Medication for treatment of obesity

Medication treatment of obesity should be used only in patients who have health risks related to obesity. Medications should not be used for cosmetic reasons.

Like diet and exercise, the goal of medication treatment has to be realistic. With successful medication treatment, one can expect an initial weight loss of at least 5 pounds during the first month of treatment, and a total weight loss of 10%-15% of the initial body weight. The first class (category) of medication used for weight control cause symptoms that mimic the sympathetic nervous system. As a result, the major side effect of this class of medication is high blood pressure.

Phentermine

The common side effects of phentermine include headache, insomnia, irritability, and nervousness. Fenfluramine (the fen of fen/phen) and dexfenfluramine (Redux) suppress appetite mainly by increasing release of serotonin by the cells. Phentermine alone is still available for treatment of obesity but only on a short-term basis (a few weeks).

Sibutramine (Meridia)

a drug which increases the levels of serotonin and norepinephrine in the brain, to treat obesity (both in attaining and in maintaining weight loss).

Orlistat (Xenical, alli)

The next class (category) of drugs changes the metabolism of fat. Orlistat (Xenical, alli) is the only drug of this category that is U.S. FDA approved. This is a class of anti-obesity drugs called lipase inhibitors, or fat blockers. By inhibiting the action of lipase enzymes, orlistat prevents the intestinal absorption of fat by 30%. Drugs in this class do not affect brain chemistry. The most common side effects of orlistat are changes in bowel habits. These include gas, the urgent need to have a bowel movement, oily bowel movements, oily discharge or spotting with bowel movements, an increased frequency of bowel movements, and the inability to control bowel movements. People with diabetes, thyroid conditions, who have received an organ transplant, or who are taking prescription medications that affect blood clotting should check with their physician before using OTC orlistat (alli), since drug interactions with certain medications are possible.

Belviq

In June 2012, the FDA approved Belviq (lorcaserin hydrochloride) as a weight loss medication. The medication works by controlling appetite (via serotonin activation). The medication is approved for patients who are obese (BMI >30 ) or overweight (BMQ >27) with one weight-related health issue.

Qsymia

Qsymia is the newest medication approved for weight loss. As with the other medications, it is only approved for patients who are obese (BMI >30) or overweight (BMQ >27) with one weight-related health issue. Other possible serious side effects include increased heart rate, eye problems (glaucoma), and suicidal thoughts. In patients with diabetes, low blood sugar was also a concern when taking Qsymia.