Oct
Hooked on this prescription weight loss drug, writer Harmony Hobbs describes her emotional struggle with addiction and alcoholism—and her decision to get sober.
Every visit to a medical weight-loss clinic unfolded with haunting familiarity. As I stepped inside, I couldn’t help but notice the dog-eared tabloids scattered on faded tables, each one quietly echoing society’s relentless obsession with the “ideal” body image. The ambiance, with its dated table lamps sporting pleated shades and dingy mini blinds drawn shut, seemed designed to allow me to hide in plain sight. In those moments, I fervently hoped that no one would perceive me for what I truly was—an alcoholic ensnared by the grip of prescription diet pills.
My early life unfolded in an environment untouched by the specter of alcohol or drugs. Raised in a conservative South Louisiana setting, my upbringing remained grounded in stability and love. However, it was during my tumultuous freshman year of college, marked by a painful breakup, that I began to search for solace to drown out the relentless hum of fear and anxiety. I sought refuge in various vices, including food, sex, drugs, and eventually, the abyss of alcohol.
Confronting trauma in solitude often resembled a quarter-life crisis to those around me, concealing the extent of my suffering. My already fragile self-esteem plummeted to unprecedented depths, and my weight began to soar. I ultimately dropped out of college, one semester shy of graduation. Alcohol offered a temporary escape from my troubles, but I was loath to let it contribute further to my weight gain. When a friend suggested diet pills, I was quick to show interest.
The allure of a simple solution beckoned me: the prospect of ingesting a pill and being spared the pangs of hunger. As an emotional eater, it seemed like an ideal remedy. I quickly located the nearest medical weight-loss clinic, and in the year 2001, I embarked on my first appointment, choosing the clinic that boasted the most appealing ad in the phone book. Little did I know, this would become a pattern, leading me to traverse the doors of various clinics.
Upon stepping onto the clinic’s scale, the digital readout settled at 170 pounds. The doctor swiftly informed me that my BMI placed me firmly in the overweight category for my height. Standing at 5 feet, 6 inches, the BMI chart indicated that a healthy weight for someone of my stature should fall between 118 to 148 pounds. The doctor briefly discussed healthy habits with me before prescribing phentermine, a widely used amphetamine-like medication designed to suppress appetite. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), phentermine was one of the four FDA-approved weight-loss drugs intended solely for short-term use, typically spanning up to 12 weeks. Five additional drugs, one of which is a combination with phentermine, received approval for long-term use, with a sixth drug reserved for specific genetic conditions.
Potential side effects of phentermine encompassed an increase in heart rate and blood pressure, insomnia, constipation, and nervousness, as outlined by the NIDDK. On more than one occasion, I awoke with my heart pounding frantically, a truly terrifying experience, yet not enough to dissuade me from continuing.
The accompanying documentation emphasized that phentermine was not meant to be taken continuously for more than three months. It was intended to complement the dietary and exercise efforts of individuals grappling with medical obesity. As soon as my weight dipped below the overweight threshold, the prescription for the medication would cease. I embarked on this journey, fervently anticipating shedding 22 pounds and falling within the normal weight range for my height.
However, I was completely unprepared for the tumultuous journey that lay ahead.
Phentermine possessed a unique quality that rendered me invincible. Not everyone experienced this effect, just as individual reactions to alcohol or opioids vary. Yet, from the very first dosage, I felt ensnared. The tingling sensation in my extremities, the numbness that washed over my face and gums, and the rapid weight loss resulting from suppressed appetite were like a siren’s call. I rarely discussed this aspect of my life because the mere thought of those blue and white pills still made my mouth water. Thirty days later, I returned for more.
My friends, who were also enthusiasts of the drug, informed me that phentermine could be obtained through primary healthcare providers or OB-GYNs. Personally, I lacked the courage to request a prescription from a healthcare provider who knew me well. The potential for probing questions loomed too large, and why take that risk when I could effortlessly visit a weight-loss clinic and evade scrutiny?
I oscillated between using phentermine and brief periods of abstinence for the next 15 years. Those pills became my lifeline, pulling me out of hangovers each morning to attend to my three young children. A twisted part of my psyche convinced me that phentermine enhanced my desirability to my husband, made me more captivating and vivacious at social gatherings, and transformed me into a superior employee. To the external world, I seemed to be thriving. Amphetamines concealed my alcoholism adeptly for many years, fueling both my creativity and my livelihood as a freelance writer.
Even though I have now surpassed two years of sobriety, I occasionally yearn for that euphoria, particularly during the summer months when the discomfort of my thighs rubbing together amplifies my already pervasive self-loathing.
A small part of me perpetually entertains the idea of just one more try—a testament to the insidious power of addiction.
Over the years, I inhabited both sides of the weight loss spectrum. In my twenties, just before my husband and I were due to marry, my weight flirted with falling below the threshold that would allow a healthcare provider to prescribe phentermine. Fear of losing access to the drug compelled me to strategically prepare for appointments, consuming a hearty meal and wearing my heaviest shoes to ensure my weight remained within the acceptable range.
However, addiction, in its relentless way, gradually eroded the efficacy of phentermine. As the National Institute on Drug Abuse underscores, the more one consumes a drug, the less potent it becomes over time. In a desperate bid to recapture the initial effects, I began pairing the pills with energy drinks or experimenting with other stimulants. Eventually, I became reliant on them to function, to feel any semblance of normalcy.
Periodic breaks seemed like a reasonable strategy. “I’ll give my body a rest,” I’d tell myself, hoping it would offer a veneer of control, a semblance of non-addiction. True addicts don’t give themselves breaks, right?
Outwardly, I didn’t appear addicted to anything. To the world, I seemed perfectly fine. But the reality was far from it.
“My, your blood pressure is perfect!” The nurse cheerfully removed the blood pressure cuff from my arm. “The doctor will be in shortly.”
The doctors at these clinics often projected an air of weariness, as if they had witnessed better days. I’m uncertain about the prerequisites for becoming a medical weight-loss clinic provider, but they all seemed to carry a profound sense of sadness. On the days when I faced them across the desk, I felt relieved. I put on a facade, striving to resemble someone who was earnestly pursuing a healthier life but kept stumbling along the way. Genetics, I would lament, or the demands of motherhood were preventing me from realizing my true potential. And, after all, the scales didn’t lie; I remained overweight (most of the time). I
deliberately maintained a specific weight range because I preferred to be slightly overweight while reliant on phentermine than to be thin and deprived of access to it.
Every summer since embarking on the path to recovery, an internal battle has waged within me.
No one would ever know.
I could easily obtain them.
It’s perfectly legal.
I’m still 20 pounds overweight—it would be effortless.
And indeed, it would be straightforward—an endeavor no more complicated than purchasing a bottle of vodka or whiskey from the grocery store and secreting it away in my home. Just as discreetly, I could imbibe when no one was watching. However, I’d also need to surreptitiously withdraw money from the shared bank account with my husband, arrange childcare for my children, schedule an appointment, secure the pills, and then meticulously conceal them.
A web of lies would ensnare me.
In my waning days of phentermine use, when I perpetually bloated from excessive drinking and my weight stubbornly refused to decrease, regardless of the number of pills I ingested, health concerns crept into my thoughts. Healthcare providers, all of them, began to regard me with curiosity. My weight remained static; it never dwindled. I would visit a clinic, obtain 30 pills, and exit. When my supply dwindled, I would seek another clinic, perhaps on the opposite side of town. I meticulously coordinated my appointments to ensure that I rarely encountered the same doctor two months in a row.
“What brings you here today?” a medical assistant inquired after taking my blood pressure. “You don’t seem like you belong here.” I suspect they may have implied that I didn’t appear to belong on that side of town, which was questionable, or perhaps they were making a general observation that I didn’t seem overweight. In either case, they were correct on all counts. I felt like I didn’t belong anywhere, including within my own skin.
My last visit to a medical weight loss clinic transpired in December 2016. When I finally decided to embark on the path to sobriety in 2017, it was born of sheer desperation. I had descended into a dark abyss of profound unhappiness and depression, and no matter how much I poured down my throat in a futile attempt to vanquish those feelings, I was never truly okay. This is the essence of addiction.
Now, many years later, as a recovering addict and alcoholic, I find myself more at ease with who I am than ever before. This newfound comfort is a product of the arduous, life-altering work that sustained sobriety demands. I hold no one else responsible for my struggles, and I continue to seek equilibrium in every facet of my life. My dissatisfaction with my weight still lingers, but I understand that the solution cannot be found within the confines of a medical weight-loss clinic.
