Weight Loss Drugs prescribed by a doctor seem to be modestly effective. Some people who take these drugs while also following a strict diet and exercise regimens drop as much as 10 percent of their body weight and keep it off for one to two years, but not all people respond to the medications.
Compared with placebo-treated patients on diet and exercise alone, the drugs seem to cause, on average, an extra 15 pounds of weight loss. To maintain a lower weight, you probably have to keep taking the drugs indefinitely, and the safety of doing that is unknown.
Cutting calories and working out are the cornerstones of successful weight loss. Few people beyond the quacks hawking the latest fat whacker or melter would argue this point. Yet some people find they need extra help sticking with a healthy eating plan. This is where prescription weight loss drugs come in.
Although many doctors believe that weight loss drugs aren’t effective enough and have too many side effects to justify their use, the American Society of Bariatric Physicians and a panel of weight loss clinic directors convened by the Institute of Medicine of the National Academies consider these drugs to have an important place in long term weight management at least for certain people.
Drugs alone won’t cause you to lose weight but they may help control your urges so you can make better food choices. But just how much of a difference can pop a pill with every meal make? Studies of the appetite suppressant sibutramine (Meridia) show that it has, at best, a small effect on weight loss. In studies lasting up to two years, many subjects on sibutramine were able to maintain all of their weight loss as long as they remained on the drug.
However, the dropout rate for treatment with the drug is high up to 75 percent of participants in many studies in order to stave off weight gain; some subjects had to increase their dosages to levels higher than currently approved by the Food and Drug Administration. Also, some of these results include only people who responded to the drug, so they don’t give the complete picture.
The most commonly prescribed appetite suppressant, phentermine, has been shown to be modestly effective but use is recommended for only six months or less. Studies show that over that time, subjects on a diet plan plus phentermine lost on average 22 pounds more than subjects on a diet plan who took a placebo.
However, in many studies, at the six-month mark, some patients stopped losing weight and some began to regain weight even while continuing to take the drug. Results have been somewhat better in real-life settings when the drug is prescribed in combination with diet and exercise and the patient is carefully monitored by a physician.
The fat blocker orlistat (Xenical) has also been shown in studies to be modestly effective. Subjects on orlistat who completed trials lasting up to one year lost about 9 percent of their body weight, while subjects taking a placebo pill but following a similar weight loss program (either a diet program or a diet plus exercise plan) lost 5.8 percent of their weight.
Orlistat has also been found to slow the rate of regaining during the second year of use. Studies show that subjects on orlistat regained 35 percent of the weight they lost, whereas subjects who lost weight through diet and exercise alone regained about 62 percent of their weight.
Unlike the stimulant diet drugs, orlistat actually has proven health benefits such as decreased blood pressure, blood sugar, cholesterol, and triglycerides. This is in contrast to stimulants, which raise blood pressure and have not been shown to improve disease risk factors, except for slight benefits in diabetics. Orlistat does have its downsides, however. Besides its unpleasant side of facts, orlistat prevents absorption of fat-soluble vitamins A, E, and K, so supplements may be necessary.
So which drugs are the most effective? Orlistat may be the best choice if you are concerned about lowering your heart disease risk factors and improving your overall health. Purely in terms of weight loss, there is no clear answer, since people respond differently to weight loss medications. Some obese patients lose as much as 10 percent of their body weight enough; studies suggest reducing risk factors for obesity-related diseases such as high blood pressure and diabetes.
If you don’t lose at least 4 pounds after four weeks on a particular drug, studies suggest, that drug is unlikely to help you. During the course of your treatment, your doctor may switch drugs or place you on a combination of drugs. Just know that all of the drugs have side effects and the likelihood of weight regain once you stop taking any of these medications is high, especially since most people tend to revert back to the behavior that caused them to carry the extra weight in the first place.
Also, while you are in weight loss drug therapy, your diet drug is only as good as your complete weight loss program Make sure that you are seeing a doctor who addresses your entire lifestyle rather than one who simply dispenses drugs and sends you on your way. Indeed, studies show that weight loss drugs are far more effective when combined with a structured diet, a consistent exercise program, and behavior modification training.