Eating less and moving more are the basics of weight loss that lasts. For some people, prescription weight loss drugs may help.
National Institute of Diabetes and Digestive and Kidney Diseases: "Prescription Medications for the Treatment of Obesity.". FDA: "FDA Drug Safety Communication: Completed Safety Review of Xenical/Alli (orlistat) and Severe Liver Injury," "Medications Target Long-Term Weight Control."
Dr. Arefa Cassoobhoy: 4 new weight loss drugs were approved recently, and more are sure to come. So, the question is, should you try one?The truth is weight loss drugs CAN help. You may want to try one if you’re obese, or if you’re overweight with a condition like type 2 diabetes or high blood pressure.So, how much weight can they help you lose? About 10% of your excess weight.Now that may not seem like a lot, but it’s a realistic goal to start with. And, once you tackle that first 10% you can set a new goal.Just remember, these drugs won’t lose the weight for you. But they will give an added boost to your diet and exercise plan.If you think this is something you want to try, talk to your doctor.For WebMD I’m Dr. Arefa Cassoobhoy.
You'll still need to focus on diet and exercise while taking these drugs, and they're not for everyone.
Before you get a weight loss drug prescription, tell your doctor about your medical history. That includes any allergies or other conditions you have; medicines or supplements you take (even if they're herbal or natural); and whether you're pregnant, breastfeeding, or planning to get pregnant soon.
How it works: Blocks your body from absorbing about a third of the fat you eat.
When a doctor prescribes orlistat, it's called Xenical. If you get it without a prescription, it's called Alli, which has half of Xenical's dose.
Side effects: The most common side effects include nausea, constipation, headache, vomiting, dizziness, insomnia, and dry mouth. Contrave has a boxed warning about the increased risk of suicidal thoughts and behaviors associated with bupropion. The warning also notes that serious neuropsychiatric issues linked to bupropion have been reported. Contrave can cause seizures and must not be used in patients who have seizure disorders. The drug can also increase blood pressure and heart rate.
What else you should know: If you don't lose 5% of your weight after 12 weeks of taking Contrave, your doctor may tell you to stop taking it, because it's unlikely to work for you, the FDA says.
Side effects: Nausea, vomiting, diarrhea, constipation, low blood pressure, and increased appetite. Serious side effects can include raised heart rate, pancreatitis, gallbladder disease, kidney problems, and suicidal thoughts. Liraglutide has been shown in studies to cause thyroid tumors in animals, but it is not yet known if it can cause thyroid cancer in humans.
What else you should know: If you don't lose 4% of your weight after 16 weeks of taking Liraglutide, your doctor may tell you to stop taking it, because it's unlikely to work for you, the FDA says.
How it works: Curbs your appetite.
Your doctor may prescribe this under the names including Adipex or Suprenza.
Approved for long-term use? No. It's approved for short-term use (a few weeks) only.
Side effects can be serious, such as raising your blood pressure or causing heart palpitations, restlessness, dizziness, tremor, insomnia, shortness of breath, chest pain, and trouble doing activities you've been able to do.Less serious side effects include dry mouth, unpleasant taste, diarrhea, constipation, and vomiting.
As with some other appetite suppressants, there's a risk of becoming dependent upon the drug.
Don't take it late in the evening, as it may cause insomnia.
If you take insulin for diabetes, let your doctor know before you take phentermine, as you may need to adjust your insulin dose.
What else you should know: Phentermine is an amphetamine. Because of the risk of addiction or abuse, such stimulant drugs are "controlled substances," which means they need a special type of prescription.
Phentermine and topiramate (Qsymia)
How it works: Curbs your appetite.
Qsymia combines phentermine with the seizure/migraine drug topiramate. Topiramate causes weight loss in several ways, including helping you feel full, making foods taste less appealing, and burning more calories.
Approved for long-term use? Yes. Qsymia has much lower amounts of phentermine and topiramate than when these drugs are given alone.
Side effects: The most common side effects are tingling hands and feet, dizziness, altered sense of taste, insomnia, constipation, and dry mouth.
Women who might become pregnant should get a pregnancy test before taking Qsymia, and should use birth control and get monthly pregnancy tests while on the drug.
You also shouldn't take Qsymia if you have glaucoma, hyperthyroidism, heart disease, or stroke. Get regular checks of your heart when starting the drug or increasing the dose.
What else you should know: If you don't lose at least 3% of your weight after 12 weeks on Qsymia, the FDA recommends that you stop taking it or that your doctor increase your dose for the next 12 weeks -- and if that doesn't work, you should gradually stop taking it.
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