Last updated: May 1, 2017
Stimulants have a long history of being used for weight loss in the United States. Ritalin is a stimulant used to treat ADHD that's less potent amphetamine but more potent than caffeine.
Today, clinicians don't prescribe Ritalin for weight loss because the cost/benefit ratio is unfavorable. There are more effective drugs for weight loss, and Ritalin has serious adverse effects that are no trifling matter.
Patients prescribed Ritalin tend to lose weight because Ritalin:
- decreases appetite
- increase metabolic rate
- increases gastrointestinal motility and diarrhea
For some Ritalin-induced weight loss is an undesirable adverse effect. But for others, weight loss may be the intended effect.
Ritalin is not an FDA-approved treatment for obesity nor should it be. There are more effective drugs for patients suffering from obesity. But if you need to lose weight and have ADHD or narcolepsy, you could benefit from Ritalin's appetite suppressing effects.
A Brief History of Weight Loss Drugs
The original weight loss (anti-obesity) cocktail was fenfluramine/phentermine, affectionately referred to as as “fen-phen.”
This potent concoction, which releases all three monoaminergic neurotransmitters in spades (dopamine, norepinephrine and serotonin), was withdrawn from the market due to causing fatal pulmonary hypertension and valvular disease.
Since fen-phen was banned, other drugs have been increasingly re-purposed for off-label use as anti-obesity medications.
Specifically, psychostimulants like Adderall and Ritalin, antidepressants like Wellbutrin and anticonvulsants like Topamax have been used as anti-obesogenic medications, despite being unapproved for these purposes.
Classes of Weight Loss Drugs
Ritalin belongs to a class of drugs known as sympathomimetic amines.
Here's a breakdown of prescription weight loss drugs by class:
Sympathomimetic amines - Benzphetamine, Diethylpropion, Phendimetrazine, Phentermine
Lipase inhibitors - Orlistat
Serotonin 2C receptor agonist - Lorcaserin
Combinations - Phentermine + Topimirate, Bupropion + Naltrexone
Ritalin and Weight Loss
So how do these drugs stack up when it comes to weight loss?
Ranked from most likely to incur weight loss to least, we obtain:
Topamax > Adderall > Wellbutrin > Ritalin
In other words, Topamax is the most effective at reducing weight and Ritalin is the least.
The psychostimulants Adderall and Ritalin, and the antidepressant Wellbutrin cause weight loss as a side effect because they increase catecholamines. Catecholamines like dopamine and norepinephrine curb appetite while also increasing metabolic rate.
Conversely, binge-eating has been linked to diminished dopamine and depression.
In one small study with 12 participants, the overweight patients lost 12 lbs in eight weeks while taking Wellbutrin. Moreover, a study conducted in Canada concluded that Ritalin reduced total calorie intake by 11 percent.
Of the four drugs discussed above, Topamax has the harshest side effect burden (with cognitive impairment being a major side effect), while wellbutrin is the best tolerated with the fewest serious side effects.
Ritalin and Adderall both have significant abuse potential, and therefore one must soberly weigh the risks of psychostimulant tolerance and dependence against the ill health effects of obesity.
Many have expressed concern and skepticism about using potent medications like Adderall and Ritalin (many of which have dangerous side effects) for weight loss.
Yet critics should appreciate that obesity is itself dangerous. Obesity increases the risk of early death and diminishes quality of life. Obesity is also designated a disease by American Medical Association.
Obesity is increasingly being recast from a lifestyle disease to a disorder with a strong genetic aspect.