n September 2014, the US FDA approved a new weight loss medication called Contrave, a sustained release combination of the popular mood stabilizer, Bupropion(Wellbutrin) and a narcotic de-additiction medication called Naltrexone.
FDA has previously approved two new weight loss medications in 2012, Lorcaserin(Belviq) and Qsymia(Phentermine and Topiramate) after a gap of 10 years when it kept denying all the weight loss medications for one reason or the other.
The urgency in which the FDA cleared these three new weight loss medications reflects the growing concern about the epidemic of obesity that is threatening the health of the nation. According to the available obesity statistics from the Centers for Disease Control, obesity and overweight status already affect up to two thirds of the entire adult population of the the United States.
More than one-third (34.9 % or 78.6 million) of U.S. adults are obese
- Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death.
- The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight.
This article is a comprehensive review of the various weight loss medications(diet pills), their side effects, how they work, expected weight loss, cost of these diet pills, availability etc.
Before going in to the details of the various diet pills, let me remind you that obesity is not a short term disease like the flu but a long term medical condition. Therefore, the treatment strategies for the long term management of this chronic condition should also be on a longer term basis.
I am also compelled to make a statement about how we got here to begin with when it comes to the problem of obesity. Despite the efforts from the various government agencies such as the United States Department of Agriculture that has been making recommendations on healthy foods through the failed food pyramid, now changed to food patterns, the waist lines of the average American has been expanding.
Is it possible that we are fighting the wrong war? What if obesity is just a proxy to a bigger and more sinister metabolic problem called insulin resistance which eventually leads to metabolic syndrome (a third of the US population has metabolic syndrome), prediabetes and diabetes.
The traditional thinking that obesity is a result of eating too much falls flat on its face as the whole population is gaining weight, not just a few individuals who might be intentionally overeating as the population acts as its own control and the population is not on a mission to gain weight. It is this metabolic process called insulin resistance that drives the metabolic starvation, overeating, weight gain and eventual risk of over 50 different medical problems.Although there are a wide variety of other causes for weight gain, the process of insulin resistance that affects up to 71 percent of the population is one of the major contributors. This insulin resitance is a direct result of the failed food pyramid that assumed fat and cholesterol are the problem and grains(read starch) is the solution, as starch needs insulin and over time of getting overexposed to insulin, the body becomes resistant to insulin. Learn more on insulin resistance here and watch these must watch youtube videos and Tedtalk.
Here are the 5 proven measures to treat obesity.
- Very low calorie diets with or without meal replacements.
- Appetite suppressants or diet pills
- Physical activity or exercise
- Correction of known causes of weight gain
- Bariatric weight loss surgery
The purpose of this article is to review the weight loss medications. So, let us focus on this topic.
How will these weight loss medications work?
The actual mechanism of action depends on the type of weight loss medication. Some of their stimulants that increase the body’s resting metabolic rate (RMR), also called basal metabolic rate or BMR. Other drugs suppress the appetite by making you less hungry. Yet others, make you not crave certain foods while others reduce food intake.
Who should consider diet pills or weight loss medications?
Body Mass Index or BMI estimates overweight and obesity based on your height in relation to your weight. Your doctor may prescribe you a medication to treat your obesity if you are anadult with.
- a BMI of 30 or greater OR
- a BMI of 27 or greater and you have obesity- related medical problems, such as high blood pressure, type 2 diabetes, or high cholesterol.
What are the benefits of taking diet pills or weight loss medications?
When combined with changes to eating and physical activity, prescription drugs may help some people lose weight (usually less than 10 percent of their body weight). Results vary by drug and by person. Losing weight may help improve your health by lowering blood sugar,blood pressure, and triglycerides (other fats in the blood).
Weight loss of 5 to 10 percent can also improve inflammation profiles and improve how patients feel and their mobility. Most weight loss takes place in the first 6 months of starting the medicine.
After that time, you may lose weight more slowly or begin to regain weight. What are the concerns?Because obesity drugs are used to treat a condition that affects millions of people, the chance that side effects may outweigh benefits is of great concern.This is why one should never take a weight loss medicine only for cosmetic benefit.
Also check the new weight loss medication Contrave information.
By far, the most effective weight loss medication in our experience has been the combination medications, especially the combination of Phentermine and Topiramate. According to many studies, this combination effectively blocks both the appetite and cravings in most people and studies have shown it to lead to about 9% weight loss in a year, more than twice as much as the competition such as 4.5% percent weight loss expected with Belviq, or 5% weight loss expected with the new Contrave.
Phentermine-topiramate (Qsymia) In July 2012, the FDA approved the drug combination phentermine and topiramate, sold as Qsymia (pronounced kyoo-sim-EE-uh) to treat obesity in adults.
Qsymia combines two FDA-approved drugs
- phentermine, a medicine approved to suppress appetite.
- topiramate, a medicine approved to control seizures.
See W8MD's review of Qsymia
It may also be used to preventmigraine headaches. It is in an extended-release form in Qsymia.Although phentermine when used as a single agent is approved for only a few weeks, the combination has been studied for 2 years and found to be safe for use.
Additionally, the doses used in Qsymia are much lower than the usual doses of phentermine and topiramate when prescribed separately. Qsymia is available in three doses: a starting dose,a recommended dose, and a higher dose.
After 1 year of treatment with Qsymia, 62 percent of patients who were prescribed the recommended dose lost at least 5 percent of their weight. If after 12 weeks on the higher dose, you do not lose at least 5 percent of your body weight, it is unlikely that the drug will work for you.Side effects. Common side effects include tingling of hands and feet, dizziness, taste alterations(particularly with carbonated beverages), trouble sleeping, constipation, and dry mouth. Serious but rare side effects include allergic reactions(such as rash, hives, difficulty breathing), thoughts of suicide, memory problems, mood problems(such as anxiety, depression, panic attacks), and changes to your vision. Rare side effects associatedwith topiramate include kidney stones and acuteglaucoma.
Qsymia must not be used during pregnancy because it may cause harm to the baby. People with an overactive thyroid gland,glaucoma, or who have recently taken certain antidepressant drugs known as MAOIs should not use Qsymia, although the drug was studied in patients taking SSRI and other antidepressants without adverse events.
Other Appetite Suppressants or diet pills
These drugs promote weight loss by increasing one or more brain chemicals that affect appetite.You may feel less hungry or feel full sooner when taking these drugs. They are FDA approved only for a short period of time (up to 12 weeks). Some doctors may prescribe them for longer periods of time (see the box “What is ‘off-label’ use?”).Several appetite suppressants may be used topromote weight loss in adults. They include
- phentermine (sold as Adipex-P, Oby-Cap, Suprenza, T-Diet, Zantryl)
- benzphetamine (sold as Didrex)
- diethylpropion (sold as Tenuate, Tenuate Dospan)
- phendimetrazine (sold as Adipost, Bontril PDM, Bontril Slow Release, Melfiat)Among these types of drugs, phentermine is the one used most often in the United States.Side effects.
Common side effects of appetite suppressants include dry mouth, difficulty sleeping, dizziness, headache, feeling nervous,feeling restless, upset stomach, and diarrhea or constipation. Severe side effects may include chest pain, fainting, fast heartbeat, shortness of breath,confusion, and swelling in your ankles or feet.
People with heart disease, high blood pressure, an overactive thyroid gland, or glaucoma should notuse these drugs. These medications are controlled substances because of their potential for abuse.
Off label weight loss medications may include
- bupropion, a drug used to treat depression
- metformin, a drug used to treat type 2 diabetes
- Victoza, a diabetes injectable medication.
How can W8MD Medical Weight Loss Centers help?
When clinically appropriate, W8MD offers the various diet pills or appetite suppressants along with a reduced calorie diet and exercise including but not limited to the following:
- Contrave (Buprion and Naltrexone) – Brand new weight loss medication
- Phentermine and Topiramate (Qsymia) – New weight loss medication (Most popular and most effective)
- Lorcaserin (Belviq) – New weight loss medication
- Phentermine (Adipex)
- Topiramate (Topamax)
- Phendimetrazine (Bontril)
- Diethylpropion (Tenuate)
- Xenical and others the other weight loss medications. Learn more…