# Why can't they make an anti-hunger pill? **URL:** \ **Category:** Factual Questions\ **Created:** [June 16, 2011, 2:32pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691 "2011-06-16T14:32:59Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![lazybratsche](https://avatars.discourse-cdn.com/v4/letter/l/ba8739/32.png) [@lazybratsche](https://boards.straightdope.com/u/lazybratsche)\ **Post date:** [June 16, 2011, 4:56pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/21 "2011-06-16T16:56:31Z")
> [@Wesley\_Clark](#): > > There are a variety but they all either have bad side effects or stop working after a year or so. Hunger involves various channels, and if one stops working due to a drug another one just seems to overcompensate. > > Obesity is pretty hard to control medically. What has been found lately is that after you lose weight and your biochemistry gets all screwy, taking supplemental leptin can help reverse all those changes so you can stabalize at a lower weight. So there might be promise in leptin as a weight maintenance drug, since maintenance is really where all the problems lie. Most people can lose weight, they just can’t keep it off for more than a few years. > > [http://www.medpagetoday.com/PrimaryCare/Obesity/9896](http://www.medpagetoday.com/PrimaryCare/Obesity/9896) Leptin is a protein that wouldn’t survive a trip through the gastrointestinal tract, so it’d have to be administered by regular injections, or perhaps an implanted device. There is precedent for either of those (plenty of people manage to treat themselves with insulin injections or a pump). Still it’s a long way from being a magic over-the-counter diet pill. ---
**Author:** ![Patty\_O\_Furniture](https://avatars.discourse-cdn.com/v4/letter/p/96bed5/32.png) [@Patty\_O\_Furniture](https://boards.straightdope.com/u/Patty_O_Furniture)\ **Post date:** [June 16, 2011, 6:28pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/22 "2011-06-16T18:28:29Z")
> [@kenobi\_65](#): > > And, it works best if taken in combination with a lower-fat diet…if you eat fatty foods while taking Alli, the fat just passes right on through, with potentially messy results. :eek: ISTM that if people could manage a low fat diet in the first place, they wouldn’t need Alli. ---
**Author:** ![purplehorseshoe](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/purplehorseshoe/32/2996_2.png) [@purplehorseshoe](https://boards.straightdope.com/u/purplehorseshoe)\ **Post date:** [June 16, 2011, 7:29pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/23 "2011-06-16T19:29:24Z")
I’m guessing the side effects of eating more fat than you should while taking the stuff provide an extra incentive . . . ---
**Author:** ![Lestrade](https://avatars.discourse-cdn.com/v4/letter/l/94ad74/32.png) [@Lestrade](https://boards.straightdope.com/u/Lestrade)\ **Post date:** [June 16, 2011, 7:50pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/24 "2011-06-16T19:50:58Z")
> [@robert\_columbia](#): > > Dexatrim was an amphetamine. Dextroamphetamine, if I recall, and not much different from Meth. No, [dextroamphetamine](http://en.wikipedia.org/wiki/Dextroamphetamine) is the “right-handed” stereoisomer of _amphetamine_. It is still available in the US by prescription, but I understand that it is losing market share. It is available as a generic, if you can find a pharmacy that stocks it. Very different from meth. > [@yabob](#): > > A stereoisomer of methamphetamine. Under trade names dexedrine, benzedrine, and methedrine, the amphetamines were available in OTC medications until the mid 1960s, when they started becoming increasingly regulated, the level of abuse being very evident. You had appetite supressants, stay awake pills and benzedrine or methedrine inhalers for nasal decongestants. People would abuse the latter by taking the inhaler apart and chewing on the amphetamine soaked strips in them. [Levomethamphetamine](http://http://en.wikipedia.org/wiki/Levomethamphetamine) _is_ an isomer of meth. It has no recreational uses that I know of and seems to be available over-the-counter. It’s possible that some companies once sold racemic methamphetamine, but that would have been very illegal. That doesn’t mean it didn’t happen, of course. If anyone can point me in the direction of an article or book on this I would love to learn more. It would be a great factoid to drop into talks for historic perspective. As for the larger question of why we can’t make drugs to do _X_ if we can do _Y_, well, we only know how to make drugs that target a tiny fraction of what we would like to affect. Modern medicine has far more stories of exploiting accidents than it does of intentional design of novel function. ---
**Author:** ![Lestrade](https://avatars.discourse-cdn.com/v4/letter/l/94ad74/32.png) [@Lestrade](https://boards.straightdope.com/u/Lestrade)\ **Post date:** [June 16, 2011, 8:58pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/25 "2011-06-16T20:58:23Z")
> [@Lestrade](#): > > [Levomethamphetamine](http://http://en.wikipedia.org/wiki/Levomethamphetamine) _is_ an isomer of meth. It has no recreational uses that I know of and seems to be available over-the-counter. It’s possible that some companies once sold racemic methamphetamine, but that would have been very illegal. That doesn’t mean it didn’t happen, of course. If anyone can point me in the direction of an article or book on this I would love to learn more. It would be a great factoid to drop into talks for historic perspective. It turns out Wikipedia has a little information on the subject, but no citations. [Benzedrine](http://en.wikipedia.org/wiki/Benzedrine) was the exact sort of racemic mixture I had in mind, sold as a bronchodilator. According to the Wiki page linked above Benzedrine was made prescription-only in 1959. Methedrine was a brand name for Pervitin, as in Methamphetamine. **yabob** , I recognized the first drug you mentioned, jumped to an unwarranted conclusion and acted like a jerk. Sorry about that. ---
**Author:** ![ladyfoxfyre](https://avatars.discourse-cdn.com/v4/letter/l/ad7895/32.png) [@ladyfoxfyre](https://boards.straightdope.com/u/ladyfoxfyre)\ **Post date:** [June 16, 2011, 9:48pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/26 "2011-06-16T21:48:11Z")
> [@Patty\_O\_Furniture](#): > > ISTM that if people could manage a low fat diet in the first place, they wouldn’t need Alli. A couple high-fat meals while taking Alli probably acts as a conditioning mechanism as well. So in addition to conditioning you to not eat a high fat diet, it also inhibits the absorption of what fat is included in the diet. ---
**Author:** ![pohjonen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pohjonen/32/423_2.png) [@pohjonen](https://boards.straightdope.com/u/pohjonen)\ **Post date:** [June 16, 2011, 10:53pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/27 "2011-06-16T22:53:04Z")
Back in the 60’s when I was a relative youngster my doctor got me started on uppers by prescribing Ambar #2. It was quite effective as an appetite suppressant, plus you didn’t eat because you were very busy out waxing the driveway or doing your budget for the next 80 years. There were also “diet doctors”. I remember all the housewives where I worked went to one to get their uppers, white ones, black ones and pink ones. He’d just give you the pills and a vitamin shot and say, “See you next week skinnier.” I used to call him Dr. Charlatan. These things did work. I was thinner, but I didn’t have any friends since uppers always made me bitchy. Never hungry, but bitchy. Does anyone else remember Whites? Those were the black market “diet pills” back in the day. I’m sure none of those things were good for you, but I don’t remember anyone going the way of meth heads today. I gave all of that up after about the age of 25. If they could invent something that worked that well without the negatives, someone would be making a fortune. And we would all have very clean houses. ---
**Author:** ![Rachellelogram](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rachellelogram/32/8689_2.png) [@Rachellelogram](https://boards.straightdope.com/u/Rachellelogram)\ **Post date:** [June 16, 2011, 11:06pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/28 "2011-06-16T23:06:37Z")
My grandma won a huge cash settlement from the [fen-phen fiasco](http://en.wikipedia.org/wiki/Fen-phen)–not sure how huge since she had to sign a hush agreement to accept it, but I believe it was \>100k given her lifestyle following the payout. No diet pill comes without consequences. ---
**Author:** ![yabob](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/yabob/32/2821_2.png) [@yabob](https://boards.straightdope.com/u/yabob)\ **Post date:** [June 16, 2011, 11:11pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/29 "2011-06-16T23:11:35Z")
> [@Lestrade](#): > > It turns out Wikipedia has a little information on the subject, but no citations. [Benzedrine](http://en.wikipedia.org/wiki/Benzedrine) was the exact sort of racemic mixture I had in mind, sold as a bronchodilator. According to the Wiki page linked above Benzedrine was made prescription-only in 1959. > > Methedrine was a brand name for Pervitin, as in Methamphetamine. > > **yabob** , I recognized the first drug you mentioned, jumped to an unwarranted conclusion and acted like a jerk. Sorry about that. No biggie. You did point out that I shouldn’t have said stereoisomer of METHampthetamine. And it was prescription only a few years before I thought. ---
**Author:** ![SeaDragonTattoo](https://avatars.discourse-cdn.com/v4/letter/s/df705f/32.png) [@SeaDragonTattoo](https://boards.straightdope.com/u/SeaDragonTattoo)\ **Post date:** [June 17, 2011, 6:16am UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/30 "2011-06-17T06:16:50Z")
> [@kayaker](#): > > My neighbor’s dog is on phenylpropanolamine, so apparently it is available for veterinary use. If you don’t mind liver flavor.😉 It’s for canine urinary incontinence, so you can get some if your dog can’t hold it. Though you may be really motivated to give it to your dog… And don’t forget, you can still get pseudoephedrine OTC, you just have to show ID and sign for it at the pharmacy counter. It’s the only decongestant that works for me when I have a cold. It’s also good for when I’m tired and have to get through a shift at the ER, and I’m also not usually hungry when I take it (no surprise, stimulant). I use the 12-hour caplets. I don’t know why so many people are resistant to just getting the stuff from the pharmacist. I don’t care, I’m not making meth, and I want the stuff that works, dammit. ---
**Author:** ![gatorslap](https://avatars.discourse-cdn.com/v4/letter/g/bb73d2/32.png) [@gatorslap](https://boards.straightdope.com/u/gatorslap)\ **Post date:** [June 17, 2011, 6:40am UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/31 "2011-06-17T06:40:44Z")
Does nobody remember ephedrine? It was all the rage for a while, and then the FDA started restricting it. Definitely an effective appetite suppressant. You can still get it, but they can no longer market it as a diet supplement. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [June 17, 2011, 2:03pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/32 "2011-06-17T14:03:28Z")
> [@SeaDragonTattoo](#): > > And don’t forget, you can still get pseudoephedrine OTC, you just have to show ID and sign for it at the pharmacy counter. It’s the only decongestant that works for me when I have a cold. Doesn’t work for me. ☹ ---
**Author:** ![Hermitian](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hermitian/32/470_2.png) [@Hermitian](https://boards.straightdope.com/u/Hermitian)\ **Post date:** [June 17, 2011, 2:05pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/33 "2011-06-17T14:05:07Z")
> [@SeaDragonTattoo](#): > > And don’t forget, you can still get pseudoephedrine OTC, you just have to show ID and sign for it at the pharmacy counter. It’s the only decongestant that works for me when I have a cold. It’s also good for when I’m tired and have to get through a shift at the ER, and I’m also not usually hungry when I take it (no surprise, stimulant). I use the 12-hour caplets. I don’t know why so many people are resistant to just getting the stuff from the pharmacist. I don’t care, I’m not making meth, and I want the stuff that works, dammit. Yes, that is what somewhat prompted this thread. I have terrible nasal congestion problems so I was used to taking 240 mg of pseudoephedrine a day for years. I’ve always been a thin guy. So I’ve had nasal surgery lately and so I’ve been trying to cut back on the amounts of pseduo-e that I take, so I halfed my dosage. SO HUNGRY! EAT FOOD NOW! I am kind of wondering if my body will eventually re-adjust to normal or will I stay like this. ---
**Author:** ![Peremensoe](https://avatars.discourse-cdn.com/v4/letter/p/ce7236/32.png) [@Peremensoe](https://boards.straightdope.com/u/Peremensoe)\ **Post date:** [June 17, 2011, 2:33pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/34 "2011-06-17T14:33:34Z")
I suggest you take up smoking. ---
**Author:** ![MeanOldLady](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/meanoldlady/32/10737_2.png) [@MeanOldLady](https://boards.straightdope.com/u/MeanOldLady)\ **Post date:** [June 17, 2011, 3:03pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/35 "2011-06-17T15:03:28Z")
> [@kenobi\_65](#): > > And, it works best if taken in combination with a lower-fat diet…if you eat fatty foods while taking Alli, the fat just passes right on through, with potentially messy results. :eek: Indeed! I remember my curiosity being piqued by Alli’s claims of being the first weight-loss pill approved by the FDA, and going off on a quick Google bullshit-detection excursion and found some of the side effects were oily discharge (egad!) and hard to control bowels. > [@Patty\_O\_Furniture](#): > > ISTM that if people could manage a low fat diet in the first place, they wouldn’t need Alli. It always amuses me when weight loss pill commercials say something like “Combined with a healthy diet and exercise, our Miracle Product will blah blah blah.” Hey, how about I skip your Miracle Product and just sign up at Bally’s since you’re telling me that’s what I need to do anyway? I thought the whole point of these drugs were to shed the points without the work. Alli’s own website says its usage should be part of an overall plan which includes changing your attitude about your health and food, eating healthier and becoming more physically fit. Right. Anywho, there’s a product line out now called FullBar, some of whose products actually get pretty decent reviews on Amazon and might actually help people feel full. ---
**Author:** ![SeaDragonTattoo](https://avatars.discourse-cdn.com/v4/letter/s/df705f/32.png) [@SeaDragonTattoo](https://boards.straightdope.com/u/SeaDragonTattoo)\ **Post date:** [June 17, 2011, 9:44pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/36 "2011-06-17T21:44:36Z")
> [@MeanOldLady](#): > > Indeed! I remember my curiosity being piqued by Alli’s claims of being the first weight-loss pill approved by the FDA, and going off on a quick Google bullshit-detection excursion and found some of the side effects were oily discharge (egad!) and hard to control bowels. Remember those potato chips that were supposed to be fat-free, made with some crap called olestra or something? Some woman sued the company because she ate a whole bag (“hey, they’re fat-free!”) and then was at a store and she shit herself, explosively and uncontrollably, right in the store? I still think that’s funny. The release of Alli made me think of those chips. ---
**Author:** ![Acsenray](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/acsenray/32/4519_2.png) [@Acsenray](https://boards.straightdope.com/u/Acsenray)\ **Post date:** [June 17, 2011, 9:55pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/37 "2011-06-17T21:55:09Z")
> [@SeaDragonTattoo](#): > > I still think that’s funny. The release of Alli made me think of those chips. It’s essentially the same principle. ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [June 17, 2011, 10:30pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/38 "2011-06-17T22:30:39Z")
> [@MeanOldLady](#): > > … I thought the whole point of these drugs were to shed the points without the work. … No … The whole point of these pills is to sell pills to people who want desparately to \*beleive \*that it’s possible to lose weight without the work. Whether the pills are effective or not is 100% optional in the eyes of the marketers. The “diet & exercise also required” verbiage you’re seeing is the weakest they can get away with under the current FDA guidelines. And it’s about 10x more realism in advertising than was required 3 years ago. ---
**Author:** ![Busy\_Scissors](https://avatars.discourse-cdn.com/v4/letter/b/d78d45/32.png) [@Busy\_Scissors](https://boards.straightdope.com/u/Busy_Scissors)\ **Post date:** [June 17, 2011, 11:00pm UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/39 "2011-06-17T23:00:40Z")
There are two approaches to drugging the obesity problem. First is the upstream approach, you try and disrupt fat uptake from digested food - current drugs are tetrahydrolipstatin derivatives already mentioned (GSK’s Alli etc). Work to a small extent but pretty uncomfortable side-effects AFAIK. The more sophisticated, downstream approach is to tackle the body’s reward systems at the CNS level and try and come up with a safe appetite suppressant. The great white hope of the pharma industry in this regard was a drug out of Sanofi-Aventis called [Rimonabant](http://en.wikipedia.org/wiki/Rimonabant), a cannabanoid receptor antagonist. Given the primitive level of precision enjoyed by your typical small molecule CNS agent, you might think this an optimistic approach, and you would be right. Nonetheless, there was massive expectation surrounding the development of rimonabant, because if you can get a pharmacological grip on the fatties’ addictive behaviour it’s a small step to smokers, gamblers, boozers etc etc. It would be a license to print money. These dreams were effectively still-born though, as it never got approval in the US from the outset, and was withdrawn in Europe following reports of severe depressive and suicidal side-effects. When a molecule fails like that it can kill the entire field - but it depends on what went wrong, the hypothesis or the molecule. If the hypothesis of cannabanoid receptor antagonism has been shown to be fundamentally flawed then it’s curtains - you have to move on to a completely new biological target. It could be, though, that the idea is still valid but they just had the wrong molecule, in which case another company can come up behind with a better product. I don’t know what is the case for rimonabant. ---
**Author:** ![GrandWino](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/grandwino/32/67_2.png) [@GrandWino](https://boards.straightdope.com/u/GrandWino)\ **Post date:** [June 18, 2011, 12:23am UTC](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691/40 "2011-06-18T00:23:42Z")
> [@SeaDragonTattoo](#): > > Remember those potato chips that were supposed to be fat-free, made with some crap called olestra or something? Some woman sued the company because she ate a whole bag (“hey, they’re fat-free!”) and then was at a store and she shit herself, explosively and uncontrollably, right in the store? > > I still think that’s funny. The release of Alli made me think of those chips. I think Lays still sells chips with Olestra, their low-fat ones (not baked). They do have a warning on the label that they may cause “anal leakage”. :eek: [Previous page](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691.md?page=1) [Next page](https://boards.straightdope.com/t/why-cant-they-make-an-anti-hunger-pill/585691.md?page=3)