Treating Obesity: Pills, Powers and Nostrums
Over the past few days we have been talking about obesity; what it is, some of its causes, as well as some of the more popular diet and eating program methods used treat it. Today we’ll take a look at some of the most popular and widely prescribed medications used to help treat this “weighty” problem.
As we have seen, long-term weight loss requires lifestyle changes which include eating moderate portions of healthy foods and regular exercise. However, in order to assist in making these changes, many physicians are prescribing new classes of drugs for their patients. It’s important to remember, however, that these medications are meant to be used in conjunction with a program that includes diet, exercise and behavior modification, not instead of them.
Factors your doctor will take into consideration before prescribing any of these drugs are:
• You have a documented history of failing with other weight loss methods
• You have a body mass index (BMI) of 30 or more
• You have a BMI greater than 27 as well as other weight related complications such as diabetes, high blood pressure, sleep apnea, etc.
The Mayo Clinic reports that the following drugs are the most widely prescribed and have been approved by the US Food and Drug Administration (FDA) for the treatment for obesity. There are other drugs being prescribed by medical professionals to treat obesity, but they have not been approved by the FDA for this purpose and their use is referred to as “off-label.”
Orlistat (Xenical). Orlistat has been approved by for long-term use in adults and children 12 and older. This medication blocks the digestion and absorption of fat in your stomach and intestines. Unabsorbed fat is eliminated in the stool. Average weight loss with orlistat is about 5 to 7 pounds (2.3 to 3.2 kilograms) more than you can get from diet and exercise after one or two years of taking the medication.
Side effects include oily and frequent bowel movements, bowel urgency, and gas. These side effects can be minimized as you reduce fat in your diet. Because orlistat blocks absorption of some nutrients, take a multivitamin while taking orlistat to prevent nutritional deficiencies.
The FDA has also approved a reduced-strength version of orlistat (Alli) that’s sold over-the-counter, without a prescription. Alli is not approved for children. This medication works the same as prescription-strength orlistat and is meant only to supplement — not replace — a healthy diet and regular exercise.
Lorcaserin (Belviq). Lorcaserin is a long-term weight-loss drug for adults. It works by affecting chemicals in your brain that help decrease your appetite and make you feel full, so you eat less. Your doctor will carefully monitor your weight loss while taking lorcaserin. If you don’t lose about 5 percent of your total body weight within 12 weeks of taking lorcaserin, it’s unlikely the drug will work for you and the medication should be stopped.
Side effects include headaches, dizziness, fatigue, nausea, dry mouth and constipation. Rare but serious side effects include a chemical imbalance (serotonin syndrome), suicidal thoughts, psychiatric problems, and problems with memory or comprehension. Pregnant women shouldn’t take lorcaserin.
Phentermine-topiramate (Qsymia). This weight-loss medication is a combination drug approved for long-term use in adults. Qsymia combines phentermine, a weight-loss drug prescribed for short-term use, with topiramate, a medication that’s used to control seizures. Your doctor will monitor your weight loss while taking the drug. If you don’t lose at least 3 percent of your body weight within 12 weeks of starting treatment, your doctor may suggest either stopping use of Qsymia or increasing your dose, depending on your condition.
Side effects include increased heart rate, tingling of hands and feet, insomnia, dizziness, dry mouth and constipation. Serious but rare side effects include suicidal thoughts, problems with memory or comprehension, sleep disorders and changes to your vision. Pregnant women shouldn’t take Qsymia. Qsymia increases the risk of birth defects.
Phentermine (Adipex-P, Suprenza). Phentermine is a weight-loss medication for short-term use (three months) in adults. Using weight-loss medications short-term doesn’t usually lead to long-term weight loss. While some health care providers prescribe phentermine for long-term use, few studies have evaluated its safety and weight-loss results long term.
There have recently been several new medication approved by the FDA for weight loss, but as they are primarily combinations of the above drugs, I have not bothered to list them here (hey I only get 800 words!).
Keep in mind that you need to be closely monitored while on any of these drugs. Also, as with other methods, medication may not work for you. Additionally, even if they do work, their effectiveness tends to taper off after about six months. Finally, when you stop taking these drugs, you are very likely to regain much if not all the weight.
Tomorrow we’ll look at several methods that are near and dear to my heart, surgical weight loss options.