Medications for Weight Loss: Indications and Usage [Consumer Update]

Take the first step to losing weight with prescription weight loss medication. These drugs can be used by people who are obese (a body mass index of 30 or greater), overweight (a BMI of 27 or greater), or mildly overweight (BMI of 25 to 29).

Doctors usually prescribe weight loss medication for patients who have other conditions accompanied by being overweight, such as high cholesterol, type 2 diabetes, and sleep apnea. The drug acts on the brain’s hypothalamus – a gland located behind the eyes – causing it to suppress appetite. In some cases, a doctor may recommend a patient take the medication in conjunction with exercise and a reduced-calorie diet.

In addition to being prescribed for medical reasons, many Americans also use these medications as part of a weight-loss plan. But it’s important to remember that the drugs only work if you also watch your calories and exercise.

Here are 10 essential facts about prescription weight loss medication:

  1. Prescription weight loss medications include Belviq, Contrave, Saxenda and Qsymia, Phentermine–Topiramate (Qsymia), and Belviq/Lorcaserin (Belviq).
  2. The Food and Drug Administration approved the first three drugs – Belviq, Belviq XR, and Qsymia – in 2012 for patients with a BMI of 30 or greater or 27 or greater who have at least one other obesity-related health condition. In July 2014, the FDA approved Contrave, a combination of naltrexone and bupropion, as safe and effective for weight loss in addition to a reduced-calorie diet and increased physical activity.
  3. The side effects of weight loss medication include insomnia, dry mouth, constipation, nausea, diarrhea, or headaches. Some drugs may also result in congenital disabilities if taken by pregnant women, so those planning on becoming pregnant should talk to their doctors about the risks versus benefits of using these medications.
  4. In most cases, the prescriptions must be filled at a pharmacy – however, they can sometimes be purchased online from places like Canada or Mexico.
  5. When losing weight is not an issue during pregnancy, some experts recommend staying away from prescription weight loss medication. However, in certain circumstances, a doctor may prescribe a mother-to-be a drug that is only approved for use by adults.
  6. To maintain the effects of these medications after losing weight, many patients must continue to take pills indefinitely or for the rest of their lives.
  7. A doctor can help you determine whether one of these prescription drugs is right for you – but there are some steps you can take on your own to get started:
  8. Ask your doctor which drug might be appropriate for you depending on your health status and any pre-existing conditions, like high blood pressure; discuss how often it should be taken, what foods to avoid while taking it, possible side effects, and any potential interactions with other medications you are taking.
  9. If your doctor prescribes a medication, ask whether it can be filled at your local pharmacy or if you will need to go somewhere else to fill the prescription. If it’s not covered by insurance, ask how much it costs and what payment options are available.
  10. Keep track of your progress – along with any weight loss results, note changes in body measurements, energy levels, sleep habits, appetite patterns, and overall mood. After losing an amount of weight determined by your doctor, talk to them about whether or not you should keep taking the drug.

Now that you know more about weight loss medication talk to your doctor about which one might work best for your needs.

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How Weight Loss Medications Should Be Used

There is a wide range of prescription weight loss medications available, and their use can be very effective when combined with other treatments. Many combination products are now marketed as well, such as orlistat/phentermine (Qsymia), naltrexone/bupropion (Contrave), and liraglutide/metformin (Saxenda).

The goal of using weight loss medications is to help patients achieve permanent weight loss by controlling hunger and feeling more satisfied with less food intake. If the patient achieves this goal, then that medication has successfully maximized its potential benefit.

Orlistat is a gastrointestinal lipase inhibitor that prevents dietary fat from absorbing in the intestines. Side effects may include flatulence and oily or fatty stools. A reduced-calorie, low-fat diet is recommended when taking this drug.

Orlistat should not be used in patients with malabsorption syndrome, cholestasis, or inflammatory bowel disease. Patients taking cyclosporine for rheumatologic or dermatologic conditions need to monitor their tacrolimus blood levels. The possible need to adjust the dose of either medication may result from the concomitant use of orlistat.

3 Major FDA-Approved Weight Loss Medications

  • Orlistat (Xenical)
  • Lorcaserin (Belviq) — a serotonin 2C agonist that reduces appetite by binding to serotonin receptors in the hypothalamus.
  • Qsymia — a combination of topiramate, an anticonvulsant that has been shown to suppress appetite. Topiramate also increases metabolism and reduces fatigue.

How Long Should You Take Weight Loss Medications?

Weight-loss medications are most effective when combined with making healthy lifestyle habits. This includes eating a healthy diet rich in fruits, vegetables, whole grains, lean meats/fish/poultry, nonfat dairy products, legumes, and nuts; limiting the intake of sugar-sweetened beverages; limiting alcohol intake; prioritizing physical activity on most days of the week; staying on target with appropriate calorie level for your height, age, gender, and activity level; and using behavioral strategies for improving adherence.

When the medication is used in this way, along with lifestyle changes, three months of treatment can result in 5-10% weight loss or about 8-16 pounds. Patients should not expect more than that, so be realistic when setting goals. After 12 weeks on the medication, adult patients who have lost at least 4% of their body weight can be switched to ongoing weight maintenance therapy without continuing therapy for another 12 weeks. You must follow up with your doctor during this time to discuss whether or not you are ready to stop taking the medication before switching over to ongoing maintenance therapy.

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