Weight loss medications: Should I or shouldn't I?

Whether weight loss medications should be used for the treatment of obesity is a decision that must be made on a case-by-case basis. In most circumstances however, weight-loss medication should be used only by people who are obese, in other words those with a body mass index (BMI) that is greater than 30 or who have a BMI greater than 27, which is also accompanied by serious medical conditions that could be improved by quick weight loss.

Weight loss medications are most effectively used when combined with diet, exercise and behavioral modification. There are several classes of prescription medications that are sometimes used to treat obesity.

Serotonin/norepinephrine reuptake inhibitors. There are some weight loss medications that enhance both serotonin and norepinephrine levels in the brain such as sibutramine (Meridia). This weight loss medication promotes feelings of satiation and thus reduces the appetite. Meridia can increase blood pressure, so you should have your blood pressure monitored regularly by your physician when taking this drug.

Lipase inhibitors. Another powerful weight loss medication is Orlistat (Xenical), which blocks the intestinal absorption of about 30% of dietary fat. This medication is referred to as a lipase inhibitor. These medications have significant side effects such as oily anal leakage, explosive diarrhea and cramping, which tend to be worse when individuals eat greater quantities of fatty foods. Fortunately, this discourages the consumption of these foods and contributes to the effectiveness of this drug.

Noradrenergics. These drugs include benzphetamine (Didrex), diethylproprion (Tenuate), mazindol (Mazanor, Sanorex), and phentermine (Fastin, Ionamin)- which are known to increase the level of norepinephrine in the brain. The neurotransmitter norepinephrine, reduces appetite by stimulating the central nervous system. However, tolerance of these drugs may develop after several weeks which then causes a slowing in the rate of weight loss. These weight-loss medications also have serious side effects which include rapid heartbeat and high blood pressure.

Antidepressants. Although these drugs have not been approved by the Food and Drug Administration (FDA) as weight loss medications, selective serotonin reuptake inhibitors (SSRI’s) such as fluoxetine (Prozac) or sertraline (Zoloft), have been known to contribute to weight loss among patients who take them for depression. Usually these drugs are prescribed for weight loss when patients are also depressed. Patients taking SSRI’s have reported feeling less hungry, less concerned with food and better able control their appetites: However, the effects frequently do not last very long and side effects of insomnia and fatigue are frequently reported.

You should always bear in mind that unless you adopt and maintain an appropriate lifestyle, weight loss medications are usually not effectively used to maintain weight loss over a long period of time. Frequently, people fail to maintain the lost weight as soon as they stop taking the weight loss medication.

Information From The Johns Hopkins Medical Guide to Health After 50

Additional Information and webpage by Paul Susic MA Licensed Psychologist Ph.D. Candidate (Health and Geriatric Psychologist)

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