Weight-Loss Medications: Are They Right for You?

Find out who qualifies — and what these drugs do

Patients often ask: Are there medications for weight loss? The answer is yes, but these medications are not for everyone.

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Diet, exercise and other lifestyle improvements are still your best bet. But weight-loss medications can help people with a lot of weight to lose or with diseases linked to being overweight or obese (co-morbid diseases).

Who is a candidate?

If you fit one of these two descriptions, medications may help you:

  • People with a body mass index of 27 or greater, with one or more co-morbid diseases — hypertension, sleep apnea, diabetes or hyperlipidemia, for example. (Don’t know your body mass index? Use Cleveland Clinic’s BMI Calculator.)
  • People with a body mass index of 30 or greater with or without co-morbid diseases.

FDA-approved medications for weight loss, which expanded in 2012, include phentermine (Adipex), orlistat (Xenical or alli), lorcaserin (Belviq) and phentermine-topiramate (Qysmia). Each works in a different way and comes with its owns pros and cons. So talk to your doctor — and weigh your options.

Phentermine (Adipex)

What it does: Phentermine is a stimulant drug that has been on the market for more than 30 years. It works through the central nervous system by enhancing chemicals in the brain to suppress appetite. Taken once per day in the morning, it allows approximately 4-5 percent weight loss after one year.

What you need to know: Phentermine may increase blood pressure levels and heart rate, so your physician will want to monitor you closely. Other medical conditions may also make this drug inappropriate for you. Side effects include constipation, insomnia and dry mouth.

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Orlistat (Xenical or alli)

What it does: This drug decreases the amount of fat the body absorbs by one-third. It is usually taken three times per day before a meal and works best if the meal contains dietary fat. It is the only FDA-approved medication that is available over the counter, in a lower dose. Average weight loss in one year is approximately 3-4 percent.

What you need to know: Side effects include cramps, gas and stool leakage. These symptoms improve if you reduce your fat intake — so this medication may actually help with behavioral change, too.

Phentermine-Topiramate (Qysmia)

How it works: Qysmia is one of two weight loss drugs approved by the FDA in 2012. This combination of phentermine and topiramate, a seizure medication, produces better weight loss than either medication alone. The two medications combined allow for 13 percent loss of excess weight after one year at the highest dose.

What you need to know: The warnings for phentermine (listed above) still apply, so it’s crucial to talk to a doctor about your health before using this drug. Other common side effects include constipation, dry mouth and tingling in the extremities.

Lorcaserin (Belviq)

How it works: Belviq, the other medication approved in 2012, decreases appetite by working on chemicals in the brain. It allows for almost 6 percent weight loss after one year.

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What you need to know: Belviq is not yet on the market, even though it is approved. Some side effects include fatigue, dry mouth, dizziness, headache and nausea.

If you are a candidate for these medications, remember this: All weight loss goals, even those aided by a drug, should come with positive lifestyle changes. Choosing healthy foods, eating smaller portions and increasing exercise are as important as ever.

By: Karen Cooper, DO

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