Medications and Weight Loss

Medication work by increasing energy expenditure, impairing energy intake, and impairing absorption. Medications is used for weight loss when lifestyle changes alone do not provide the necessary weight loss. Prescription weight-loss drugs are used in those with a BMI greater than 30 or above 27 with obesity-related conditions, such high blood pressure, type II diabetes or high cholesterol.

Medications are not effective for everyone. A weight loss of two kilograms over the first month, should occur when on medications. Changing medications, adjusting the dose or discontinuing are all options if this two kilogram weight loss does not occur. It is important to determine if the risk of medication is worth the benefit of using the drug. Most side effects of these medications are mild and often improve with continued treatment. Rarely, serious and even deadly outcomes have been reported.

Weight loss drugs come with a long history of complications. In the past, thyroid medication was used to increase metabolism and led to thyroid dysfunction. Many of these cases led to death as it was used at a time when there were not effective treatments for thyroid disease. Amphetamines are used as weight loss aids but may lead to addiction. Most recently fenfluramine and dexfenfluramine, more popularly known as phen/fen, were linked to valvular heart disease and primary pulmonary hypertension.

Medications are more effective in some. On average, people lose 4-22 pounds a year more on medication than with non-drug treatments.

Appetite suppressants are a popular type of medication for weight loss with phentermine and sibutramine being two common drugs in this class.

Sibutramine (Meridia) acts on chemicles in the brain to promoate weight loss. It provides a sensation of being full. It is most appropriate in those who struggle with binge eating, irregular eating and frequent feelings of hunger.

Increased blood pressure and heart rate are the main side effects of sibutramine. These changes are usually small but may be of problematic in some patients. Other side effects include headache, dry mouth, constipation, and sleep problems. Those with poorly controlled blood pressure, heart disease, history of a stroke, or irregular heartbeat should not take sibutramine, and all patients taking the medication should have their blood pressure monitored on a regular basis.

Phentermine is still available for weight loss treatment. It is an appetite suppressant that is used for short-term use. It reduces appetite and possibly increases the amount of energy expended. Side effects include sleep problems, palpitations, high blood pressure, nervousness, and euphoria. They should not be used in those with heart disease, high blood pressure, hyperthyroidism, glaucoma or those less than 17 years old.



Orlistat (Alli), which is now over the counter, reduces the absorbtion of dietary fat by about one-third. It blocks the enzyme lipase, which breaks down dietary fat. Consequently, the body takes in less fat and less calories.

Cramping, gas, abdominal pain, diarrhea and leakage of oily stool are  side effects of orlistat. Eating a low-fat diet can reduce side effects. Deficiencies of fat-soluble vitamins are a potential side effect of this medication and taking a multivitamin two hours prior to after taking the drug is recommended.

Orlistat is best for patents with cardiovascular problems as side effects are less than with sibutramine. It is also ideal for someone who eats high-fat foods and eats out often because those who eat high fat foods will have more side effects and it may prevent them from making these food choices.

Many medications are used, but not approved for the treatment of obesity. These include: the anti-seizure medications zonisamide (Zonegran) and topiramate (Topamax) and bupropion (Wellbutrin).

There are many more medication that are working their way down the pipeline to approval for the