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ARUN RATH, HOST:

It's ALL THINGS CONSIDERED from NPR West. I'm Arun Rath.

Each week, we check in with the online magazine Ozy about some of the most exciting stories they're following. This week, we're going to dig deeper into one piece in particular by freelance writer Samantha Schoech. She's struggled with her weight for most of her life.

SAMANTHA SCHOECH: I am a sort of a lifelong yo-yo dieter, and like many women, weight is a frustrating topic for me.

RATH: Recently, Samantha crossed the line into clinical obesity.

SCHOECH: That bothered me on a lot of different levels, but I couldn't quite figure out how to lose weight on my own. So I sought out a diet clinic in the Bay Area and was prescribed phentermine at my first meeting.

RATH: Phentermine - one half of the infamous diet pill cocktail fen-phen that was big in the 1990s. The other half, fenfluramine, was taken off of the market after a multibillion-dollar lawsuit. Even with that notorious association, phentermine is the most prescribed diet pill in the U.S.

SCHOECH: I chose to take it because I felt like anything that might help was welcome. And that's - yeah, that's how it started.

RATH: And in your writing, you've described yourself as a feminist, and you talk about it being sort of a tricky thing to - you have to, as a woman in the world, I guess, struggle with what society throws you in terms of body image, but also being a feminist, you don't want to give into that thinking either.

SCHOECH: Exactly. I live, as many women do, in sort of this frustrating dichotomy between wanting to be filled with self-acceptance and a sense of power and efficacy and value and being constantly told: oh, that's great, but if you're overweight, you're sort of a loser.

RATH: So with all of that stuff swirling through your head, what was it like for you when you had that pill in your hand for the first time?

SCHOECH: So honestly, I took that pill without a backwards glance. I was sort of at a point of desperation, mostly because I was tired of how much brain space my weight was taking up in my life. I have a family, I have a career, I have a marriage, I have friends. I don't have time to spend 50 percent of my time loathing my body.

Plus, I just honestly didn't like the way I looked, so, you know, there's vanity in there too. Honestly, I didn't take the time to do any research before I started taking phentermine. And it was only after I dropped about 25 pounds that I went and found out what the side effects are. I personally have not had any negative side effects. So I'm - I'm still taking it.

RATH: What are the side effects?

SCHOECH: The more serious side effects are cardiovascular side effects, and those are less than one percent. And I'm not here to defend phentermine by any stretch of the imagination.

RATH: So you've been very open about this in this piece. Before the piece, were you open about using phen?

SCHOECH: No. In fact, I didn't tell anybody.

RATH: Really?

SCHOECH: I didn't even tell my husband, in part because I didn't want it to lessen my accomplishment. I felt like if people saw my use of phentermine as this crutch, they would write off my efforts. And then I was a blogger for a long time, and I've sort of had it with people weighing in on my decisions and my life.

RATH: Of course, now, you've published this piece, and I have to imagine there's a lot of chatter you must be getting. What have the responses been like?

SCHOECH: You know, mostly, it's been overwhelmingly positive. And people have been grateful for me stepping into this conversation about feminism and body image and dieting and health and secrets we keep and all of that. But there's been some criticism too. I mean, somebody told me that it was irresponsible of me as a mother to take phentermine.

You know, I got a comment on the story, saying: Don't listen to the lies. Go on an ego diet and binge on love. And I thought, you know, that's great. But it's also just way too facile. I mean...

RATH: Yeah. Pay your bills with love too.

SCHOECH: Yeah, exactly. I mean, the truth of the matter is, you know, I care about how I look to a certain extent. I am not trying to be a supermodel, by any stretch of the imagination. I am trying to be a healthy 43-year-old mother of two.

RATH: Samantha, thank you so much for sharing this with us.

SCHOECH: Thank you so much for having me.

RATH: Freelance writer Samantha Schoech is the co-editor of the book "The Bigger the Better, the Tighter the Sweater." Her piece "Even a Feminist Take Phentermine" ran this week on ozy.com.

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