What Are Medications for Obesity?
The following medications are available in the United States by prescription. If you have been unsuccessful losing weight through diet and exercise, ask your doctor about these medications. For more information about these drugs, see Medication in the Treatment of Obesity. These are not a substitute for dietary management. Over the long term, successful long-term weight loss requires changes in overall eating patterns.
- Orlistat (Xenical 120 mg by prescription or Alli 60 mg available over the counter) is a medication approved by the FDA in 1999. Your doctor may prescribe it if you weigh more than 30% over your healthy body weight or have a BMI greater than 30. Over one year, people who followed a weight-loss diet and took orlistat lost an average of 13.4 pounds, almost 8 pounds more than people who used diet alone to lose weight. It works by reducing the absorption of fat from the intestine. Diarrhea and incontinence of stool may be side effects of this medicine.
- Lorcaserin (Belviq 10 mg one to two times daily) was approved by the FDA in 2012. It may be considered if your BMI is 30 or greater or if you have a BMI greater than 27 with weight-related conditions. Studies demonstrated that 50% of patients lost an average of 5% of their body weight when combined with diet and exercise (compared to 25% of patients with diet and exercise alone). Lorcaserin works by activating the serotonin 2C receptor in the brain, which helps you feel full after smaller portions. The most common side effects were headache, nausea, and dizziness.
- Qsymia (combination of phentermine and topiramate) was approved by the FDA in 2012. It is only approved for those with a BMI greater than 27 with weight-related conditions. When combined with diet and exercise, studies have shown that half of the participants lost 10% of their body weight and four-fifths lost 5% (which equates to 12 pounds in a 227 pound person). Topiramate is associated with a high risk of birth defects such as cleft lip and palate. Phentermine (an appetite suppressant) was one of the ingredients in fen-phen and is associated with an elevation in heart rate. Because of these potentially serious side effects, Qsymia is only available through mail order. Other side effects include tingling, dizziness, alterations in taste, insomnia, dry mouth, and constipation.
- Contrave, a combination of bupropion (an antidepressant) and naltrexone (used to treat opiate abuse) was approved by the FDA in 2014 to treat adults with a BMI of 30 or more, or a BMI of 27 or more if you have a weight-related illness, such as hypertension, type 2 diabetes, or high cholesterol. Studies have shown that approximately 40% of patients taking Contrave lost 5% or more of their total body weight after one year. This medication can cause elevated blood pressure and seizures. It should not be taken if you are being treated with opiates such as morphine, hydromorphone, oxycodone, or hydrocodone. Side effects can include nausea, vomiting, diarrhea, constipation, dizziness, insomnia, and dry mouth.
Medically Reviewed by a Doctor on 4/7/2016
Gayle M. Galletta, MD, FACEP
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