Speed diet: Women using ADD drugs to get thin

Doled out like candy
Tamara*, a junior editor at a magazine in L.A., knows how the game is played. She will take Adderall because it makes her feel "intensely creative," she says. "I can sit down at my computer and just write, write, write when I'm on it." But in her college days, she relied on it for weight management too. "Everyone told me I looked sickly, but sitting down and not having stomach rolls never gets old," she explains. She is already svelte, but if she gained a few pounds, "I'd definitely use Adderall right before a bikini vacation." Not having a prescription is a nonissue. "I have friends who have the script and dole it out like candy. It's insane," she says. "Some sell them for $5 to $10 a pill. But mostly I get them for free. I don't know how many pills their doctors give them on a monthly basis, but I've always been surprised at the generosity."

In young working women, the drug may not initially be used for weight loss; more often, it's for the lift of getting through a stressful, busy life. "I have this one friend with this hugely busy career, kids, husband," says Amanda. "She's asked for my Adderall a few times just to make it through the day." But then the friend — and countless other women — discover its effect on the appetite. The Neil George Salon in Beverly Hills is popular among young starlets, and co-owner Neil Weisberg hears his share of how-I-dropped-the-pounds chatter. One client who started taking Adderall for ADD became so obsessed with her weight loss that she kept increasing the dose and eventually graduated to street speed ... more, and more, and more. "It wasn't good," Weisberg says. The latest buzz on Adderall is about cheating the time-release delivery system of the XR capsules by grinding and snorting their contents, or parachuting — wrapping a crushed pill in toilet paper and eating it to avoid the nasty taste. The result? A bigger rush and maximum appetite suppression.

Indeed, the weight-loss effects of Adderall have not been lost on some physicians. Fuad Ziai, a pediatric endocrinologist in Oak Lawn, Illinois, made headlines last year when CNN reported that he had prescribed Adderall to hundreds of obese kids; reportedly, 90 percent of his patients lost weight. His rationale? The risk of side effects — headaches, irritability, mood swings, and increased heart rate — was far smaller than the risk of diabetes to the overweight-kid population. The report neglected to mention a detail that might have been used to bolster Ziai's treatment: The formulation now known as Adderall was originally marketed as the weight-loss drug Obetrol. (In a statement to Allure from Shire Pharmaceuticals, the maker of Adderall XR, Matt Cabrey, the company's director of corporate communications, noted that a physician can prescribe Adderall "off-label" — i.e., in whatever way he sees fit — but that a pharmaceutical company cannot promote it for anything other than what the FDA approved it for. Says Cabrey, "Shire does not support the abuse, misuse, or diversion of any prescription medicine and Shire does not promote the use of ADHD medicines for any purpose other than the approved indication as an ADHD treatment.")

Addiction to amphetamines
Adderall is more famously related to crystal meth — both are amphetamines, though with different molecular structures. Where meth can cause brain damage, "Adderall would have to be taken in a very high dose to kill brain cells," says Thompson, who has mapped the effects of methamphetamine on the brain. "Note that the daily dose of Adderall is available in 5-, 10-, 15-, 20-, or 30-milligram doses, and our meth addicts, who lost 1 percent of their brain tissue per year, were taking about 100 times that, or around 3,000 milligrams a day. Of course, people who are taking Adderall for weight loss are probably taking it in higher dosages than they need, which increases the likelihood of addiction."

And therein lies the problem. Amphetamines have a way of creeping up on you. "Young people don't realize that medications like Adderall can be harmful if not prescribed for the appropriate condition," says Sophy. When taken at higher than prescribed dosage, Adderall can be psychologically and physically addictive, and some long-term users need to take increasing amounts to get the same appetite suppression, says Thompson. There are also a number of undesirable side effects: dry mouth, headaches, "fast heartbeat," "trouble sleeping." Many users turn to other drugs, like sleeping pills, Thompson says, to counteract Adderall's stimulant effect.

And then there was the incidence of sudden death. In 2005 Health Canada (the equivalent of our Food and Drug Administration) suspended the sale of Adderall XR after a manufacturer's review submitted to the agency found 20 sudden and heart-related deaths and strokes in adults and children taking prescribed doses since the introduction of Adderall in 1994. (In a statement to Allure, Matt Cabrey, a Shire Pharmaceuticals representative, noted, "Just because a person has an adverse event while taking a medicine, it does not mean the medicine caused the event.") The drug was reinstated later in the year — with much harsher warning labels than we have in the U.S., plus letters to all prescribing doctors informing them of the risks associated with the use of Adderall XR.

Finally, consider this reason for not abusing Adderall: the rebound effect. "If you don't keep taking it," says Amanda, who occasionally runs out of her pills before she can revisit her doctor, "your appetite returns, your motivation is nothing, you're really tired." Moreover, as tolerance for Adderall builds, "there is a concern that those who abuse the drug may need to take more just to maintain their new, lower weight," according to Thompson.

Still, I can't help wondering: If she didn't have the ADD that, in the past, had kept her from holding a job for more than six months when she was unmedicated, would she still take A to keep her weight under control?

Amanda ponders for a moment, then smiles. "Well," she says, "this is Hollywood."

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