Forget the fountain of youth, the pot of gold, the Holy Grail - what the masses really want is a way to lose weight without torturous hunger pangs or nagging food fantasies.
Have scientists finally found it? Maybe.Ever since a 1992 study showed that a combination of appetite suppressants - fenfluramine and phentermine - can help obese people lose weight and keep it off, demand for the drugs has soared. This year, the Food and Drug Administration approved a similar drug, dexfenfluramine - marketed as Redux - which can be used over a more prolonged period.
The drugs work by releasing a brain chemical called serotonin, which reduces appetite and allows users to cut back on their food intake more comfortably.
Despite side effects such as dry mouth and drowsiness, sales surged 70 percent between 1994 and 1995. Some 4.4 million people are using the fen-phen combination, at a cost of about $2.30 a day. Redux costs about $2.40 a day.
For one-tenth the price, over-the-counter appetite suppressants such as Acutrim and Dexatrim might seem a better alternative. But while such diet aids may help with short-term, "cosmetic" weight loss, they don't have the sustained effect of the prescription drugs, says James Merker of the American Society of Bariatric Physicians, a group of obesity specialists.
The prescription pills are not for every seeker of slimness. Candidates should be at least 20 percent above their healthy body weight. Still, that leaves about 58 million potential users.
With Redux, patients run a slight risk of pulmonary hypertension, a life-threatening condition. People with a history of that disorder should not take Redux, and those who are taking certain other medications, including antidepressants, should not take either fen-phen or Redux.
The prescriptions may be covered by insurance if deemed medically necessary, DiBartolomeo says. But many insurers are still reluctant to cover the drugs - a position that may change as more begin to view obesity as a long-term illness, says Dr. Robert Kushner, director of the Nutrition and Weight Control Clinic at the University of Chicago.
And the bottom line, of course, is that you still must employ those old standbys, diet and exercise, for the regimen to work.
"It's really a weight-control plan that incorporates drug treatment," Kushner says. "People have been led to believe it's a cure, a breakthrough - and it's not."