I'm currently taking 20 milligrams of Pravachol and 80 mg Diovan. I've quit smoking but my weight has now become a problem. I walk a half-hour per day and also go to Curves (a cardio/strength training class) three days a week, but I would also like to use an appetite suppressant. I had a right coronary stent put in on July 3, 2002, and prior to this was using Metabolite (ephedra free). I did not notice any rapid heartbeat or any other symptoms, but I know it helped to control my appetite. Is there ANYTHING I can take while on the above mentioned medications that won't adversely affect my heart? I'm 5-foot-2 and weigh 144 pounds.

Thank you for your interesting question. Although obesity is a major problem in the United States, the medical treatment for this condition has been significantly underutilized. With regards to your particular condition, you do not meet the current criteria for medical treatment. The current guidelines state that an individual with a BMI (body mass index, an indicator of weight and height) greater than 30 may be started on medication. For patients with one other comorbidity, such as hypertension, diabetes, or heart disease, then medication can be started for BMI 27 to 30.

Your height and weight calculates a BMI of 26. Hence, you do not require medication intervention. Most appetite suppressants can cause high blood pressure or heart disease, since the active ingredient can exacerbate both of those problems.

There are some medications that work in the brain to decrease appetite. Other medications that do not actually cause appetite suppression, but alter fat metabolism can also reduce overall weight.

Since these medications all require prescription, you must consult with your physician. I would not recommend that you do this alone without medical advice. If you do try a medication that is over the counter, remember to advise your physician of this medication. Thanks again.

Dr. Fung

-- Gordon Fung, MD, MPH, is a cardiologist and associate clinical professor of medicine at the University of California at San Francisco Medical Center at Mt. Zion.

First published May 3, 2004
Last updated June 24, 2008
Copyright © 2004 Consumer Health Interactive