, we are schooled in the treatment of disease states. We learn very well how to treat diabetes, hypertension, heart disease, etc. We learn how to use drugs to approach these disease states. What we dont learn however is how to PREVENT them. Of course we are taught that if someone is overweight, you need to "tell them to lose weight". But, we are not schooled in HOW to help them lose the weight. You can hand out diet plans, refer people to nutritionists, etc, but these interventions are rarely successful. It is amazing how little we learn about how to approach obesity, which is by far and away the most important risk factor for disease states that kill millions of Americans every year. Physicians universally are not "scared" of prescribing hypertensives, diabetic meds, cholesterol meds, antidepressants, etc. for their obese patients that are walking time bombs for a disastrous medical event, yet most physicians abhor the use of a medication that can help people significantly lose weight. The last I looked, the deaths in America due to phentermine usage is very very small (as a matter of fact, I have not recently read of any cases of death directly attributed to phentermine usage at all) yet deaths in America due to diabetes complications, heart disease, etc are in the millions. So what truly is more "dangerous" for an obese patient? A medication used under strict medical supervision to help a person lose a significant amount of weight or the disease states that accompany the untreated obesity? Many of my colleagues need to take a different look at this situation and realize that their obese patients KNOW already that they need to eat less and exercise more to lose the weight. Handing them a 1200 calorie diet sheet or giving them a name of a nutritionist is not enough. The obese patient often needs more support during the process and a part of this support, initially, can be a "jumpstart" by using , under good supervision, a diet pill.