Photo: Martí Pardo

Why do athletes use phentermine?

Athletes often take appetite suppressants to lose weight in order to increase their power to weight ratio. Phentermine is just one of many appetite suppressants.

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Doesn’t everybody wish that they had access to a personal coach for their questions about training and fitness? Road Bike Action recently caught up with Johnathan Edwards M.D. Dr. Edwards is a practicing sports doctor and anesthesiologist in Las Vegas, Nevada. He has been a sports doctor for American cyclists as well as in Europe. He also worked with athletes during the Paris Dakar rally. As a former professional motocross racer and current Cat 2 road racer, he understands the health and training needs of cyclists of all levels.

If phentermine is used for weight loss than how is it used as a performance enhancing drug? And why is it legal during non competition and illegal during competition?

This is a tricky question and we must look at the mechanism of action of phentermine in the body. Phentermine gained national awareness after deaths from heart valve problem were occurring from the once popular weight loss drug, Phen-Fen. Phentermine also gained notoriety after Health Net terminated the contract of Nathan O’Neill for testing positive during competition after winning the Tour of Elk Grove. He did have a prescription for the drug, but its presence is banned during competition. Power to weight ratio is something all cyclists live and die by. If your weight is up, then it becomes harder to produce watts and keep up with an already grueling pace. Athletes often take appetite suppressants to lose weight in order to increase their power to weight ratio. Phentermine is just one of many appetite suppressants. Phentermine is a medication which weakly stimulates the sympathetic nervous system and reduces appetite by stimulating a part of the brain called the hypothalamus. The sympathetic nervous system is a network of nerves inside the body, when stimulated by the brain, causes the body to increase awareness, run faster, breath easier and muscles to work stronger. Basically everything you need to escape danger or run from a bear. Phentermine has similarities to the drugs amphetamine and cocaine. When the sympathetic nervous system is stimulated by these drugs, the body can perform better by enhanced lung and heart function, increased muscle strength, and increased focus and pain tolerance. Inflicting pain on every inch of your body and not caring are classic effects of amphetamines. Think back to the movie Scarface, at the end when Al Pacino is being shot multiple times but he doesn’t die! That is a real effect of cocaine that will make the body withstand more than it normally would. Taken at its proper dose, phentermine would not cause a performance enhancing effect per se. This is one reason it is likely allowed out of competition. The problem arises when it is taken at 4 to 5 times its normal dose, or along with another stimulant drug, is when the fireworks begin. Taken in excessive amounts, phentermine affects the body more like a strong amphetamine or cocaine and this causes a performance enhancing effect. Unfortunately, high doses of phentermine will impair judgment and make you more stupid by the minute! It is kind of like being the drunk guy at the black jack table, you think that you are stronger and hence burn many more matches during a race and thus usually lose. It also causes nausea, seizures, heart attacks, intestinal ischemia, to name a few side effects.

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Phentermine is drug only approved for weight loss and is not meant to be taken in excessive amounts or long periods of time and should only be given under the direction of a qualified physician. Voila! The information provided in the ASK THE COACH column does not constitute formal medical advice. The information provided on this public web site is provided solely for general interest of the visitors to the site. Information in this column does not constitute medical advice nor establish a doctor-patient relationship with Dr. Johnathan Edwards. Readers of this column should not act upon any information contained in the web site without first seeking medical advice from their personal physician.

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