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I do. They have to go on an exercise program, and diet, preferably see a dietician or nutritionist. They get 30d, and have to f/u q 30 to get more. Must demonstrate at least a 8 lb weight loss or won't keep Rxing. Obviously they can't have HTN, it will worsen that.

I heard an endocrinologist once at a Cardiology conference he thought most of his diabetics should be on it and would keep them on forever. I tell them it is only to help get them jump started, and if they dont' do the exercise and weight loss, they will gain it all back plus more as soon as they stop it. In addition I tell them, and have seen, that most people get a tolerance to it within 3-6 months. So it won't work forever, but does suppress their appetite at first.

I have in past Rx'd Phen/Fen back in it's hey day, Meridia, Xenical( now ALLI, natural compound, cheaper in health food store is Chitin or crab shell powder capsules), and anything they come up with in the future that actually helps people.

Cote' MD

MD COTE, Medical, Laser, and Aesthetics

Snowed in in Maple Valley, no mail or newspapers for 5d. STill have power, food, heat, TV. Yippe.

-------------- Original message --------------

Anybody prescribe phentermine for weight loss?

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Same here! Also take a family history for DMll and/or obesity. If positive, put them on metformin and a diabetic diet with exercise. Compulsive/ emotional eating ? Buproprion. Dx: Adj dis. NOS (worried about weight gain, interfering with life).

Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

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I've done this also for patients at high risk for DM because of family history

and obesity,

but I stay aware of the evidence that supports this practice only at the

margins. Studies

have shown only a modst 2.5% weight loss at 3 years of follow-up from consistent

Metformin use, and that was in patients with demonstrated glucose intolerance -

not just

those at high risk of diabetes due to family history etc. It obviously varies

by patients, but

I also worry about the potential message to the patient that the pill they take

is at all

comparable in importance to their diet and exercise regimen. As with

hypertension,

diabetes, chf and just about every other chronic disease, obese patients on

weight loss

meds often behave as if they can slack on their lifestyle change as long as they

take their

pills.

Chad

>

> Same here! Also take a family history for DMll and/or obesity. If positive,

> put them on metformin and a diabetic diet with exercise. Compulsive/

> emotional eating ? Buproprion. Dx: Adj dis. NOS (worried about weight gain,

> interfering with life).

>

>

> Lynette I Iles MD

> 301 South Iowa

> Ste 2

> Washington IA 52353

> Flexible Family Care

> 'Modern medicine the old-fashioned way'

> This e-mail and attachments may contain information which is confidential

> and is only for the named addressee. If you have received this email in

> error, please notify the sender immediately and delete it from your

> computer.

>

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