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Like a character straight from a Woody Allen script, Sarah* is a classic Manhattan type: the fashion-obsessed diet connoisseur. Her closets are packed with Balenciagas, Lanvins, and Yves Saint Laurents, and—despite her petite stature and inoffensive waistline—her kitchen overflows with fat-melting, appetite-zapping products that promise to shrink her down to their diminutive sizes. Among other things, she has tried colonics at a Chinatown clinic; juice fasts advised by a team of crystal-wielding mystics; mysterious jars of an acrid mushroom extract FedExed from California; and Xenical, the fat-absorption-blocking drug she got from a French MD while on vacation. But Tenuate (diethylpropion)—the speedlike appetite suppressant that an ethically questionable Upper East Side diet doctor prescribed three years ago—is the one she credits with the demise of her marriage. “Look, I’m not saying it’s a bad thing. My edit function went right out the window. I told people how I really felt about them. It was take no prisoners!” she says. “Plus, I lost 30 pounds in six months without ever breaking a sweat.”
As this country’s thriving diet industry attests, there are plenty of Sarah's out there who aren’t afraid to take their chances in the weight loss stakes. But whether they get their tablets via prescription or buy them at the supermarket, even the most adventurous weight watchers know that health wise, their little secret can be risky business.
Cautionary tales about pill-assisted dieting abound—and jitters and irritability are the least of the problems. Consider the now-verboten cocktail Phen-Fen, a one-time weight-loss phenom that ended up being associated with an increased risk of heart valvular disease. Or ephedra, the Chinese herb that once revved up the drugstore classic Dexatrim, but was yanked off shelves in 2004 after more than 16,000 adverse events such as heart palpitations, tremors, and insomnia were reported. In 2000, the FDA warned that Phenylpropanolamine—another once-common OTC appetite suppressant and nasal decongestant—increased the risk of hemorrhagic stroke. And the latest Internet blockbuster, Clenbuterol, reportedly melts six to 10 pounds per week off some of Hollywood’s most scarecrowesque starlets. Its intended use? Treating horses for asthma.