Weight Loss Medication
These drugs may be prescribed along with other treatment options, like bariatric surgery. They can also improve health problems related to obesity, such as high blood pressure and diabetes.
Phentermine is an appetite suppressant that works by altering the levels of neurotransmitters in your brain. It also helps you feel more alert and makes it easier to concentrate on daily tasks. It can help you maintain a lower-calorie diet and exercise regimen. However, the results will vary from person to person. Some people may see little to no weight loss with phentermine, while others lose a significant amount.
The drug is prescribed for people who are clinically obese or who have a BMI over 30 and have another health condition, such as high blood pressure or diabetes. It is a powerful tool for those who are struggling to lose weight on their own, but it should always be used in combination with diet and exercise. The FDA classifies it as a schedule IV controlled substance because of its potential for abuse and addiction. If you use it, you should have a doctor’s prescription and a copy of your medical records. You should also carry a valid driver’s license and be prepared to provide a urine sample for drug testing, since phentermine can cause a positive result for some drugs.
This medication is usually taken orally and is available by prescription only. It can be found in various forms, such as tablets or capsules. A doctor will prescribe the appropriate dose to each patient. It is important to tell your doctor about any other medications, supplements or vitamins that you are taking.
Phentermine may interact with certain medications and cause serious side effects. It is also not recommended for pregnant women or those who are breastfeeding. In addition, it is not safe for people with glaucoma, severe heart disease, uncontrolled high blood pressure or overactive thyroid. It is also not a good choice for people who have history of drug abuse.
There are many natural phentermine alternatives on the market, which have been shown to be effective in suppressing your appetite. They are generally safer than prescription pills and can be purchased at a fraction of the price. Some of these products also have additional health benefits, such as lowering cholesterol and blood sugar.
This medication can help people with severe obesity lose weight and keep it off. It is often used in combination with a low-calorie diet and increased exercise. It works by changing the way the brain responds to satiety signals, making patients feel full even when they eat less. It is also used to treat other medical conditions related to obesity, such as high blood pressure and type 2 diabetes. It is available in tablet form and can be taken by mouth. It should not be taken by pregnant women or those with liver disease.
In the CAMELLIA-TIMI 61 study, 12,000 overweight or obese patients with atherosclerotic cardiovascular disease and multiple cardiovascular risk factors were randomly assigned to either lorcaserin or placebo. The patients were treated for 1 year, and the primary analysis showed that those receiving lorcaserin lost more weight than those on placebo. These results were confirmed in three sensitivity analyses: a per-protocol population, a repeated-measures analysis using the last observation carried forward approach, and an intention-to-treat population.
Patients in the lorcaserin group lost 5.81+-0.2% of their baseline body weight at the end of year 1. This compared to a loss of 2.16+-0.1% among those on placebo. In the per-protocol population, 47.5% of the lorcaserin group had lost 5% or more of their body weight, compared to 20.3% in the placebo group.
A meta-analysis of four randomized controlled trials, including the BLOOM and BLOSSOM studies, found that those taking lorcaserin had a more significant weight reduction than those who took placebo (mean difference [MD] = -3.42 kg, 95% CI -3.49 to -2.64, P 0.00001, I2 = 61%). The authors of the study noted that this was a large and clinically meaningful benefit.
Lorcaserin can interact with many medications, so it is important to tell your doctor about any other medicines you are taking, including over-the-counter drugs and supplements. It is also important to avoid alcohol and other sedatives during treatment. This is because they can slow down your response to lorcaserin and increase the chances of side effects.
Topamax is an anticonvulsant medication that has also been shown to help people lose weight by decreasing appetite and helping people stick to a reduced-calorie diet. It works by increasing the levels of GABA in the brain, which reduces activity in neurons associated with hunger and cravings. It is available as a pill, a liquid, or an extended-release capsule and can be used alone or in combination with Phentermine, another medication that suppresses appetite. These medications are usually prescribed together in a treatment plan that includes a reduced-calorie diet and exercise routine.
In addition to reducing appetite and cravings, topiramate has been used to treat some mood disorders in patients who are not responding to other treatments, especially when used in conjunction with risperidone, which is also an antipsychotic. In one study Vieta et al  gave topiramate as add-on therapy to 25 patients with treatment resistant bipolar spectrum disorder. Of these, over 50% were rated improved and 10 of them experienced weight loss.
Topiramate has also been shown to have some positive effects on weight loss in studies done by Grunze et al  and McElroy et al . In one of these studies, 18 patients with manic or mixed episodes who were resistant to other mood stabilizers were given add-on topiramate. Over the course of 6 to 12 months, these patients were rated improved and their weights decreased.
Despite its success in helping people with some mental health conditions lose weight, topiramate has many possible side effects, including mood and sleep changes and cognitive impairment. It can also cause sedation and may interfere with some other medications that are used to treat mood disorders. It is important to discuss any potential side effects with your doctor.
In 2012, the FDA approved Qsymia, a controlled-release combination of topiramate and phentermine, for weight management. This duo has been shown to be effective for many patients and can work well with other non-medication treatment like talk therapy and behavioral modification. However, Qsymia is not without risk and the FDA warns that it can increase your heart rate, lead to suicidal thoughts, and can lead to seizures if you suddenly stop taking it.
There are also older FDA-approved medications that work by altering your body’s fat absorption or slowing digestion. These include orlistat, which is available via prescription as Xenical and over the counter as Alli, and bupropion-naltrexone (Contrave), which is typically combined with a low-fat diet to promote weight loss in adults. It’s important to note that these drugs carry side effects, which can range from mild to severe.
For example, orlistat can cause oily stools and constipation; it also can increase your risk for heart attack and stroke. And naltrexone can cause liver problems and suicidal thoughts, so it’s not right for people with depression or bipolar disorder.
Another prescription option is phentermine/topiramate, which is sold as the brand-name medication Qsymia. This oral medication is part of a class called sympathomimetic amines and includes the central nervous system stimulant phentermine and anticonvulsant topiramate. It reduces hunger and increases satiety to support weight loss. It’s a good choice for those who can’t lose weight with a healthy diet and exercise.
There are also newer medications for weight loss, including the weekly injections Ozempic and Semaglutide. The former was approved for chronic weight management in 2014 and targets the GLP-1 receptor, while the latter is an under-the-skin shot that aims to curb food intake by blocking your brain’s ghrelin signaling, which tells you that you’re hungry. But these are expensive: Semaglutide costs $1,600 a month and won’t be covered by Medicare or most insurance plans. And a drug being developed by AstraZeneca, cotadutide, works on both the glucagon and GLP-1 receptors, but isn’t expected to hit the market until 2022.