Is sibutramine for you? – GOOD SHAPE

The friend took it and it was fine. The sister-in-law changed models. And, from story to story, her desire to try that pill that makes the body dry grows. But, before you think that this article has the magic formula for you to lose weight quickly, a word of warning: the path to the dream body still includes challenges, such as switching from a warm bed to a spinning class on lazy days and refusing the second piece of the birthday cake. Resorting to medication – including sibutramine – to achieve the shape you consider perfect in a faster and easier way can be a very dangerous shortcut.

Although released in Brazil by the National Health Surveillance Agency (Anvisa), the medicine causes side effects and, therefore, should be used by those who really need it – and, of course, always with the supervision of a doctor. The synthetic pill acts in the brain, inhibiting the reuptake of noradrenaline and serotonin in the synapses of neurons. We explain: this mechanism makes you rarely feel hungry and, when eating, you are quenched with little. Wonderful, if it weren’t for the risks to the heart. Sibutramine, in addition to increasing heart rate, raises blood pressure. “These are alterations that do not cause problems in healthy patients”, attests to endocrinologist Márcio Corrêa Mancini, vice president of the Obesity Department of the Brazilian Society of Endocrinology and Metabolism (Sbem). People with heart disease (people who have coronary artery disease) should stay away. “In these cases, the inhibitor can trigger a heart attack”, warns Mancini. Uncontrolled hypertensives are also at risk, as well as those who have a history of psychiatric disorders, such as bulimia and anorexia, because the list of adverse effects also includes anxiety, anguish and irritation.

Another weight loss released in Brazil, in addition to sibutramine, is orlistat (the famous Xenical), which reduces the absorption of fat by the body. Amphetamine-derived inhibitors (amfepramone, mazindol and femproporex), banned in the country in 2011, were authorized by the Senate in 2014. However, Anvisa registrations are conditional on long-term studies, which do not exist. Therefore, they cannot be traded. In September last year, Beatriz Martins, from Goiás, published an outburst letter on Facebook, in which she said that the side effects of sibutramine led her 17-year-old daughter, Carolina Martins Moura, to commit suicide after having hallucinations. The student, according to her mother, bought the drug without a prescription. Many women do the same: inspired by the neighbor who quickly lost weight, they take the appetite suppressant on their own. They order a formula borrowed from someone to manipulate or consume the rest of the pills left over from their friend. They think just a little bit won’t hurt. “Self-medication is what most worries doctors because of the dangers of uncontrolled use”, warns endocrinologist Cintia Cercato, president of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso). And the black market doesn’t help. Worse, it makes it easy: just a quick search on the web is enough to find those who promise to deliver sibutramine by mail – without a prescription, obviously. Buying a medicine on an unknown website is the same as buying it from a street vendor, do you agree? “Medicines sold in pharmacies undergo strict control by the Sanitary Surveillance. Those available on the internet, however, do not receive any type of follow-up”, warns Cintia. That is, we cannot know what is inside the jar.

WHO CAN TAKE IT. The inhibitor is recommended for obese people (who have a body mass index, BMI, above 30), overweight people (BMI above 25) associated with any disease impaired by excess weight, such as diabetes, sleep apnea, hypertension and osteoarthritis, and also for those with a waist circumference equal to or greater than 102 centimeters (men) and 88 centimeters (women). This is what the Guidelines for the Pharmacological Treatment of Obesity and Overweight, prepared by the Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso), establish.

CASES WHERE IT IS CONTRAINDICATED. People with severe coronary artery disease, uncontrolled hypertension or with a history of psychiatric illness. CONSUMPTION TIME. There is no limit. “Obesity is a chronic disease and should be treated indefinitely in patients who respond well to pharmacological treatment, as long as they are tolerable”, says endocrinologist Márcio Corrêa Mancini.

THE RULES IMPOSED BY THE GOVERNMENT. Sibutramine is sold with a prescription, held in a pharmacy. Each prescription can sell a maximum of two boxes of the drug. Doctor and patient must sign a liability waiver.