• Sun. Sep 19th, 2021

Diet pills, Prescription weight loss drugs, Appetite suppressant

ByDonald L. Leech

Feb 25, 2020

Eating less and moving more are the foundations for lasting weight loss. For some people, prescription weight loss medications can help.






Video transcript

National Institute of Diabetes, Digestive and Kidney Diseases: “Prescription Drugs for the Treatment of Obesity. FDA: “FDA Drug Safety Communication: Completed Safety Review of Xenical / Alli (orlistat) and Severe Liver Injury”, “Drugs Target Long-Term Weight Control.”

Dr Arefa Cassoobhoy: 4 new drugs for weight loss have been approved recently, and more will certainly 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 are obese or overweight with a problem like type 2 diabetes or high blood pressure.
So how much weight can they help you lose? About 10% of your excess weight.
It might not sound like a lot, but it’s a realistic goal to start with. And, once you’ve hit that first 10%, you can set a new goal for yourself.
Remember that these drugs will not make you lose weight. But they will give your diet and exercise program an extra boost.
If you think this is something you want to try, talk to your doctor.
For WebMD, I am Dr Arefa Cassoobhoy.

You will always need to focus on diet and exercise while taking these medications, and they are not suitable for everyone.

Doctors usually only prescribe them if your BMI is 30 or more, or if it is 27 or more and you have a condition that may be related to your weight, such as Type 2 diabetes or high blood pressure.

The drug semaglutide (Wegovy) received FDA approval for the treatment of obesity in 2021. The most common prescription weight loss drugs that have been in use for longer include: liraglutide (Saxenda), naltrexone-bupropion (Contrave), orlistat (Alli, Xenical), phentermine (Adipex-P, Ionamin, Pro-Fast) and phentermine-topiramate (Qsymia).

Before getting a prescription for weight loss medication, tell your doctor about your medical history. This includes any allergies or other conditions you have; any medicines or supplements you are taking (even if they are herbal or natural); and if you are pregnant, breastfeeding, or planning to become pregnant soon.

Liraglutide (Saxenda)

How it works: Liraglutide is a higher dose of the type 2 diabetes medicine Victoza. It mimics a gut hormone that tells the brain that your stomach is full.

Approved for long term use? Yes.

Side effects: Nausea, vomiting, diarrhea, constipation, low blood pressure and increased appetite. Serious side effects can include a fast heart rate, pancreatitis, gallbladder disease, kidney problems, and suicidal thoughts. Studies have shown that liraglutide causes thyroid tumors in animals, but it is not yet known whether it can cause thyroid cancer in humans.

What else you need to know: If you do not lose 4% of your weight after 16 weeks of taking Liraglutide, your doctor may tell you to stop taking it because it is unlikely to work for you, according to the FDA.

Naltrexone HCl and bupropion (Contrave)

How it works: Contrave is a combination of two FDA approved drugs, naltrexone and bupropion, in a sustained release formula. Naltrexone is approved to treat alcohol and opioid dependence. Bupropion is approved for treating depression, seasonal affective disorder, and helping people quit smoking.

Approved for long term use? Yes.

Side effects: The most common side effects are nausea, constipation, headache, vomiting, dizziness, insomnia, and dry mouth. Contrave has a boxed warning about the increased risk of suicidal ideation and behavior associated with bupropion. The warning also notes that serious neuropsychiatric problems with bupropion have been reported. Contrave can cause seizures and should not be used in patients with seizure disorders. The drug can also increase blood pressure and heart rate.

What else you need to know: If you do not lose 5% of your weight after 12 weeks of taking Contrave, your doctor may tell you to stop taking it because it is unlikely to work for you, according to the FDA.

Continued

Orlistat (Xenical)

How it works: Prevents your body from absorbing about a third of the fat you eat.

When a doctor prescribes orlistat, it is called Xenical. If you get it without a prescription, it’s called Alli, which contains half the dose of Xenical.

Approved for long term use? Yes.

Side effects include abdominal cramps, gas, leaky oily stools, more frequent bowel movements, and inability to control bowel movements.

These side effects are usually mild and temporary. But they can get worse if you eat foods high in fat.

Rare cases of serious liver damage have been reported in people taking orlistat, but it is not certain whether the medicine caused these problems.

What else you need to know: You should be on a low fat diet (less than 30% of your daily calories are from fat) before taking orlistat.

Also, take a multivitamin at least 2 hours before or after taking orlistat, as the medicine temporarily makes it harder for your body to absorb vitamins A, D, E, and K.

Orlistat is the only drug of its type approved in the United States. All other prescription weight loss medications curb your appetite, including the following.

Phentermine

How it works: Limit your appetite.

Your doctor may prescribe it for you under names such as Adipex or Suprenza.

Approved for long term use? No. It is approved for short-term (a few weeks) use only.

Side effects can be serious, such as raising your blood pressure or causing heart palpitations, restlessness, dizziness, tremors, insomnia, shortness of breath, chest pain, and difficulty doing activities you may have done. Less serious side effects include dry mouth, bad taste, diarrhea, constipation, and vomiting.

As with some other appetite suppressants, there is a risk of becoming dependent on the drug.

Do not take it late at night, as it can cause insomnia.

If you are taking insulin for diabetes, tell your doctor before taking phentermine, as you may need to adjust your insulin dose.

You should not take phentermine if you have a history of heart disease, stroke, congestive heart failure, or uncontrolled high blood pressure. You should also not take it if you have glaucoma, hyperthyroidism or a history of drug abuse, or if you are pregnant or breastfeeding.

What else you need to know: Phentermine is an amphetamine. Because of the risk of dependence or abuse, these stimulant drugs are “controlled substances”, which means that they require a special type of prescription.

Continued

Phentermine and topiramate (Qsymia)

How it works: Limit your appetite.

Qsymia combines phentermine with topiramate, a medicine for seizures / migraine. Topiramate causes weight loss in several ways, including helping you feel full, making food less appetizing, and burning more calories.

Approved for long term use? Yes. Qsymia contains much lower amounts of phentermine and topiramate than when these medicines are taken alone.

Side effects: The most common side effects are tingling in the hands and feet, dizziness, altered taste, insomnia, constipation, and dry mouth.

Serious side effects include certain birth defects (cleft lip and cleft palate), a faster heart rate, suicidal thoughts or actions, and eye problems that could lead to permanent vision loss if left untreated.

Women who could become pregnant should have a pregnancy test before taking Qsymia, and should use birth control and have monthly pregnancy tests while taking the medicine.

You should also not take Qsymia if you have glaucoma, hyperthyroidism, heart disease, or stroke. Get your heart checked regularly when you start the medicine or increase the dose.

What else you need to 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 your doctor increases your dose for the next 12 weeks – and if that doesn’t work, you should gradually stop taking it.

Semaglutide (Wegovy)

How it works: Semaglutide works by mimicking a gut hormone that stimulates insulin production, reduces your appetite, and makes you feel full.

Semaglutide was originally approved as a treatment for type 2 diabetes and is prescribed for that use under the names Ozempic and Rybelsus. Like Wegovy, it is specifically intended for the treatment of obesity.

Approved for long term use? Yes.

Side effects include abdominal cramps, constipation, vomiting, gas, headache, fatigue, and gastroesophageal reflux disease.

These side effects are usually mild and temporary.

In rare cases, problems involving the kidney as well as blurred vision have occurred. Semaglutide has been linked to cases of pancreatic disease (pancreatitis). Get medical help right away if you develop symptoms of pancreatitis, including: severe abdominal / stomach pain, persistent nausea / vomiting.

Continued

What else you need to know: The indications are that you would need to take semaglutide for life to manage your weight. Stopping taking it could lead to regaining most of the lost weight.

You should also follow a low calorie diet and exercise program.

Sources

SOURCES:

National Institute of Diabetes, Digestive and Kidney Diseases: “Prescription Drugs for the Treatment of Obesity. “

FDA: “FDA Drug Safety Communication: Completed Safety Review of Xenical / Alli (orlistat) and Severe Liver Injury” and “Drugs target long-term weight control. “

MedlinePlus: “Phentermine.”

Press release, FDA.

MedlinePlus.

Up to date.

Qsymia.com.

novo-pi.com: “Saxenda.”

static.contrave.com: “Contrave.”


© 2020 WebMD, LLC. All rights reserved.


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