OBJECTIVES: To determine the prescribing and cost of appetite suppressants in a defined private sector patient population, as well as the prescribing of other medicines to the patient sample. METHODS:   A retrospective drug utilisation study was conducted on a medical insurance claims database in South Africa for 2010 and 2011.  No clinical information was available in the database. RESULTS:   In 2010, 37 patients (86.49% females) were prescribed 44 appetite suppressants at a total cost of R9813.39, of which 75.0% were for phentermine.  The average age of patients was 40.95 (SD=12.37) years.  In 2011, 27 patients (77.78% females) received 42 prescriptions for appetite suppressants at a total cost of R9967.73.  The average age of patients was 40.04 years (SD=10.41) (females:  37.95 (SD=7.76) years;  males 47.33 (SD=10.52) years).  Most products (80.95%) were for phentermine, followed by d-norpseudoephedrine (14.29%) and diethylpropion (4.76).  Prescribing patterns in 2010 and 2011 were similar.  Appetite suppressants are strictly regulated in South Africa.  In 2011, a total of 630 products (all therapeutic classes) were prescribed.  The most often other prescribed classes in 2011 were gastrointestinal tract products (14.60%), cardiovascular agents (11.11%) and antimicrobial products (9.52%).  The most frequently prescribed subclasses were HMG-CoA reductase inhibitors (statins), analgesic combinations, non-selective COX-inhibitors and selective serotonin re-uptake inhibitors.  The total amount claimed from the medical insurance scheme for all the products was R73013.71, however, only R37553.24 was paid out.  Appetite suppressants were excluded from patients’ medical insurance benefits. CONCLUSIONS:   A limited number of strictly regulated appetite suppressants were prescribed.  Appetite suppressants that patients can buy over-the-counter were not included in this study.  Pseudoephedrine has recently been rescheduled to be more strictly controlled due to its abuse potential.  Further consumer studies on appetite suppressants which include clinical information will provide a useful insight into the role of these products in weight loss efforts.