Medications for Weight loss

Weight loss medications are not for all overweight people because the medications have some risks. They are only prescribed for people who need them for health reasons: those who have obesity-related conditions such as type 2 diabetes or hypertension, or those at high risk for developing such disorders. NIH (National Institutes of Health) advises that weight-loss drugs be given only to people with a BMI (body mass index) of 30 or more, or-in the case of those with weight-related health problems-a BMI of 27 or more. The use of diet drugs by people with lower BMIs is likely to pose more risks than benefits. NIH makes clear that weight-loss drugs should be used only in combination with lifestyle modifications. To lose weight requires recognizing and changing the behaviors that led to the weight gain.

There are/were some medications for weight loss approved by FDA. Fen-Phen was a famous medication. Fen-Phen is the combination of two drugs (fenfluramine and phentermine) and increases serotonin level in brain which blocks feeling of hunger. Fenfluramine is more commonly known as Pondimin. Phentermine is more commonly known by its brand name Ionamin. Fen-Phen was withdrawn from the market place in 1997 because of serious complications like pulmonary hypertension, heart valve problems. But Phentermine is still used alone. I don't think you are interested in the history of drugs for weight loss. I will tell you present medications used for weight loss.

There are four kinds of medications for weight loss: Noradrenergic drugs, Serotonin/norepinephrine reuptake inhibitor, Lipase inhibitor, Antidepressants. Not all drugs are FDA-approved for weight loss; some are prscribed off-label.

1. Noradrenergic drugs-phentermine (Adipex-P, lonamin, others), diethylpropion (Tenuate generic): Increase level of norepinephrine; supress appetite; Side effects include rapid heartbeat (phentermine), nervousness, restlessness, and diarrhea; Should not be prescribed for more than three months at a time; Blood pressure should be checked every four weeks; On average, people taking phentermine lose 2-13 pounds over a six-month period. After that, weight loss tends to level off.

2. Serotonin/norepinephirine reuptake inhibitor-sibutramine (Meridia): Increases levels of norepinephrine and serotonin; reduce food intake; Side effects include elevated blood pressure; Should not be taken by people with a history of heart disease, cardiac arrhythmia, stroke, or uncontrolled high blood pressure; Initial weight loss with sibutramine predicts long-term response to the drug: One study showed that people who lost more than four pounds in the first month were more likely to lose 10% of their body weight after one year than those who lost less weight initially.

3. Lipase inhibitor-orlistat (Xenical, Alli): Blocking the action of lipase, an enzyme released by the pancreas to help digest dietary fat; Cuts fat absorption in the intestine by 30%; Side effects include oily stool leakage, gas, bloating,and malabsorption of fat-soluble vitamins, especially A, D, E, and K. People taking orlistat should take supplements of these vitamins and be closely monitored for vitamin B12 and iron deficiencies; Now Alli is sold as a over-the-counter drug; In a two-year trial, those who used orlistat had average weight losses over 20% better than participants who received a placebo-and more than 50% greater success in keeping weight off.

4. Antidepressants-bupropion (Wellbutrin), fluoxetine (Prozac): Wellbutrin increases levels of norepinephrine and dopamine and helps control appetite; Side effects include dry mouth, agitation, constipation or diarrhea, headache, and insomnia; Prozac increases serotonin levels and may help suppress appetite; Side effects include insomnia, agitation, nausea, sleepiness, diarrhea or constipation, and problems with libido; Some people gain weight on Prozac.