Teenage obesity is a growing problem. Not only does it make teens susceptible to type 2 diabetes, but it’s also very hard on the teens themselves, who are often bullied or ostracized because of their weight. What can a doctor do when a teen can’t seem to lose weight with diet and exercise?
One physician has found success with such patients by prescribing Adderall, an amphetamine that’s normally used for attention-deficit disorder.
Dr. Fuad Ziai, a pediatric endocrinologist, has prescribed Adderall to over 800 overweight children and teens, more than ninety percent of whom have lost weight. He believes that the drug, combined with Glucophage, has helped the children avoid type 2 diabetes and he believes that there was no other option.
The ADA publication DOC News quotes Dr. Ziai as saying, “What we have noticed is that once they begin to lose weight, following failure after failure, suddenly there is an increase in self esteem and confidence. As a result of this positive development, they begin to do things on their own about exercise and diet. This establishes a virtuous cycle in place of the vicious cycle they were in before.”
Dr. Ziai’s concerns about obesity among young people are borne out by statistics from the National Health and Nutrition Examination Surveys: the prevalence of overweight among children and adolescents is 16 percent among girls and 18.2 percent among boys.
But is it really a good idea to prescribe amphetamine to children off-label? Adderall is classed as a Schedule II controlled substance because of its potential for addiction and abuse. After its introduction in the mid-1950s as a weight-loss drug based on an older drug named Obetrol, Adderall counted pop artist Andy Warhol and Beat Generation icon Neal Cassidy among its frequent users. Later, Adderall was re-purposed into a treatment for childhood attention-deficit disorder.
Adderall is hugely popular on college campuses as a study aid because of its speed-like effects. Just recently, former Vice-President Gore’s son was arrested with it in his possession without a prescription; he was driving 100 miles per hour at the time. On the other hand, Adderall has apparently helped hundreds of teens lose weight under medical supervision without ill effect. Whether Dr. Ziai is doing the right thing is certainly debatable.
Source: CNN.com. Go to www.cnn.com and search for Adderall Ziai
Diabetes Heath Board Member Checks In
Editor-in-Chief Scott King interviewed Keith Campbell, RPh, CDE, about using amphetamines to help children lose weight. Campbell, a professor of pharmacy at Washington State University who has lived with type 1 for 49 years, have a surprisingly candid answer.
Scott King: Dr. Ziai is a pediatric endocrinologist who is putting his overweight kids on Adderall – and sometimes metformin – and they are losing weight and feeling good. Of course, Adderall is speed. People criticize him, but he says there’s nothing else that works and his patients are losing the weight. What’s your reaction to that?
Keith Campbell: Well, if it works, then I think it’s a good idea. Remember, drugs either speed up or slow down normal physiological reactions. So, if you speed up normal physiological reactions, you’re going to have some side effects, and if you slow them down, you’re going to have some side effects.
A good way to look at drugs is to find the balance between the effect and the side effects. If the side effects are greatly outweighed by the beneficial impact of the drug, then we’re willing to tolerate them a bit. And I think people who think that way, like this physician, are doing everybody a service to kind of check that out. Since Adderall isn’t approved for weight loss in children with diabetes, there is a little bit of legal risk and so on, but the thinking makes sense.
Read Patient Advocacy Advisor Joan Hoover’s response to this article.