Weight Loss: Prescription Weight Loss Medicine

Obesity often requires long-term treatment to promote and sustain weight loss. As in other chronic conditions, such as diabetes or high blood pressure, use of prescription medications may be appropriate for some people. While most side effects of prescription medications for obesity are mild, serious complications have been reported (see below.)Keep in mind that these drugs are not a cure-all. The use of weight-loss medications should be combined with physical activity and improved diet to lose and maintain weight successfully.  What Prescription Medicines Are Used to Treat Obesity?Currently, most available weight-loss medications approved by the FDA are for short-term use, meaning a few weeks or months.Most available weight-loss medications are “appetite-suppressant” medications. These include: Didrex, Tenuate, Sanorex, Mazanor, Adipex-P, Ionamin, Bontril and Meridia. These medications generally come in the form of tablets or extended-release capsules (pills that release medication over a long period of time). Appetite suppressants can be obtained by a doctor’s prescription or purchased over the counter.In the mid-1990s, doctors also prescribed the popular appetite suppressant Redux or the combination of phentermine and fenfluramine, called “phen-fen.” However, fenfluramine (Pondimin) and Redux were withdrawn from the market in 1997 because they caused damage to heart valves. Phentermine is still available by prescription. Taking phentermine alone has not been associated with the adverse health effects of the fenfluramine-phentermine combination.Another type of prescription weight loss drug is a fat absorption inhibitor. Xenical is the only example of this type of treatment approved for use in the U.S. Xenical works by blocking about 30% of dietary fat from being absorbed, and is the most recently approved weight loss drug.Meridia and Xenical are the only weight-loss medications approved for longer-term use in significantly obese people, although the safety and effectiveness have not been established for use beyond 2 years.Newer drugs are being studied as potential treatments for obesity, some of which are showing promise and may be available in the near future. Do Prescription Weight Loss Drugs Really Work?In general, Xenical and Meridia are moderately effective, leading to an average weight loss of 5 to 22 pounds over a 1-year period, more than what would be expected with non-drug treatments. However, the response to these medications is based on each individual, and some people experience more weight loss than others. Likewise, there is no one correct dose for these medications. Your doctor will decide what works best for you based on his or her evaluation of your medical condition and your response to treatment. Patients generally experience a maximum weight loss within six months of starting medication treatment.Over the short term, weight loss due to prescription drugs may reduce a number of health risks in obese individuals. However, there are currently no studies to determine the effects of these medications over the long term.Are There Risks to Taking These Medications?When considering the use of long-term weight-loss medication treatment for obesity, the following possible concerns and risks should be discussed with your doctor:·          Addiction. Currently, all prescription medications to treat obesity except Xenical are “controlled substances.” This means that doctors are required to follow certain restrictions when prescribing them since they could be addictive.·          Developed tolerance. Most people’s weight tends to level off after 6 months while taking a weight-loss medication. This leads to a concern that the person has developed a tolerance for the medication. However, it is unclear whether this leveling off is indeed due to a developed tolerance or if the medication has reached its limit in effectiveness.·         Side effects. Most side effects of weight loss medications are mild (although some can be unpleasant) and usually improve as your body adjusts to the medication. Rarely, serious and even fatal outcomes have been reported

What Are the Side Effects?Most appetite suppressants are used as a short-term treatment for people with obesity. Not only do the drugs’ effects tend to wear off after a few weeks, but they can also have some unpleasant side effects, including:

v       Increased heart rate

v       Increased blood pressure

v       Sweating

v       Constipation

v       Insomnia (inability to sleep or stay asleep)

v       Excessive thirst

v       Lightheadedness

v       Drowsiness

v       Stuffy nose

v       Headache

v       Anxiety

v       Dry mouth

Some side effects with Xenical include abdominal cramping, passing gas, leakage of oily stool, increased number of bowel movements and the inability to control bowel movements. These side effects are generally mild and temporary, but may be worsened by eating foods that are high in fat. Patients should start and maintain a low-fat diet (less than 30% of calories from fat) before starting treatment with Xenical. Because Xenical reduces the absorption of some vitamins, people taking Xenical should take a multivitamin at least 2 hours before or after taking the medication.People with poorly controlled high blood pressure, heart disease, irregular heartbeat, or a history of stroke should not take Meridia. All people taking Meridia should have their blood pressure and heart rate monitored on a regular basis.