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 just approved by the FDA in June 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 almost half 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 just approved by the FDA in July 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.
Gayle M. Galletta, MD, FACEP
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