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''People tend to want to be thinner than in the rest of the country.'' He said the drugs ''work like magic.'' He himself takes them. Adam Drewnowski, director of the Center for Human Nutrition at the University of Michigan, said that an overweight but not obese friend of his had gone to a weight loss clinic near Atlanta looking for the drugs but that the doctor at the weight loss center had refused to prescribe fen-phen for him.Д«ut there is no doubt that some clinics have prescribed the drugs to huge numbers of people.ДЄbout 10,000 people visiting the 16 Los Angeles area offices of California Medical Weight Loss Associates have taken the drugs, said Aaron Baumann, the group's administrator. Luke's-Roosevelt Hospital in New York City, said his center's doctors had prescribed the drugs for fewer than 5 percent of their patients.ДЄnd Dr. Xavier Pi-Sunyer, director of the Van Itallie Center for Weight Loss and Maintenance at St. Of course, not every weight loss center freely prescribes the drugs. Hillman said, ''you have a potential disaster on your hands.'' When a nearly untested drug combination enters the obesity market in a country where people are willing to try almost anything that promises to help them shed pounds, Dr. Hillman and others question whether it was wise.

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That was legal because doctors are free to prescribe approved drugs for any uses they please, but Dr. Hillman, an internist and economist who is associate dean of the University of Pennsylvania School of Medicine, when doctors began prescribing the drugs en masse, they were conducting an uncontrolled experiment on millions of Americans. Weintraub's small study, no one has tested fenfluramine and phentermine together, and no one has looked for adverse effects when people take the drugs for long periods of time. He suggested that obesity be treated as a chronic illness, with patients taking drugs for life.Д«ut except for Dr. Bernard Weintraub of the University of Rochester, who conducted the study, noted that the patients had not actually reached their ideal weights but that most had lost enough weight to lower their blood pressure and blood sugar levels. Doctors started combining them only recently, after a four-year study of 121 obese people indicated that the combination could succeed where diets alone failed. The Food and Drug Administration sent out a letter to thousands of doctors advising them of the valve defects but not telling doctors to take patients off the drugs.ДЇenfluramine and phentermine are old drugs, approved two decades ago as short-term diet aids for the obese. Wyeth-Ayerst, one of two companies that make fenfluramine and the sole maker of dexfenfluramine, sold as Redux, sent out a news release saying it was working with the Mayo Clinic to further investigate the question of whether the fen-phen combination causes the heart valve defects but added that at this time the data were ''limited and therefore not conclusive.'' In addition, said the company, a unit of the American Home Products Corporation, obesity itself ''is associated with serious health disorders.'' Previous studies have linked fenfluramine and dexfenfluramine, a chemically purer version of the drug, to primary pulmonary hypertension, an often fatal condition in which the artery that feeds blood to the lungs becomes choked off. Last week, doctors at the Mayo Clinic and elsewhere reported that 35 women who had taken fenfluramine and phentermine had developed an unusual and serious heart-valve defect. The evidence that the drug combination may be dangerous is preliminary, but leading cardiologists and obesity experts say they are alarmed. What does it say about the American medical system when millions of healthy people rush to take an untested combination of drugs for long periods of time? What are people willing to risk to be slim? Patients got 18 million new prescriptions and refills last year, said IMS America, which tracks drug sales.Д«ut now, in the wake of new hints that the drug combination might be dangerous, some medical experts are asking what the nation has wrought. Not since the amphetamine craze of the 1970's have diet pills swept the country like fen-phen, as the drug combination is known. So far, he said in an interview, he has given the drugs to 800 people. Now he has an office in Culver City, Calif., and is about to open two more, one in San Luis Obispo, Calif., and the other in Hawaii. He began by advertising on the Internet and seeing patients in his living room. Krentzman, a family practitioner, said he had come out of retirement last year to prescribe the pills. There are no contraindications, his web page says.Дr. In fact, he advertises on his web page that if you cannot make it to his office, he will prescribe the drugs anyway over the phone. PIETR HITZIG of Timonium, Md., is so impressed with the diet pill combination fenfluramine and phentermine that he has given it to 8,000 people.