Background: Pharmacotherapy is recommended for the treatment of obese persons with a body mass index of 30 kg/m(2) or higher or a body mass index of at least 27 kg/m(2) plus an obesity-related comorbid condition. Objective: To estimate the prevalence of use of prescription weight loss pills in the United States in 1996-1998. Design: 1998 Behavioral Risk Factor Surveillance System, a nationally representative telephone survey. Setting: United States. Participants: 139 779 adults 18 years of age and older. Measurements: Self-reported pill use for 1996-1998, body mass index (current and before pill use), age, sex, and race or ethnicity. Results: The 2-year prevalence of pill use was 2.5% (95% CI, 2.1% to 2.9%); or 4.6 million U.S. adults. Use was higher in women than in men (4.0% vs. 0.9%, respectively) and highest among Hispanic respondents (3.2%). Of pill users, 25% were not overweight (body mass index < 27 kg/m(2)) before using pills. Conclusions: Nearly 5 million U.S. adults used prescription weight loss pills in 1996-1998. However, one quarter of users were not overweight. suggesting that weight loss pills may be inappropriately used, especially among women, white persons, and Hispanic persons.