Diet Pills - An Aggressive Weight Loss Treatment
What They Are, Their Side Effects, and Who Can Use Them
Sep 7, 2009
When speaking of weight loss or weight maintenance, theory suggests that ideal weight can be achieved if caloric intake equals energy output. Eating less food than what one needs results in weight loss; or eating less and moving more (exercise) also results in weight loss. Theoretically, this concept is plausible. Unfortunately, everyone's physiology is different, and may not conform with this model. Our bodies are influenced by biologic elements and physiologic reactions that result in different health outcomes. Many have tried weight loss diets and exercise programs and found success, but many more have failed countless times. For these people - those with body mass indexes (BMIs) that are greater than 30 - physician supervised medical drug therapy may be necessary.
Weight Loss Medications
There are currently two FDA approved weight loss medications available in the market. They are sibutramine and orlistat. They can only be obtained with a prescription from a board-certified physician.
Sibutramine
Trade name: Meridia - suppresses appetite by inhibiting the uptake of serotonin. It is most effective when used with a low-calorie diet and regular exercise. Side effects include dry mouth, headache, constipation, insomnia, and high blood pressure. The Food and Drug Administration (FDA) warns persons with high blood pressure to avoid using sibutramine and to monitor their blood pressure.
Orlistat
Trade name: Xenical - interferes with pancreatic lipase activity, thereby blocking dietary fat digestion and absorption (about 30%). It is taken with meals and is most effective with low-calorie diets. Side effects include gas, frequent bowel movements, and reduced absorption of fat-soluble vitamins (vitamin A, D, E, and K).
Other Drugs
Several other drugs are currently under study including those that block neuropeptide y and others that stimulate uncoupling proteins.
Over-the-Counter Drugs
There is only one FDA approved over-the-counter medication to help with weight loss. It contains benzocaine which anesthetizes the tongue, reducing taste sensations. In 2000, the FDA banned over-the-counter medications containing phenylpropanolamine - an appetite suppressant. Phenylpropanolamine's side effects included dry mouth, rapid pulse, nervousness, insomnia, dizziness, restlessness, headaches, nausea, increase in blood pressure, kidney failure, and stroke.
Facts to Remember:
- With weight loss, fat cells decrease in size only; they don't go away. When a person regains weight, the de-flated fat cells become engorged with fat. When these cells become fully engorged, they replicate, and their daughter fat cells also replicate when the cells contain their maximum fat load, repeating the cycle.
- Obesity is caused by multiple elements such as genetic inheritance, lifestyle factors, medical condition, etc.
- The biggest problem linked with the use of weight loss pills in obesity is adverse side effects.
- A realistic goal for weight loss is to reduce body weight by 10% over 6 months.
- A nutritionally-sound weight-loss diet may include a 500 calorie per day deficit. A diet that restricts more than 500 calories per day may be too restrictive which may prompt the person to become non-compliant.
- Successful weight loss depends on reducing energy intake and increasing physical activity. This remains the golden standard in weight loss or weight maintenance programs.
- Physical activity does not help a person to lose fat in trouble spots.
- Eating high calorie foods regularly will not help a person lose weight.
- Before launching on a weight loss program involving the use of weight loss medication(s) including prescription drugs, over-the-counter drugs, or herbal supplements always inform your physician. Herbal remedies does not necessarily imply safety.
- Be aware of food-drug interactions, and drug-drug interactions.
References
Atkinson RL "Use of Drugs in the Treatment of Obesity" Annual Review of Nutrition 1997;17:383-403
Aronne LJ " Modern medical management of obesity:The role of pharmaceutical intervention." Journal of the American Dietetic Association 1998;98:S23-S26
National Institute of Health Obesity Education Initiative, Clinical Guidelines on the Identification, Evaluation, andTreatment of Overweight and Obesity in Adults (Washington, DC: U.S.Department of Health and Human Services, 1998)
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