If you've been keeping up with the fat activist community, I'm sure you're aware of proposed guidelines to "Treat the Weight First"- or as I think of it, holding healthcare for fat people hostage until they lose weight.

The topic has been pretty well covered by Ragen Chastain at Dances with Fat, Liss at Shakesville, and S.E. Smith at xojane, so I'm not going to get into the weeds of the proposal too much, except to say that this is a goddamn nightmare come true for people like me.

What I want to address is the part of this guideline where it calls for the mandatory use of diet pills.

Whenever anyone talks about new diet pills, I want your brain to immediately think- FEN PHEN.

Let's all remember what happened the last time Pharma was so excited about diet pills. It's all been shoved down the memory hole pretty hard, but it's time to dig it back up.

Fen phen is a drug combination of two drugs. The Fen is one of two drugs- fenfluramine (Pondimin) or dexfenfluramine (Redux), and the Phen is phentermine.

Podimin and Redux are selective serotonin reuptake inhibitors (SSRI)- they reduce appetite by boosting the amount of serotonin in the brain. Phentermine is phenethylamine, which is similar to amphetamine. Speed, basically.

These two drugs together caused damage to heart valves that resulted in open heart surgery for people. It also caused a lung disease called Primary Pulmonary Hypertension (PPH).

PPH is a narrowing of the blood vessels from the heart to the lungs, like crimping a water hose so less and less water can get through. The heart pumps faster and faster, trying to get blood to the lungs to get oxygen into the blood. You suffocate to death, slowly.

Mary Linnen wanted to lose 20 pounds to fit into her wedding dress. She took fen phen for 23 days, and she got PPH.

Mary had to have a tube implanted into her heart to have a machine continuously pump a drug into it to help her heart pump faster.

"For the rest of her life, Mary would be hooked up to a portable machine. She would have to make up her solution daily, fill her tube, clean all the equipment. Infection would always haunt her. The machine was equipped with an alarm. If it malfunctioned, she had only two minutes to fix it or call an ambulance, because she would probably go into cardiac arrest." (Alicia Mundy, Dispensing with the Truth)

The tube was always in danger of becoming dislodged, and when it did, it sprayed blood everywhere. Mary lost her eyesight completely in one eye. Less than a year after taking the drug combo, she was dead.

Pulmonary hypertension was a death sentence.

The drug maker Wyeth* was responsible for the approval of Redux and the marketing of the drug combo as a new wonder drug for weight loss.

Wyeth knew that Redux caused PPH at much higher rates than they had previously admitted to. They knew and they hid it from the FDA. They hyped up the risks from 'obesity' because an effective diet pill is worth billions.

Redux also only caused a 3% weight loss when compared to a placebo. That is a 6 pound weight loss in a 200 pound person. And the weight loss only lasted as long as the pills were taken.

Wyeth conducted a $100 million PR campaign to bury fen phen, to pay as few damages as possible, to not be punished in any way by the government, and to make sure that people forgot about fen phen. To make sure that people never knew the extent of the damage in the first place.

I am working on a longer piece about the history of fen phen and how it is still affecting us today.

But just for now- where does this leave us? Where we are is with a pharmaceutical and weight loss industry that thinks it's been long enough to start shelling out diet pills again. That everyone has forgotten.

There's a new phentermine combination to sell to people and other diet drugs that the industry wants doctors to get on the ball and prescribe to fat people.

The industry has argued before that the enormous benefits of diet drugs out weigh any deaths that may occur.

I would argue that these huge, ridiculous numbers of people supposedly dying every year have been often repeated but never proved. There are no enormous benefits to point to. Just people who have been injured and killed.

So when you hear diet drugs-- think about fen phen. And don't be fooled by FDA approval. All of the drugs in fen phen were FDA approved. The FDA works for the drug companies, not the public.

The weight loss industry wants to erase what they did from our memories. Don't let them.

*Wyeth was originally American Home Products and has since been bought by Pfizer and there's another company called Interneuron that was involved, but I'm going to just refer to the whole shebang as Wyeth to keep it simple.

** This information is from the book Dispensing with the Truth by Alicia Mundy, Battling Goliath by Kip Petroff, and Public Health Profiteering by James T Bennett and Thomas J DiLorenzo.