Speed diets crash and burn

20th August 2008

posted in Diets, Health, Nutrition & Fitness |

I’ve mentioned several times here that I have ADD. Like many women with ADD or ADHD, I wasn’t diagnosed with the disorder until adulthood in my early 20s. At the time, I was also in recovery for my eating disorder so my doctor was hesitant to prescribe some of the most common drugs to treat ADD. Why? Because popular ADD drugs like Adderall are amphetamines. And amphetamines, as a side effect, suppress the appetite. The information was news to me, but as Allure magazine reports, its old hat for an increasing number of girls and women who don’t have AD/HD and yet are taking Adderall to induce weight-loss (see also this March ABC story).

Since 2002, the number of prescriptions for all amphetamine-based drugs used to treat ADD — including Concerta and Strattera — have skyrocketed. Sales for Adderall XR (extended release) have more than doubled in the past five years, from 4.2 million in 2002 to 9.5 million in 2007, according to IMS Health, a health-care information company. And online, Adderall ranks right up there with Viagra in most-hawked pharmaceuticals on the Internet; indeed, type in the words “Adderall abuse” and you’re likely to be directed to a site that sells the stuff.

Adderall, a central nervous system stimulant prescription medicine that uses a patented blend of mixed amphetamine salts, is approved solely for the treatment of AD/HD. I began taking Adderall (or as I call it, my legal crack) last fall for my ADD after trying both Concerta and Strattera, which are, I believe, what they fill the candy dishes in hell with. I’ve had no adverse reactions to Adderall, and although I have noticed that I don’t get hungrier until later in the day, I haven’t experienced the mythical weight loss, either.

Once, while speaking with my therapist of the time about my concerns that I had the disorder, she asked me if I had ever tried cocaine. “Of course not! I’ve never even been drunk,” I replied indignantly. My therapist apologized and then explained the question. For people with ADD, stimulant drugs like cocaine do not induce the manic highs seen in people without ADD; instead they feel a sense of mental clarity and a focused sense of normality. This is because ADD sufferers have an imbalance of three chemicals in the brain: dopamine, norepinephrine and serotonin. Cocaine, amongst other things, acts as a dopamine reuptake inhibitor and a serotonin reuptake inhibitor, or in plain speak, it inhibits the absorption of these chemicals so that the synapses soak longer in them. It is the stimulation of dopamine – or pleasure – center of the brain that causes appetite suppression.

For people with AD/HD, the drug is completely safe. But for those abusing the drug, health risks abound. Adderall’s sister drug is crystal meth – both are amphetamines, though with different molecular structures. And since it’s defined as a class II narcotic – the same as cocaine – illegal distribution of Adderall is a felony. My doctor can only prescribe the drug in 30-day prescriptions because it can be both psychologically and physically addictive. My brother used to work for manufacturer Shire Pharmaceutical and he says the warehouse vault the drugs are stored in rivals that of a prestigious bank.

Often people find that they build up a tolerance to Adderall and some long-term users need to take increasing amounts to get the same appetite suppression. High doses of stimulants can result in an irregular heartbeat, dangerously high body temperatures, the potential for cardiovascular failure or seizures and can lead to eating disorders. In 2005 Health Canada (the equivalent of our Food and Drug Administration) suspended the sale of Adderall XR after a manufacturer’s review submitted to the agency found 20 sudden and heart-related deaths and strokes in adults and children taking prescribed doses since the introduction of Adderall in 1994 (Adderall manufacturer Shire Pharmaceuticals disputes this). For others, taking high doses of some stimulants repeatedly over a short period of time have been shown to induce hostility or feelings of paranoia. And appetite suppression is just one side effect of Adderall; there are many more unpleasant ones, including dry mouth, headaches, trouble sleeping and an increased heartbeat. People who have AD/HD usually do not become addicted to Adderall and usually do not need to worry about withdrawal symptoms.

Speed diets are nothing new; Adderall is just the latest drug used by people dying (literally, in some cases) to lose weight. The only difference is, Adderall is easier to obtain – legally or otherwise – than cocaine, crack and heroin.

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This entry was posted on Wednesday, August 20th, 2008 at 11:15 am and is filed under Diets, Health, Nutrition & Fitness. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

1 On August 20th, 2008, Linda said:

That’s fascinating, thanks for this.

posted on August 20th, 2008 at 1:19 pm

2 On August 20th, 2008, Jackie said:

There’s a film called Requiem for a Dream that has a very sad portrayal of a woman, played extremely well by Ellen Burstyn, who becomes addicted to some form of speed diet drug. It really helps you understand, how paranoid and anxious the pills make you feel. Although, I personally found the idea of the refrigerator turned monster at one point, rather campy in sort of a “I know it’s not funny, but that effect is so rediculous and cartoonish I can’t help but laugh.” There also is a very disturbing scene where Ellen Burstyn’s character has to get her stomach pumped. So if that freaks you out, I would suggest not seeing the film.

At one point Ellen Burstyn’s character’s drug addicted son, tells her that what she’s taking to loose weight is no different than if he were to buy Speed out on the street. I wish doctors could understand, that these diet drugs are no less dangerous.

posted on August 20th, 2008 at 1:56 pm

3 On August 20th, 2008, Tori said:

I don’t even take adult OTC medications. I use kids tylenol, kids motrin, and Tums for pretty much all of my problems, including after I had surgery. I’m sure at this point it’s completely psychological but I’ve really never even “advanced” to the adult versions of anything, so I was really, really cautious when my doctor prescribed my anti-anxiety med (Zoloft). Obviously anything can be addictive if not used carefully, but I would be freaked out to try anything addictive like that even once, just because who knows what would happen with my body.

posted on August 20th, 2008 at 2:06 pm

4 On August 20th, 2008, Rachel2 said:

Interesting post, Rachel. I’m glad you mentioned this.

I am one of the women you mention that is in my mid-20’s (25, in fact) that has been recently diagnosed with ADD. I cannot tell you, or anybody, how beneficial being on methylphenidate (generic Ritalin) has been for me! I can focus on tasks, the constant “brain fog” has lifted, and I generally feel like I’m on the right track to making something for myself in life. I was a tad apprehensive at first to go on yet another med, but only a teeny bit, as I researched the hell out of ADD/AD-HD and was finally able to put my finger on WHAT exactly has been going on for these many, many years. This could, indeed, be partially the cause of my disordered eating and anxieties. I am confident in saying that I am on the right track with this medication, and that because of the LEGITIMATE diagnosis and use, I am beginning to pick up the pieces of my life that have been shattered for so long.

To the girls, women, and men who abuse these powerful narcotic stimulants and do so for the sole purpose of suppressing appetite in order to lose weight: These are serious drugs with serious side effects that do occur if not used as intended (i.e. to lose weight rather than put yourself together in an ADD diagnosis). The appetite suppression is mild, and for those not legitimately in need of these powerful Class II drugs, it will cause serious harm.

In my experience, the dry mouth was pretty irritating at first, but I’m keeping myself well-hydrated and mindful of what is going into my body and what is happening with my body as I go through the dose of the drug. It seems less pronounced now than when I first started, but I’ve got a high-stimulus job that keeps me constantly stimulated and so, the effects of the ritalin are less apparent than they were when I was unemployed and in a quiet, focused environment for most of the day. I do find that while on the methylphenidate during a shift, I can focus a whole lot better and keep my train of thought long enough to generally function pretty well. Now, if only I could get there ON TIME so that way I could get that promotion! (Chronic lateness is indeed an affect of AD/HD.)

Nice work, Rachel. Thanks for posting this and opening this discussion. As always, you are witty, intelligent, and very thought-provoking. Thank you.

posted on August 20th, 2008 at 2:41 pm

5 On August 20th, 2008, Rachel said:

as I researched the hell out of ADD/AD-HD and was finally able to put my finger on WHAT exactly has been going on for these many, many years.

SAME HERE. It was such a relief to know that I wasn’t just lazy and stupid, but that there was an actual diagnosis explaining away much of my life!

The appetite suppression is mild, and for those not legitimately in need of these powerful Class II drugs, it will cause serious harm.

Good point. Not only is it relatively mild, it also wears off over time. I’ve steadily increased my medication dosage since the fall (you have to graduate Adderall dosages) and while I experienced appetite suppression at first, over time, the side effect has worn off. So, to keep the same level of appetite suppression, you have to take higher and higher dosages of the drug, which increases both the physical danger of the drug and the likelihood that one will become addicted to it.

I think folks have to ask themselves: Would you take heart medication if you didn’t have a heart problem? Would you undergo chemotherapy if you didn’t have cancer? Why would you then take Adderall if you don’t have AD/HD?

posted on August 20th, 2008 at 2:59 pm

6 On August 20th, 2008, Bree said:

Like Tori, I don’t take OTC medicine except for Lactulose, which is to keep me regular (I have IBS with chronic constipation and Lactulose does not cause cramping like some other laxatives do). My doctor at the time told me to take that instead of Zelnorm. Good thing, because now Zelnorm is one drug they stay away from due to awful side effects. And Lactulose is in liquid form (I have a very hard time swallowing pills and have to crush them to take them).

I use ibuprofen for pain. When I had all 4 wisdom teeth pulled, I was prescribed Vicodin but refused to fill it. The antibotic I was given, Biaxin, makes me nauseous and gives me gag reflexes. I just took generic ibuprofen and it did the trick.

I avoid strong medicines at any cost but I pulled my shoulder one time and was given 1200 MG of Flexerall. For the entire day, I felt like I wasn’t even here. My mind was cloudy, I felt like I walked on air. I will never understand the allure of using drugs when you don’t need them.

posted on August 20th, 2008 at 3:55 pm

7 On August 20th, 2008, Mary Sue said:

I self-medicate my ADD with coffee. When my coworkers comment on my coffee consumption I always bust out with “the other option for self-medication of attention disorders is cocaine”.

posted on August 20th, 2008 at 5:15 pm

8 On August 20th, 2008, La di Da said:

I take pseudoephedrine semi-regularly for my near-constant sinus problems. It does make me lose some appetite, but when I’m off it for a few days my body goes “Whoops! Missing some energy! Eat something!” and so at least it generally evens out over a week to a normal amount of food.

posted on August 20th, 2008 at 5:45 pm

9 On August 20th, 2008, Sara A. said:

I’m the odd woman out here… I’ve been diagnosed ADD since I was 8-10 years old, and I resent it. I wish that I hadn’t been diagnosed at all. Granted, I’ve learned a lot of coping mechanisms over the years, but I would’ve done that anyway had I not been diagnosed. What I remember most about being a kid with ADD is the buzzing behind my ears.. like when the radio is kind of on a station and kind of not. Everything had to come through this static and I didn’t like it at all. I didn’t have as much fun, and I had to hear everything the other kids said. When I was undiagnosed I had a fairly constant dialog going on in my head between my thoughts and what was going on in the room. When I was on the ritalin or later the adderall this didn’t happen and I still couldn’t sit still or do one thing at once. There was that static and the teacher’s voice and the things the other kids were saying behind me and an inability to take it all in. In high school I stopped taking it regularly and my friends commented on the difference in me. I was more serious on the drug, I didn’t laugh as much. Another thing I remember is getting home from school and feeling ashamed for eating and eating and eating after my medication wore off. And after I went off it entirely, my weight spiked and only now, at almost 23 is it beginning to normalize and not feel the need to snack constantly if I’m watching tv or something. I feel like I lost my childhood to ritalin and ADD.

posted on August 20th, 2008 at 11:03 pm

10 On August 21st, 2008, guineapig said:

I have two kids with ADD/ADHD, and both take stimulant meds that are effective. However, one of the most difficult “side effects” for my teen is the rebound-appetite. He isn’t as hungry while his blood levels are still up, but when it begins to wear off … he is starving, eats very quickly (says he feels shakey and panicky), and eats quite a bit.

When they prescribed a small dose in the afternoons to “even him out” and try to provide a smoother transition, he began “night-eating” … waking up in the middle of the night, mostly asleep, and eating lots of everything … leaving the wrappers and evidence (and a big mess) everywhere. He didn’t remember it and was distraught at the weight gain.

Stratterra actually *did* cause suicidality in our 10-year-old, and it was very scary … b/c it was so out-of-the-blue. If he had been older and able to act on the impulses, we might have lost him. It also caused him liver and heart problems and was a nightmare.

Adderrall was the evil candy-dish for both of our boys. They were aggressive and angry, nauseated and vomited daily.

Extended-release concerta and focalin have been our friends. And for those who have a real diagnosis and aren’t drug-seeking for other reasons, it makes such a huge difference.

We can tell for sure if one of them forgot to take their meds … toasters in the fridge, can’t find anything, school papers everywhere and stuffed/left in the garage on the way to the bus, distracted, blurting out, impulsive, physically overactive.

Our psychiatrist said many people “think they’re ADD” b/c we live in a distractable, overstimulated world with too much to do in too little time … and anyone would be more focused with a little bit of ritalin. College students and medical residents have long taken it to study for tests and get through shifts. Just because it makes a person more focused doesn’t mean the person has ADD/ADHD.

posted on August 21st, 2008 at 7:28 am

11 On August 21st, 2008, Rachel2 said:

“SAME HERE. It was such a relief to know that I wasn’t just lazy and stupid, but that there was an actual diagnosis explaining away much of my life!”

It was very exciting AND relieving to realize that I wasn’t lazy or stupid, or even crazy!! It was also very helpful to realize that some of these things were legitimately beyond my control, and that has eased some of the pressure significantly. A book that I read in the beginning that I’ve mentioned here before is “Women with Attention Deficit Disorder” by Sari Solden. Somebody also mentioned “Reviving Ophelia” by Mary Pipher, Ph.D. Although not directly related to the ADD discussion thread, it was also a very good read and is helping me through this process.

Rachel, do you mind if I ask whether or not you feel that the ADD could be one of the underlying roots in your eating disorder? I theorize that because of our lack of ability to control our focus, we found something that we COULD focus on and ran to hell and back with that. That is my theory, and I am wondering if your experiences would back that up. I feel that because this slippery snake has been in the background for so long (since childhood, obviously), that it could have played a part in my development of the anxiety issues and such.

Mary Sue, that’s funny! I work in a coffee shop, and I’m sure that there are some that come regularly to do the same thing. In fact, I’m sure that my own dad has self-medicated with coffee and nicotine for 40 years for his ADD tendencies. I find that I forget to drink the coffee, so self-medicating with it isn’t at all condusive.

Sara, I’m sorry that you’ve lost so much due to your brain abnormalities. I’m actually in the same boat right now. I am gaining some clarity in this mess, and I am realzing how much I have actually lost out on due to attention-deficit disorder, obsessive-compulsive disorder, pre-menstrual disphoric disorder (PMDD – PMS from the tenth level of hell… In fact, I may write about it in my blog…), and then the ‘minor’ ones like seasonal affective disorder and bipolar II disorder. Actually, I will go more in-depth into my blog, but for the time being, I’ve lost a lot. I’m just now finding that there IS more to life than this, but it’s difficult because there is a very intense grieving process that I must go through before I can heal. I empathize with your frustration and pain, though, most certainly.

As far as the ADD/appetite thing… There IS a weird rebound eating effect, and I notice that if I’ve forgotten to take it for the 2nd or 3rd time, I will eat more and want to eat more. I modulate between wanting to overeat and binge (and then want to purge) and/or not wanting to eat at all and maintain that. At the moment, I’m in the eating phase, which is a bit disconcerting, but that also goes in-hand with the premenstrual thing. It also goes with actually menstruating. And I just (as in right now, this very second) figured out that the body DOES need calories during this time to replenish and rebalance itself. You are also right, Rachel, it takes more and more for the appetite suppression effect to work. Similiar to Strattera, Ritalin needs to be graduated up on, which I did in the beginning. I’m glad I did it for a few days at the lower dose, because I would have been bouncing off the walls-NUTS and probably taken myself off of it.

When I’m on it, I’m stabilized. My focus is much improved, and I don’t have this underlying driving need to find something to focus on, which would usually be negative: i.e. anxiety, germs, fat, calories, dirt, contamination… etc…

There was an interesting article on MSNBC concerning the non-prescription use of Ritalin:

http://health.msn.com/health-topics/adhd/articlepage.aspx?cp-documentid=100213191&GT1=31001
Performance Enhancement for the Brain
Do stimulants help you if you don’t have ADD?

Some people take the stimulants illegally to enhance their cognitive performance as well. My answer to the question is: Sure, they can help, but they’ll help like steroids for physical enhancement. Basic idea that I’m prodding at: If it’s not broken, don’t fix it. If your brain works fine without them, then why contribute to this addictive cultural workaholic need?

posted on August 21st, 2008 at 3:59 pm

12 On August 21st, 2008, Sara Anderson said:

I just started taking ADD-type drugs, and it made me stop and wonder how we could be raising an adderall-addled generation that is also extremely obese, considering the appetite-suppressing effects of the drugs.

posted on August 21st, 2008 at 6:24 pm

13 On August 21st, 2008, Rachel2 said:

Well, Sara A, there are a couple of reasons. The appetite suppression is only temporary, and the second reason is that our culture is saturated with stimulus bombardment for profit. From brightly colored cereal boxes to McDonald’s, we are constantly on the go and do not have time to sit down, breathe, and think about things. Companies know this and play on it. They also toy with “Low fat” “100 Calorie Snack Packs” that are all about as nutritionally sound as Saran Wrap. And also, not everybody is on these Adderalls and Ritalins. In fact, outside of myself, I have got one cousin that is on Ritalin. The other cousins and family members that have AD/HD are not taking meds because they feel that they can otherwise function. It seems like we are an Adderall-riddled culture, but there is also a lot of media hype about it that does not represent the actual demographic of people taking these drugs. Yes, it is abused, but I do not believe that it is abused nearly to the extent that the news makes it out to be.

The obesity issue in our culture is a very complex set of problems that has a very complex set of answers. Genetics play a role. Our Junk Culture plays a role, but most importantly, poverty plays a huge role. Nowadays, the cheapest foods are the prepackaged corn-syrup laden crap. When you’ve got a food budget of $75 per person per month, we have to get the most for our money. Also, a lot of us have not ever had the time to sit down and learn to cook. We were raised by two-income households (or single parent households) and by the time the parents got home, all they had energy for was to throw a frozen pizza in the oven.

Fatigue plays a role. We are also one of the most fatigued nations in the world with our workaholic tendencies. People eat more when fatigued, and have a tendency to go for the high calorie, sugary snacks as opposed to an apple or an orange. It’s funny that the US is the richest country in the world, yet we’ve got HUGE poverty issues as well as this HUGE problem of being overworked. We are a lot bass-ackwards, and it shows in many, many ways.

Having time to work out and eat right is something that at this point traditionally is reserved for the mid to upper classes, as the rest of us spend all of our time and energy into working our butts off to pay the rent and then utilities.

Like I mentioned before, the appetite suppression is only a temporary effect, and after awhile, things normalize out at these lower doses intended for people who have an upset brain chemistry balance. Hence the tendency for addiction if not used as prescribed.

As far as the article I mentioned earlier, people taking the stimulants for cognitive performance enhancement should be frowned upon as people who take steroids are. If there is not legitimate medical reason to take it, then don’t take it. It’s dangerous and makes those of us who are in legitimate need look really, really bad. Hence Sara’s comment about “our Adderall-riddled culture”. There’s a lot of press about it, but that does not make it the case. The media will whore out anything it possibly can to keep its ratings up and will feed any line of bullshit it can get away with to anybody in order to keep the ratings and money. I have generally stopped buying magazines and cut the cable television due to this.

posted on August 21st, 2008 at 8:37 pm

14 On August 22nd, 2008, lilacsigil said:

For people with AD/HD, the drug is completely safe.

This is dangerously incorrect – as other people have said in the comments, there are numerous side-effects that some people experience even when the medicine is taken correctly. I know a woman who started taking Adderall for diagnosed AD/HD, but then took more and more, and had all her children diagnosed with the same condition so she could take their drugs too. She ended up very thin, covered in scabs, and in rehab. She still takes it herself, but in strictly controlled doses.

Like all drugs, there are negative and positive effects, they vary hugely from person to person, and it’s important for each individual to find out what is the most effective drug with the least side-effects for them. It sounds like you eventually had the benefit of good diagnosis and a thoughtful therapist, so it’s great to hear you’re doing well.

posted on August 22nd, 2008 at 5:15 am

15 On August 25th, 2008, Chelsea said:

I am a 17 year old girl who takes Adderall for ADHD. Mostly it helps me focus and be motivated in school. It changed my appetite a lot when I first started. I was prescribed 20 miligrams in the morning, so I do experience wanting to eat more when it is night time. I also have noticed that right before I get my period, it seems a lot less effective. I don’t know if anyone else has experienced that. It doesn’t seem to make sense that I would become so used to the drug so fast because I just started taking it. It helped me right away when I first started it, but now it feels just less effective, and it’s right around the time my period is coming. Does anyone know why this is? I will be asking my doctor this Thursday…

posted on August 25th, 2008 at 9:25 pm

16 On August 25th, 2008, Chelsea said:

I’m just worried if I’ve already become used to it or not.

posted on August 25th, 2008 at 9:26 pm

17 On August 28th, 2008, haley said:

I recently abused adderall, it was a stupid, one time mistake. I was up for three days straight with no sleep. I also ate very little..maybe a little more than one meal total in the course of three days. I took a fairly high amount orally and crushed up the pills because they were time released and I wanted the full effect at once. I took about 80mg. When it first hit i was very happy..and extremely talkative. I got skin crawls (expecially in the back of my head) It was like a tingly sensation. I was restless. Coming down was EXTREMELY rough..the reason i wont do this again actually. HUGE headache..stomache pains..nausea. I think the reason i couldnt sleep was because i constantly had thoughts running through my mind..it was crazy. I could have written an 80 page essay at the time. But thats over and done with..
wouldnt recomment it folks.
peace

posted on August 28th, 2008 at 5:04 pm

18 On September 7th, 2008, Kate said:

Recently I started “the speed diet” as it were but when I dont do it for a day I find myself propa munching out but all I wanna do is loose some weight but dont wanna become addicted to it though….how long til the weight starts to shift or do I literally have to starve myself for days on end with no sleep just to get the end results I want?!?!

posted on September 7th, 2008 at 4:39 pm