Author: Johanna Ryan
The story below, a first-person account of life on (and off) amphetamine “diet pills,” was written over forty years ago. It couldn’t be more relevant. Under the cover of a public-health crusade against obesity, drug companies are bringing back old-fashioned “speed” in brand-new packages. Last week’s post described the newly-approved weight loss pill Contrave, a combination of the stimulant bupropion and naltrexone. Contrave will compete with Qsymia, a combination of the stimulant phentermine and the anticonvulsant Topamax approved last year.
Won’t get fooled again..
This month the U.S. Endocrine Society released treatment guidelines based on what they called a new paradigm: Treating Obesity First. Rather than trying to manage patients’ Type II diabetes, hypertension, etc. with a plethora of prescriptions, the experts said, doctors should treat the underlying cause: excess weight. There’s a lot to recommend this idea – enough so that at first these guidelines could look like a breath of fresh air.
Until you read further, and realized that “treating obesity” meant expanding the use of Contrave, Qsymia, Belviq and other newly-patented, stimulant-based weight loss drugs. The customary hosannas were sung to exercise and healthy diet, of course. The Who nailed it in an early 1970s Hosanna – in one of Rolling Stones 500 greatest lyrics ever – See Here to play
The Change, it had to come
We knew it all along
We were liberated from the fold, that’s all
And the world looks just the same
And the history ain’t changed
Cause the banners they are flown in the next war
I’ll tip my hat to the new constitution
Take a bow for the new revolution
Smile and grin at the change all around
Pick up my guitar and play
Just like yesterday
Then I’ll get on my knees and pray
We don’t get fooled again
So we shouldn’t have been surprised to wake up January 15 to a media fanfare about the “promise” shown by a new treatment for binge eating disorder – Vyvanse or lis-dex-amphetamine, already marketed for ADHD. None of the admiring media accounts used the word “amphetamine”, let alone “speed” or Pep Pills. You wouldn’t have known that the use of amphetamines as appetite suppressants in the mid-twentieth century helped unleash an epidemic of addiction on both sides of the Atlantic, which by the 1970’s led to several U.S. Congressional hearings on the amphetamine crisis.
We’d like to thank Lester Grinspoon, M.D., who testified at the 1976 hearings, for permission to use this story. It first appeared in The Speed Culture, his excellent 1975 book on the use and abuse of amphetamines. The title appears to be the author’s riff on the opening line of the hit 1970 film tearjerker, Love Story (‘What do you say about a 25-year-old girl who died?’).
“What do you say about a 25-year-old girl who’s fat?”
Not a great deal. She said even less about herself, until one day, after convincing herself her problem was basically metabolic, she announced she was going to a doctor. Not particularly sympathetic about her weight problem, the doctor told her she had to diet, but to help her he would prescribe an appetite depressant, Dexedrine, to be taken before breakfast.
That was in November, and thus began my own experience with amphetamines.
I was convinced, because I was not told otherwise, that these magic little pills would solve my weight problem, which was substantial, amounting to an excess 50 pounds. I left the office confident that if I followed the regimen and exercised willpower, I would eventually be thin. I filled the prescription and the next morning took the first pill. Granted, I wasn’t hungry, but fat people often don’t eat because they’re hungry – they eat because they are unhappy and there is nothing else to do, or because it’s raining, or because it is a beautiful day.
The day passed uneventfully and so did the evening (fat girls don’t go out), and then I got ready to go to bed. And couldn’t. What’s the sense in going to bed if you can’t go to sleep, and that’s what eluded me. I was so “high” that my mind was running circles around itself. My thought patterns resembled Joyce’s stream of consciousness technique: I couldn’t concentrate on any thought for more than a matter of seconds and then my mind would dart to something else, seemingly unrelated. To say the least, I was disconcerted, because I had no control over my thoughts. I tried all the standard remedies for insomnia, but none worked; I couldn’t even count more than half a dozen sheep. Finally, around 4:00 am, I dozed off.
The next day was little better, but eventually, as I recall, my tolerance built up quickly. I no longer had night-time “highs” after a couple of weeks. My weight problem was much more persistent. I found that Dexedrine did depress my appetite as long as my willpower was in high gear; when it slipped, I became a compulsive snacker, eating literally anything and everything I could get my hands on. When willpower took the reins again, I would manage to drop a few pounds.
Weeks and months passed, and I remember thinking the pills were no longer doing their job. I experienced a craving to take more than my one pill a day, but never quite had the courage to do so. I also found myself becoming jittery and jumpy. Minor things would unnerve me, and I tended to want to be alone more and more. I became progressively unhappy and would burst into tears over the most trivial things. I remember a period of strange, weird dreams, where I was thin, lovely and the center of attention. Then I would wake up to fat reality.
After six months I began to question the validity of continuing. I wasn’t losing weight, and I was miserable into the bargain. Interestingly enough, my friends had begun to question long before, seeing sometimes subtle, sometimes obvious personality changes in me. I was far more irascible than usual and developed a temper that was out of character. I am a fairly even-tempered person, not given to moods or highs and lows. However, I became alternately moody, euphoric, depressed. I would snap at people for no reason at all and was generally “bitchy” to those around me.
In April I decided to stop taking the “magic diet pills.” I took my last pill on a Thursday and on Friday went to work as usual. By 2:00 pm my solicitous boss told me I looked awful, and asked what was wrong. I told him nothing, really, except that I felt like the Boston Celtics were using me as their basketball. As the afternoon wore on, I wore out, and felt like the players had let the air out of the basketball. The boss told me to go home, and I did. And went to bed. Until late Sunday afternoon. My mother’s repeated attempts to rouse me met with no success. Each time I tried to get out of bed, I fell back exhausted. When I finally managed to get downstairs, I explained that I’d stopped taking the Dexedrine on Thursday, and could only attribute the events of the past several days to its side-effects. We agreed that the rest of the pills should be flushed down the toilet. They were.
What can you say about a 32-year-old girl who’s thin? A lot, and she does. After the Dexedrine, her personality took a month to return to what it was. She slipped back into her old eating habits, but after a while decided that the time had finally come. She joined Weight Watchers and she lost 52 pounds, without so much as an aspirin to help her.
Girls on pills
We’ve presented this story “as is” although the time has long passed when women in their thirties and older were routinely referred to as “girls.” It’s a typical story for its time, and ended much more happily than some. Another woman quoted by Dr. Grinspoon, a nurse who took amphetamines for twenty years, experienced nightmares and transient episodes of genuine psychosis while trying to come off her weight loss pills. “The symptoms of withdrawal were so severe that at times I couldn’t think who I was and at other times where I lived,” she said. “The floor was coming up at me and the walls seemed to move.” She had to endure this alone, after three psychiatrists assured her there was no such thing as amphetamine “addiction.”
There must be readers, now in their sixties, who remember the heyday of diet doctors and pep pills. Perhaps a doctor or two as well who was practicing medicine in the 1960’s. Did you take these pills, or have family, friends or patients who were hooked on them? If so, we’d love to hear your stories. They could do the current Millennial generation a tremendous amount of good.
In Celtic countries (Ireland and Scotland) the chromosomally complete (CCs) are girls to the age of 90. In England, any CC is a woman from the age of 14. In America – at least New York – I am reliably informed by counsel for Forest pharmaceuticals, that because of the huge ethnic mix, anything – girls women – goes.
All of these drugs are of course routinely used for ADHD, which is the only “disease” in medicine that changes gender distribution with age – under the age of 18 there are supposedly 4 CD cases for every CC and after 18 more CCs than CDs.
A great deal is made of the use of stimulants by college students for cognitive enhancement – something for which there is little evidence. It’s at least as likely that college use is driven by CCs trying to lose weight.