Prescription weight-loss drugs, also called antiobesity medications, are medicines that can be taken by adults who have a body mass index (BMI) of 30 or above—or between 25 and 29.9 along with an obesity-related health condition such as type 2 diabetes, high blood pressure, heart disease, or sleep apnea.
The three prescription weight-loss drugs currently approved for use in the United States are Orlistat (Xenical, generic version: Alli), Meridia (sibutramine, generic version: Reductil), and Qsymia (phentermine and topiramate extended-release). Note: Phendimetrazine is no longer available due to serious side effects, including heart problems.
Research shows that prescription weight-loss drugs can be effective when combined with a reduced-calorie diet and increased physical activity. Orlistat blocks some of the fat you eat from being absorbed by your body, allowing your bowel to absorb fewer calories from the fats you eat. Phentermine stimulates specific receptors in the brain, making you feel less hungry. Topiramate reduces your desire to eat by affecting chemicals in the brain that communicate hunger signals between nerve cells.
Side Effects of Prescription weight-loss drugs
Prescription weight-loss drugs may cause serious side effects or interactions with other medications, so it’s essential that they only be used under a doctor’s supervision and direction. The Food and Drug Administration (FDA) has issued an advisory about combining prescription weight-loss drugs with other medications called monoamine oxidase inhibitors (MAOIs)—also prescribed for Parkinson’s disease and depression —because of potentially serious side effects. These side effects may include heart problems, shivering, and spasms. In addition, the FDA has warned that taking more than the recommended dose of sibutramine can cause dangerously high blood pressure or severe heart problems.
A few researches on Prescription weight-loss drugs
In 2009, the FDA reviewed data from clinical trials on Qsymia because of concerns about a possible increased risk for congenital disabilities. The agency required that VIVUS run a postmarketing study to investigate this further.
Also, in 2009, after an extensive review by a joint panel representing several federal agencies, the FDA removed the clinical indication for the use of Meridia based on concerns about heart-related severe side effects.
Orlistat, phentermine, and topiramate are not approved for children or adolescents. Orlistat can cause severe kidney damage if taken without enough liquid, vomiting, diarrhea, oily stools, gas with discharge, an excessive amount of fat in the chair, or if used together with another weight loss medicine it is not supposed to be taken with (such as certain HIV medicines). Topiramate can increase appetite or make you feel nervous, and some people have experienced depression. If you have any concerns, speak to your doctor first before taking these drugs at all.
Who can take weight-loss drugs?
A weight-loss drug may be an option for you if you haven’t lost weight through diet and exercise alone.
The first step is to talk with your doctor about your weight, any medical problems that might be prevented or improved by losing weight, and what kind of treatment plan would work best for you.
Your doctor may consider prescribing a weight-loss drug if:
- You have a body mass index (BMI) of 30 or higher.
- Your BMI is 27–29, and you have serious medical problems related to obesity, such as high blood pressure or diabetes. You plan to make changes in your lifestyle, like eating less and exercising more. Your doctor will want follow-up information every 1–3 months while you’re taking the drug.
Then, your doctor will want to see you at least every 3–6 months while you’re taking the weight-loss drug. You should also follow up with your primary care doctor or a registered dietitian nutritionist (RDN) about your weight, exercise routine, and eating habits.
Anyone under 18 shouldn’t take weight-loss drugs without first checking with their doctor.
If you stop taking the medication, it won’t prevent regaining weight loss while on the drug. After talking with your doctor about which type of medication might work best for you, they can give you more information about what you can expect from the drug and possible side effects.
A weight-loss drug may come as a pill, an injection, or a skin patch. A doctor can tell you how much of the drug to take when to take it, and for how long.
How well do weight-loss medications work?
About 60% to 80% of people taking the drugs lose at least 5% of their body weight in a year. In comparison, about 40% to 70% of people using lifestyle changes alone achieve this level of success, which means that the combination is much more successful than lifestyle changes alone. However, since not all medications work for everyone and participants lost a smaller percentage of their initial weight with VLCD’s (deficient calorie diets) compared with other methods, they found it best to put patients on a healthy diet and exercise plan before giving medication.
Older adults may need lower doses than younger adults do because older adults tend to have less body water, which causes orlistat to be eliminated from the body at a slower rate.
How long should you take weight-loss drugs?
Patients can use these medications for up to 1 year when combined with lifestyle changes. However, the FDA has approved these medications for only 12 weeks when used alone. Weight loss is typically less than 10 pounds above that achieved with lifestyle changes over a year.
A study found that using weight loss medication may not be effective in helping people lose more weight compared to those who have healthier diet and exercise plans alone because most participants lost a smaller percentage of their initial weight with VLCD’s (deficient calorie diets) compared with other methods.
Weight loss medication may be effective only in the short term because people taking them typically regain about half or more of their weight within 5 years. This is because the rate at which the body reduces its energy stores even during caloric restriction is not much different from that which occurs when no food is consumed.
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