Being overweight, particularly in our image-driven era, is no laughing matter. In fact, it can be a major factor in clinical depression. Obesity, as defined by Jennifer Sisk, MA, is “an abnormal accumulation of body fat, usually 20 percent or more over an individual’s ideal body weight.” Obesity has been associated with a higher risk of illness, disability and death.

Particularly disconcerting is that obesity in children has risen at alarming rates. According to Sisk, the rate of obesity among children quadrupled from 1980 to 2004. Experts tell us the primary cause is too many calories coupled with a sedentary lifestyle. Most schools have dropped daily physical education requirements, and active play has been replaced with watching TV and playing computer games. Kids today are more inactive than in any previous generation.

Sisk also informs us that fast food consumption has increased by 300 percent since 1977, as has the size of meals eaten per person at fast food restaurants.

Genetics have always been with us, and overweight parents tend to have overweight children. When you add environmental factors, lifestyle and diet to the picture, you can easily see how these societal changes influence obesity rates. Alarmingly, obesity can lead to a myriad of physical and emotional problems, including a dramatic rise in childhood diabetes and mental illness.

The role of prescription drugs in dealing with obesity has frankly been a history of dismal failure. Not only that, but most appetite suppressant drugs that have been used are central nervous system (CNS) stimulants, which can lead to even more physical and psychological problems, such as drug dependence and emotional disturbances.

When I first started in retail pharmacy it seemed like every other prescription was for a drug related to dextroamphetamine (e.g. Dexedrine), a medicine invented by Germans back in the 1920s. I’m told they are still used today by military pilots, who call them “go pills.” At times back then, it seemed as if most housewives were taking prescription medications such as Dexamyl spansules, Biphetamine, Tenuate Dosespans and others to lose weight. I suppose some of them did lose weight temporarily, but I can’t help but wonder what it did to their cardiovascular systems and blood pressures. I suspect that most of them gained back whatever weight they lost once they stopped taking their prescriptions.

These kinds of CNS stimulants also create a sense of euphoria — at least initially — which was part of their appeal. Doctors rarely prescribe these drugs today because of the health risks to patients. I sometimes wonder if the dramatic rise in coffee drinking, with its accompanying dose of the CNS stimulant caffeine, is this era’s equivalent to Dexedrine — without all the stigma and regulation.

Doctors prescribe medications for weight loss these days mostly for a short period to jump-start a full diet and exercise program, or for those who are so obese they can’t be physically active. Of course, there’s a huge market, so new drugs are in development all the time. Current drugs increase metabolism or block the absorption of fat, but also require the patient to reduce calories and increase physical activity. As of now, there really is no quick fix on the pharmacy shelf to address this problem.

As a pharmacist, I feel it’s my duty to help educate patients about the health risks that come with carrying excess weight, including diabetes, cardiovascular disease and orthopedic problems, among others.

Remember the old canard “Enjoy your life, you only live once”? I think the best advice I could give is that there are risks in everything we do in life — and if you choose the path of moderation, including a healthy lifestyle, you might just have a longer, more enjoyable journey.

Ed Clark enjoys his life as the proprietor of Webster Pharmacy here in Alameda. You can reach him at