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Medical Author:

Gayle M. Galletta, MD, FACEP

Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical treatment of obesity focuses on lifestyle changes such as eating less and increasing activity level. There are medications that can promote weight loss, although they work only in conjunction with eating less and exercising more.

Most medications that promote weight loss work by suppressing the appetite. Some medications used in the past have been shown to be unsafe and are no longer available. The newer appetite-suppressing medications are thought to be safe, but they do have side effects and may interact with certain other drugs. They are used only under the supervision of a health care professional.

For more information about weight-loss medications, go to the article Medication in the Treatment of Obesity.

Some weight-loss products are known to be dangerous. The safety of others is in question. This includes certain prescription and over-the-counter drugs and herbal supplements. Avoid them.

• "Phen-fen" and Redux: These prescription drugs have been removed from the market in the United States and many other countries. They are linked to heart valve problems and pulmonary hypertension. Pulmonary hypertension affects the blood vessels in the lungs and is often fatal.
• Ephedra: This natural substance is essentially an herbal phen-fen. It is the active ingredient in MaHuang and is used as a stimulant and appetite suppressant. Ephedra resembles the amphetamines -- the popular "diet drugs" that were banned in the 1970s -- in that it is highly addictive. Ephedra is often combined with caffeine and aspirin ("the Stack"), which increases the thermogenic (fat-burning) effect of ephedra. Ephedra increases the risk of high blood pressure, irregular heartbeat, insomnia, seizures, heart attack, stroke, and death. The FDA has recently banned ephedra because it has been linked to more than 100 deaths.
• Phenylpropanolamine (PPA) is often found in appetite suppressants as well as over-the-counter cough and cold remedies. The FDA has recommended that products containing PPA be removed from the market. Studies have suggested that this product is associated with an increased risk of hemorrhagic (bleeding) stroke in women.
• Sibutramine is an oral anorexiant that was removed from the U.S. market in 2010 due to the risk of serious adverse cardiovascular events.

Some people have tried combining more than one weight-loss drug or combining a weight-loss drug with other drugs for the purposes of losing weight. The safety and effectiveness of such drug "cocktails" is not known.

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