Finding a silver bullet for weight loss

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Dr. Art Mollen, Special for The Republic | azcentral.com

5:04 a.m. MT March 21, 2017

There is no one size fits all when it comes to weight loss drugs as some people will simply respond to one drug better than another

Many people are looking for the silver bullet to weight loss. In fact, for some people, it may be a good idea.  However, most doctors only prescribe them if your body mass index is above 30 or at least 27 and you also have diabetes or high blood pressure.

The most common prescription weight loss drugs include Orlistat, Contrave, Belviq, Saxenda and Qsymia.  In the past the most common prescription weight loss drugs were amphetamines, which had the potential for addiction and abuse.

The most important consideration before taking medications for weight loss is to evaluate your medical history for high blood pressure, diabetes, heart disease and a compromised immune system, all of which could be affected.  Even natural or herbal weight loss products can cause significant problems.

How the drugs work

Orlistat also called Xenical, blocks your body from absorbing the fat that you consume and may cause side effects, including abdominal cramping and excess gas.

Contrave is a combination of naltrexone and wellbutrin.  Naltrexone is also approved to treat alcohol and drug dependence. Wellbutrin is also approved to treat depression.  Contrave works on the brain’s thermostat, which controls appetite, temperature and how the body burns energy signaling the brain to reduce food intake.

Belviq works by suppressing your appetite. However, some common side effects, include headaches, dizziness, nausea and fatigue.

Saxenda is the same drug as Victoza used to treat diabetes.  It helps diabetics by mimicking a hormone in the intestines and tells the brain that the stomach is full. The side effects include nausea, vomiting and diarrhea.

Phentermine is an amphetamine and combined with Topamax, an anticonvulsant drug in a medication called Qysmia.  It makes you feel full, suppresses appetite and speeds metabolism, however, it can raise blood pressure, cause heart palpitations and insomnia.  It is a controlled substance and potentially addictive.

All of these medications have a caveat which is, if you do not lose at least 5 percent of your body weight after 12 weeks of taking it, you should discontinue the medication.

Physician monitoring

These weight loss drugs must be monitored by a physician and are indicated to be taken in conjunction with exercise and fewer calories. If the medication galvanizes you to exercise and eat differently, that may be a good idea.

A recent study in the Journal of the American Medical Association pointed out that the best prescription weight loss drug is the one that works for you. Qsymia and Contrave were able to create about a 5 percent loss of body weight, which is 11-12 pounds and is considered to be the most effective.

There is no one size fits all when it comes to weight loss drugs as some people will simply respond to one drug better than another. At the end of the day there is no silver bullet to weight loss simply exercise, diet changes and lifestyle.

One last note as a practicing physician, I seldom prescribe these medications for my patients, not because they are ineffective, but because they are the antithesis of my personal philosophy for long-term weight control.

Dr. Art Mollen is an osteopathic family physician and a health, fitness and preventive medicine expert. Reach him at 480-656-0016 or askdrartmollen@gmail.com. 

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Finding a silver bullet for weight loss

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