I Was Addicted to the Weight-Loss Drug Phentermine for 15 Years: 'I'd Spiraled to a Dark Place'
Every time I walked into a medical weight-loss clinic, the experience was the same: dog-eared tabloids, subtle reminders of what an ideal body should look like, were scattered next to dated table lamps with pleated shades. Dingy mini blinds (were they beige or white and just really dusty?) remained closed, allowing me to hide in plain sight, praying that no one would see me for what I really was—an alcoholic addicted to prescription diet pills.
I did not grow up around alcohol or drugs. My upbringing was a conservative one, in a stable, loving environment in South Louisiana. It wasn’t until I went through a painful breakup during my freshman year of college that I began searching for something to numb the constant buzz of fear and anxiety coursing through my body. I found that something in food, sex, drugs, and finally, at the bottom of a bottle.
Struggling silently through PTSD looked a lot like a quarter-life crisis to everyone on the outside, and my already low self-esteem was in the crapper. My weight ballooned; I dropped out of college one semester shy of graduation. Alcohol made me forget all of my troubles, but I didn’t want to continue packing on weight. So when a friend recommended diet pills, I immediately took interest.
How easy would it be, I thought, to just take a pill and not be hungry? For an emotional eater like me, it seemed like the perfect solution. I looked up the nearest medical weight-loss clinic and took the first appointment. The year was 2001, and I picked the clinic with the nicest ad in the phone book. Little did I know, I would eventually visit them all.
When I stepped on the scale at the clinic, it read 170. I was informed that my BMI was firmly in the overweight category for my height. I am 5’6, so a normal weight for someone my height can be anywhere between 118-148 pounds. The doctor talked to me briefly about healthy habits, and prescribed phentermine, a commonly prescribed amphetamine-like medication used to suppress appetite.
Phentermine is one of four FDA-approved weight-loss drugs intended for short-term use only. (Five other medicines are approved for long-term use.) Potential side effects include an increase in heart rate and blood pressure, insomnia, constipation, and nervousness. On more than one occasion, I woke up with my heart beating out of my chest—scary as fuck, but not scary enough to make me stop.
The paperwork accompanying the drug explained that it isn’t intended to be taken for more than three months at a time; it’s meant to shore up or support a medically overweight person’s diet and exercise plan. Once my weight dipped below a number considered overweight, then they would no longer be able to prescribe the medication. I was excited to lose 22 pounds and drop into the normal range for my height.
I had no idea what was about to happen to me.
There is something about phentermine that made me feel invincible. Not everyone has that reaction, just like not everyone has the same reaction to alcohol or opioids. But for me, from the very first time I took it, I was hooked. The way my extremities tingled, my face and gums felt numb, and the weight fell off because I wasn’t eating or sleeping—I don’t talk about it much, because the very thought of one of those blue and white pills makes my mouth water. Thirty days later, I went back for more.
The medication can also be obtained from a primary-care physician or an ob-gyn, according to my girlfriends who were fans of the drug. I personally never had the guts to ask a doctor who knew me to prescribe phentermine; the potential for questions was too high, and why risk it when I knew I could waltz in and out of a weight-loss clinic and skip the interrogation?
In 2015, the New York Times reported on the remarkable staying power of the weight-loss drug, which came on the market in 1959. One reason: Phentermine is prescribed widely at for-profit diet clinics nationwide.
I continued using phentermine on and off for the next 15 years.
“It’s sort of like a cheap speed,” C. Richard Allen, then director of the Georgia Drugs and Narcotics Agency, which oversees the use of controlled substances like phentermine, told the Times.
Those pills are what I used to snap myself out of a hangover every morning in order to parent my three small children. The sick part of my brain told me that phentermine made me more desirable to my husband, more fun and interesting at parties, and a better employee. On the outside, I was winning at life. Amphetamines helped camouflage my alcoholism for many, many years. They’re what I used to fuel my creativity, and by extension, my livelihood as a freelance writer. Even though I’ve been sober for over two years, I miss that high; especially during the summer months, when the sensation of my thighs sticking together fuels my already rampant self-loathing.
There will always be a small part of me that wants to try just one more time. That is the devastating power of addiction.
Over a stretch of years in a variety of cities across the South, I sat staring at mauve or tan waiting-room carpets, wishing I was a naturally thin person who didn’t have to resort to such nonsense to get just one more bottle, one more month of feeling on top of the world. Of course, now that I’m sober, I know that even if I were naturally thin, I would still be an addict.
No one in the waiting room made eye contact. Our shame was palpable. The overweight patients, it seemed to me, were embarrassed to have let themselves go this far—far enough to be in a clinic dedicated to helping overweight people become less so. The thin women seemed ashamed, too, because they either suffered from body dysmorphia, or because they were addicts. Either way, no one wanted to be there.
Over the course of my prescription pill-popping career, I’ve fallen into both the fat and thin camps. There was a time when I was in my 20s, just before my husband and I got married, that my weight almost dropped below the line of allowing the doctor to write me the prescription. Fear of living without phentermine ensured from that point on that I made certain to eat a big meal and wear my heaviest shoes before going back for a refill.
The problem was, as it always is with addiction of any kind, that after years and years of taking a drug expressly made for short-term use only, it stopped working. I began pairing a pill with a Red Bull, or adding in other types of uppers, in an attempt to reach the same effect. I had to take it in order to function, to feel normal.
Sometimes I’d take a few months off. “I’ll give my body a break,” I told myself, because that makes an addict feel like she isn’t truly an addict. Real addicts don’t give themselves breaks, right? They can’t because they’re too busy administering a blow job to a random stranger in a windowless van for drug money. True addicts don’t have families or properly sized undergarments, if they have undergarments at all.
I still had all my teeth. I still had properly sized undergarments. I wasn’t giving strangers sexual favors. I was fine.
“Your blood pressure is perfect!” The nurse ripped back the Velcro to pull the blood-pressure cuff from my arm. “The doctor will be in shortly.”
The doctor was usually someone who looked like he or she had seen much better days; I don’t know what the rules are, but all of them carried a deep sort of sadness. On the day I sat across from him or her, I was grateful. I smiled, I tried to look like the type of person who was attempting to be healthy but kept falling short. Genetics, I’d say, or motherhood, was preventing me from reaching my true potential. The scales didn’t lie: I was overweight, most of the time. I kept myself within a certain range on purpose because I’d rather be a little fat on speed than thin without access to it.
Every summer since I have been in recovery, an internal battle rages on.
No one would know.
I could go get them anytime.
I’m 20 pounds overweight—it would be so easy.
And it would. Just as easy as picking up a bottle of vodka or whiskey at the grocery store and stowing it away somewhere in my house. Just as easy as taking a drink when no one is looking, except that I’d have to sneak money out of the bank account I share with my husband, figure out a place to put my children, make an appointment, get the pills, and then hide them.
I would have to lie over and over and over again.
By the end, when I was perpetually bloated from drinking too much the night before and gaining weight rather than losing, no matter how many pills I was taking, I started worrying about my health. The doctors—all of them—began looking at me curiously because my weight never went down; it always stayed the same. I’d go in, get 30 pills, and leave. When I ran out, I went to a different clinic, perhaps on the other side of town. I rotated my appointments so that I rarely saw the same doctor two months in a row.
“What are you doing here?” a medical assistant asked me once, after taking my blood pressure. “You don’t belong here.” I suspect he may have meant that I didn’t look like I belonged on that side of town, which was questionable, or maybe he was making a general comment that I didn’t appear overweight. Either way, he was right on all accounts. I didn’t feel like I belonged anywhere, including my own skin.
My last visit to a medical weight loss clinic was in December 2016. When I finally made the decision to get sober in 2017, it was out of desperation. I’d spiraled to a dark place of profound unhappiness and depression, and no matter what I poured down my throat to combat those feelings, I was never okay. That is the essence of addiction.
As a 39-year-old recovering addict and alcoholic, I can now say that I’m more comfortable with myself than I’ve ever been before, due to the intense, life-altering work that sustained sobriety requires. I can’t place blame on anyone but myself for my struggles, and I’m still looking for balance in every part of my life. I am still not happy with my weight, but I know the answer to that can’t be found inside of a medical weight-loss clinic.
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