Though there are exceptions, “in general, of which’s where we start treating people,” said Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine in addition to also also NewYork-Presbyterian. Drugs are typically prescribed along with diet in addition to also also physical activity improvements.
Since there is usually a broad range of medications available, finding one of which will work is usually almost always possible, according to Aronne, who co-authored the Endocrine Society’s clinical practice guidelines for the pharmacological management of obesity.
Identifying the right match is usually key, as a drug may or may not be appropriate for someone depending on their health history. For example, if someone has uncontrolled high blood pressure, you wouldn’t prescribe phentermine (a weight loss drug approved for short-term use), Aronne explained.
FDA-approved weight loss drugs
In order for a weight loss drug to be approved for long-term use, of which must have two years of data showing of which of which is usually safe in addition to also also of which works.
In general, a medication can be considered effective for weight management if, after one year of treatment, at least 35% of those inside the drug group (in addition to also also about double the proportion of people of the placebo group) lose at least 5% of their weight.
Weight loss drugs approved for long-term use include orlistat (brand name Xenical), lorcaserin (Belviq) in addition to also also liraglutide (Saxenda) as well as the combination drugs naltrexone-bupropion (Contrave) in addition to also also phentermine-topiramate (Qsymia).
Losing 5% to 10% of your body weight is usually associated with enhanced blood pressure, triglycerides in addition to also also blood sugar, factors of which lower the risk for heart disease in addition to also also diabetes.
“A lot of people will say, ‘Wow, 5% of body weight, of which doesn’t sound like a lot of weight loss,’ however an average weight loss of 5% reduces your risk of developing diabetes by 50%. of which sounds much better right now, doesn’t of which?” asked Aronne, who disclosed relationships involving research, funding in addition to also also advising with some of the approved obesity drug companies in addition to also also companies of which make weight loss devices (i.e. the balloon EndoBarrier).
Some medicines are prescribed “off-label,” of which is usually, for a use various other than what of which was approved for. For example, metformin is usually a drug of which is usually FDA-approved for diabetes, however there is usually evidence of which of which can produce weight loss even in people without diabetes.
How they work
All of the FDA-approved weight loss drugs except Xenical work on hypothalamic pathways, resulting in decreased appetite in addition to also also increased feelings of fullness after eating, Aronne said. (Xenical inhibits the absorption of fats by blocking the enzymes of which break down fat.)
In essence, when too many calories come in too quickly, of which damages nerves inside the brain of which receive hormonal signals coming from the stomach, intestine in addition to also also fat cells of which tell the brain how much you’ve eaten in addition to also also how much fat is usually stored. The nerves then become resistant to the hormonal signals, Aronne explained. Medications essentially mimic more food coming in in addition to also also stimulate more nerves, which gives more of a signal to your brain.
“People say, ‘I know why he’s fat; he just ate too much’ … however the part of which’s been left out is usually of which there is usually a physical change in these nerve pathways of which makes of which hard to go back. While eating less does temporarily treat obesity, of which doesn’t change the body’s physiology. in addition to also also of which’s where medication comes in.”
Aronne compares of which to smoking in addition to also also lung cancer. “If somebody smoked their whole life in addition to also also they developed lung cancer, you could probably tell the person to stop smoking — however do we expect stopping smoking to be a treatment for lung cancer?”
Factors to consider
Weight loss drugs are not for everyone. Reasons doctors may not prescribe them include pregnancy in addition to also also breastfeeding as well as any acute serious medical conditions, such as a recent heart attack, stroke or kidney failure, Aronne explained.
There are various other factors doctors are looking for as well. Before starting medication, of which’s best when weight has been stable for some time.
“We often introduce (medication) when one is usually ‘stuck’ at a stable weight in addition to also also is usually not gaining or losing,” Cummings said. Hitting a weight loss plateau, for example — something common among dieters who have lost some weight, when their metabolism drops to accommodate a smaller body size — might warrant the help of a drug in order to break through the plateau.
A drug should be continued only if a weight loss of at least 5% of body weight is usually achieved after three months. If of which’s not the case, or if there are any safety or tolerability issues — for example, if someone’s blood pressure goes up when taking the drug phentermine — of which’s probably time to try a different drug.
“There are numerous options. … No medicine is usually right for everybody,” Aronne said. “in addition to also also the process right right now is usually … trial in addition to also also error, in order to minimize side effects in addition to also also maximize effectiveness in any given person.”
Sometimes, a combination of medications will be necessary in order to achieve results. “of which’s where the obesity medicine specialist can actually help the patient work through of which to get the right medicine for them,” Cummings said.
Experts say you shouldn’t count on going off of a weight loss drug of which has worked for you — of which is usually, as long as you want to continue to maintain your weight loss.
“People say, ‘Give me the meds, in addition to also also when I lose the weight, I can go off of which,’ however of which doesn’t work of which way,” Cummings said.
“I don’t tell people of which’s forever, however of which’s long-term,” Aronne agreed.
Taking a weight loss drug doesn’t guarantee results. “We’re not entirely sure why some people don’t respond to medications,” Aronne said.
Lisa Drayer is usually a nutritionist, an author in addition to also also a sy88pgw health in addition to also also nutrition contributor.