Weight loss

Weight loss medications

Weight loss medicationsWeight loss medications

Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat (adipose tissue), or lean mass (namely bone mineral deposits, muscle, tendon, and other connective tissue).  Weight loss can either occur unintentionally because of malnourishment or an underlying disease, or from a conscious effort to improve an actual or perceived overweight or obese state. Maintaining a healthy weight is important to avoid life-threatening medical conditions and to prolong an active lifestyle. Obesity is a condition in which a person has an abnormally high and unhealthy proportion of body fat.

Staying at a healthy weight or losing weight requires a combination of regular exercise, healthy eating with portion and calorie control, and drinking low-calorie fluids such as water. Intentional weight loss is commonly referred to as slimming.

Weight loss medications     Before                After

A physician may decide that a weight loss medication may be an appropriate aid in some treatment plans. A patient and their physician may instead decide that surgical weight loss, such as gastric bypass surgery, is the appropriate action, based upon weight and current health risks.

Benefits to Weight Loss

Weight loss in individuals who are overweight or obese may reduce many health risks. Studies have found that weight loss with some medications can improve several health risks, such as:

  • High blood pressure, heart disease, and stroke
  • High blood lipids (cholesterol, triglycerides)
  • Diabetes and insulin resistance (the body’s inability to utilize blood sugar)
    sleep apnea

Weight loss medicationsWeight loss medications

Anti-obesity medication or weight loss medications are pharmacological agents that reduce or control weight. These medications alter one of the fundamental processes of the human body, weight regulation, by altering either appetite or absorption of calories. The main treatment modalities for overweight and obese individuals remain dieting and physical exercise.
In the United States orlistat (Xenical) is currently approved by the FDA for long-term use. It reduces intestinal fat absorption by inhibiting pancreatic lipase.
  • Rimonabant (Acomplia), a second medication, works via a specific blockade of the endocannabinoid system. It has been developed from the knowledge that cannabis smokers often experience hunger, which is often referred to as “the munchies”. It had been approved in Europe for the treatment of obesity but has not received approval in the United States or Canada due to safety concerns. The European Medicines Agency in October 2008 recommended the suspension of the sale of rimonabant as the risks seem to be greater than the benefits.
  • Sibutramine (Meridia), which acts in the brain to inhibit deactivation of the neurotransmitters, thereby decreasing appetite was withdrawn from the United States and Canadian markets in October 2010 due to cardiovascular concerns.
Because of potential side effects, and limited evidence of small benefits in weight reduction especially in obese children and adolescents, it is recommended that anti-obesity medications only be prescribed for obesity where it is hoped that the benefits of the treatment outweigh its risks.

Side Effects Associated With Weight Loss Drugs

Medication Name Drug Category Common Side Effects
Adipex-P (phentermine Appetite-suppressant; sympathomimetic amine Increased blood pressure and heart rate, insomnia, nervousness, restlessness, dependence, abuse, or withdrawal may occur with long-term use. When given as a single agent, phentermine is not implicated in valvular heart disease; avoid use at bedtime.
Xenical (orlistat) Lipase inhibitor Oily spotting, gas (flatulence), fecal urgency, soft stools, fecal incontinence; take Xenical with a daily multivitamin containing fat-soluble vitamins.
Belviq (lorcaserin) Selective serotonin 2C receptor agonist (suppresses your appetite by affecting a chemical in your brain) Headache, nausea, cough, dizziness, fatigue, dry mouth, constipation; euphoria/dissociation may occur with higher doses; do not exceed 10 mg two times a day.
Bontril PDM, Bontril (phendimetrazine) Appetite-suppressant; sympathomimetic amine Increased blood pressure and heart rate, insomnia, nervousness, restlessness, dependence, abuse, or withdrawal may occur with long-term use; decreased appetite, avoid use at bedtime.
Contrave (bupropion and naltrexone) Antidepressant (weak inhibitor of norepinephrine and dopamine) and an opioid antagonist Nausea, vomiting, headache, fatigue, constipation, dizziness, difficulty sleeping, dry mouth, diarrhea, increased blood pressure, fast heart rate anxiety, tremor, hot flush, unusual taste.
Desoxyn (methamphetamine) Appetite-suppressant; sympathomimetic amine High abuse potential and not frequently prescribed; use only if alternative treatments are ineffective; increased blood pressure and heart rate, insomnia, nervousness, restlessness, dependence, abuse or withdrawal may occur with long-term use; avoid use at bedtime.
Didrex (benzphetamine) Appetite-suppressant; sympathomimetic amine Increased blood pressure and heart rate, insomnia, nervousness, restlessness, dependence, abuse or withdrawal may occur with long-term use; decreased appetite, avoid use at bedtime.
Diethylpropion (generic only) Appetite-suppressant; sympathomimetic amine Constipation, restlessness, dry mouth, increased blood pressure and heart rate, insomnia, nervousness, restlessness, dependence, abuse or withdrawal may occur with long-term use; avoid use at bedtime.
Qsymia (phentermine and topiramate extended-release capsules) Combination appetite suppressant-seizure drug; exact action of topiramate on weight loss is not known Tingling or numbing sensation (paresthesias), dizziness, altered taste, insomnia (difficulty sleeping), constipation, dry mouth. The dose is taken once daily in the morning; avoid an evening dose as it may keep you awake. Do not use if pregnant or planning pregnancy due to possible birth defects; avoid use at bedtime.
Saxenda (liraglutide) Glucagon-like peptide-1 (GLP-1) receptor agonist; regulates appetite and food intake injection only. Nausea and vomiting, diarrhea, constipation, decreased appetite, dizziness, headache, heartburn, fatigue, dizziness, stomach pain, gas, dry mouth, low blood sugar in type 2 diabetes, elevated heart rate, increased lipase.

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