Each overweight person has a different reason for their weight gain: they may be eating very large meals, cravings, eating due to anxiety or boredom, or even eating in the middle of the night. You must first identify her particular eating problem and then find an eating plan that best suits her personal dietary preferences and requirements. The role of medication is to help people who struggle with hunger, cravings, and compulsive eating. Diet drugs, even then stronger, are not “magic bullets”, just “helpers”, and that even the strongest pill cannot prevent one from eating some very bad and readily available foods.
Diet changes, even simple ones, always take precedence over medication. Taking these medications, even for short periods of time, often helps people with their weight loss plan. Some people experience satiety for the first time in their lives, while others feel in control of their food and learn to make better food choices. Many overweight people learn that they don’t really need as much food as they once thought they did.
While some people might do well taking the medications for just a couple of weeks to help “jump start” their weight loss plan, others may need to take them for months or even years. Since each overweight individual has a different reason for their weight gain, the right drug must be matched to the “right person” not only in choice of drugs, but also in dosage and duration.
Here is an overview of prescription drug options for obesity today:
Phentermine: Ionamin, Adipex
Phendimetrazine: Bontril
Diethylpropion: tenuated
Subutramine: Meridia
Xenical: orilstat
First approved as an appetite suppressant in 1959, phentermine is sold under a variety of brand names, including Ionamin and Bontril, as well as its generic name. Phentermine and its cousins ​​phendimetrazine and diethylpropion are sympathomimetic amines, which are similar to an amphetamine. They are also known as “anorexic” or “anordemandic” drugs. They stimulate the central nervous system (nerves and brain), which increases heart rate and blood pressure while also suppressing appetite. Dr. Weintraub, in groundbreaking studies, combined Phenteramine with Fenfluramine in a combination called Fen-phen. Interest in these drugs peaked in the mid-1990s, when he could find a doctor on virtually every street corner who would prescribe them. The rare occurrence of heart disease and, even more rarely, pulmonary hypertension led to the drugs being withdrawn from the market in 1997. The 1990s and early 2000s saw the use of herbal fen/phen and combinations of phentermine and prozac, all without significant weight loss benefits. .
However, these drugs still play a role in weight loss and have been taken by millions of people over the last 25 years.
How it works, side effects, who should take it
Phentermine, phendimetrazine, and diethylpropion are closely related drugs that reduce appetite but have little effect on cravings and binge eating. They increase blood pressure in some people and are often limited by the development of tolerance in others. These are useful medications for those who simply eat too much, particularly during the day when these medications are most effective. They should be used with caution in people with high blood pressure. They should also not be used in people who have heart disease, who have had strokes, or other serious heart or brain problems. These medications are most effective when used at low doses and adjusted slowly to avoid side effects and the development of tolerance. Some doctors alternate phentermine with phendimetrazine to avoid tolerance. Of all the drugs in this group, diethylpropion has fewer side effects and fewer tolerance problems. Related to bupropion, Wellbutrin, not only reduces appetite but helps many people with compulsive eating.
subutramine
Approved by the US FDA in 1997, Meridia (sibutramine) is believed to decrease appetite by inhibiting the reuptake of serotonin, epinephrine, and dopamine in the brain. By doing this, you help increase the levels of these hormones that control appetite and hunger. It was the first selective serotonin reuptake inhibitor (SSRI) used specifically for weight loss, although other drugs in the same class, such as prozac and paxil, have been used as antidepressants. The drug causes a small increase in mean arterial pressure. and heart rate.
It was released just after the phen-fen problems of the late 1990s and has not seen widespread use.
Sibutramine reduces appetite and produces satiety resulting in early satiety. Aside from raised blood pressure in some people, this is an effective drug, especially for those with cravings and binge eating. The feeling of satiety rather than reduced appetite may be the most significant effect. This is a drug approved for long-term use, months and even years. It has substantial benefits for those who have a lot of weight to lose and are willing to take the drug for long periods of time.
Orlistat
Approved by the US FDA in 1999, Xenical (orlistat) is a lipase inhibitor for obesity control that works by inhibiting the absorption of dietary fat. Orilstat prevents enzymes in the gastrointestinal tract from breaking down dietary fats into smaller molecules that the body can absorb. This undigested fat is excreted in the bowel movement. Side effects of flatulence, fecal urgency, oily stools, and leaking have limited its widespread use. An over-the-counter version, the Alli brand has been on the market for the last two years,
Although it is expensive and has limited benefits, some studies show that adolescents have done well.
New Weight Loss Medications for 2010:
After the cannabinoid receptor antagonist drug Rimbonbant (Acomplia) was rejected by the FDA due to psychiatric concerns and the latter was withdrawn from the European market, the focus in the US has been on combining drugs more ancient, each with different effects. This has been used very successfully in the treatment of hypertension, diabetes, and high cholesterol. Doses can be kept low, and there is a synergistic effect of taking two drugs, each at lower doses. Three older drug combinations are being tested:
Qnexia-phentermine and topamax
Empatic-buprion and zonisamide
Contrave-buproion and naltrexone
Of these three, the best result appears to have been Contrave, which is reminiscent of phen/fen, only fenfluramine has been replaced by the migraine/headache pill, Topamax. I have prescribed this combination of pills, off-label, and have had very good results, especially in patients who eat for cravings or emotional issues and are not even hungry. The biggest side effect was fatigue and drowsiness.
Another approach has been to use the GLP-1 antagonists used to treat diabetes, including Pramlintide, Exenatide, and Symylin. The downside is that they need to be injected once or twice a day. A long-acting weekly injection is being tested that may offer many benefits to obese diabetics and people who are morbidly obese. Medications normalize blood sugar levels (but do not cause them to fall below normal), decrease gastric emptying time so that a person feels full longer, and may actually decrease appetite through of the pathways of the central nervous system.
All the pharmaceutical companies are looking at this market and no doubt in the coming years there will be exciting new drugs available to help overweight people. However, medications are just helpers, not unlike bariatric surgery in that people still need to pay attention to food and move more. If you are considering taking medications, you should consult a doctor who has experience with these medications. prescription drugs (except Alli) and all have significant side effects if not taken correctly.
Buying these types of drugs on the Internet is dangerous, you don’t know which is the best drug for you and you have no idea what you are buying. Visit an MD or DO, weight loss is serious business. Treat your body with the same care you treat your computer or car. You’ll also save a lot of money, internet prices are often four or five times what you’d pay in a pharmacy!