Overweight & Obesity: Explained

1. Overweight & Obesity: Overview
2. Causes
3. Health Risks
4. Who Is At Risk
5. Signs, Symptoms & Diagnosis
6. Treatment
7. Weight Loss Medications
8. Weight Loss Surgery
9. Maintaining Weight Loss
10. Quick Facts Refererence
11. View All

Weight Loss Medicines

Weight loss medicines approved by the Food and Drug Administration (FDA) may be an option for some people. If you’re not successful at losing 1 pound a week after 6 months of using lifestyle changes, medicines may help. These medicines should be used only as part of a program that includes diet, physical activity, and behavioral changes.

Weight loss medicines may be suitable for adults who are obese (a BMI of 30 or greater). People who have BMIs of 27 or greater and a risk for heart disease and other health conditions also may benefit from medicines.

The FDA has approved two prescription weight loss medicines for long-term use: sibutramine (Meridia^®) and orlistat (Xenical^®). These medicines cause a weight loss between 4 and 22 pounds, although some people lose more weight. Most of the weight loss occurs within the first 6 months of taking the medicine.

• Sibutramine (Meridia). This medicine sends signals to your brain to curb your appetite. Sibutramine raises blood pressure and pulse. You shouldn’t take it if you have high blood pressure or a history of heart disease or stroke.
• Orlistat (Xenical). This medicine reduces the absorption of fats, fat calories, and vitamins A, D, E, and K by the body. Orlistat can result in mild side effects such as oily and loose stools.

The FDA also has approved Alli^TM, an over-the-counter weight loss aid for adults. Alli is the lower dose form of orlistat. It’s meant to be used along with a reduced-calorie, low-fat diet and physical activity. In studies, most people taking Alli lost 5 to 10 pounds over 6 months.

Like orlistat, Alli reduces the absorption of fats, fat calories, and vitamins A, D, E, and K to promote weight loss. It also has similar side effects to orlistat. If you’re taking orlistat or Alli, you should take a multivitamin at bedtime due to the possible loss of some vitamins. You also should talk to your doctor before starting Alli if you’re taking blood-thinning medicines or being treated for diabetes or thyroid disease.

Combined with healthy eating and physical activity, these medicines can help people lose weight. If you think you would benefit from the prescription medicines, sibutramine or orlistat, talk to your doctor. People taking these medicines need regular checkups with their doctors, especially in the first year after starting the medicine. During checkups, your doctor will check your weight, blood pressure, and pulse and order laboratory tests. He or she also will discuss any medicine side effects and answer your questions.

Other Medicines

Some prescription medicines are used to treat weight loss, but aren’t FDA-approved for treating obesity. They include:

• Drugs to treat depression. Some medicines for depression cause an initial weight loss and then a regain of weight while taking the medicine.
• Drugs to treat seizures. Two drugs used for seizures, topiramate and zonisamide, have been shown to cause weight loss. These drugs are being studied to see whether they will be useful in treating obesity.
• Drugs to treat diabetes. Metformin may cause small amounts of weight loss in people with obesity and diabetes. It’s not known how this drug causes weight loss, but it has been shown to reduce hunger and food intake.

Over-the-Counter Products

Over-the-counter (OTC) products often claim that a person taking them will lose weight. The FDA doesn’t regulate these products because they’re considered dietary supplements, not medicines. However, many of these products have serious side effects and aren’t generally recommended. A few OTC products include:

• Ephedra (also called ma-huang). Ephedra comes from plants and has been sold as a dietary supplement. The active ingredient in the plant is called ephedrine. Ephedra can cause short-term weight loss. It also has serious side effects. It causes high blood pressure and stresses the heart. In fact, because ephedra poses a serious health risk, the FDA has advised people to stop using dietary supplements that contain it.
• Chromium. This is a mineral that’s sold as a dietary supplement to reduce body fat. While studies haven’t found any weight loss benefit from chromium, there are few serious side effects from taking it.
• Diuretics and herbal laxatives. These products cause you to lose water weight, not fat. They also can lower your body’s potassium levels, which may cause heart and muscle problems.
• Hoodia. Hoodia is a cactus that is native to Africa. It’s sold in pill form as an appetite suppressant. However, there is no firm evidence that hoodia works. No large-scale research has been done on humans to show whether hoodia is effective or safe.

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