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Prescription weight-loss drugs: Can they help you?
Common weight-loss drugs
Diethylpropion (Tenuate) and phentermine (Adipex) are approved by the Food and Drug Administration (FDA) for only short-term use — generally less than 12 weeks. Only orlistat (Xenical) has been approved by the FDA for long-term use. Orlistat is also available in a reduced-strength form without a prescription (Alli).
The chart shows the commonly used prescription weight-loss drugs, how they work and their side effects.
| Drug | Mechanism of action | Possible side effects |
|---|---|---|
| Diethylpropion | Decreases appetite, increases feeling of fullness | Increased blood pressure and heart rate, insomnia, dizziness |
| Phentermine | Decreases appetite, increases feeling of fullness | Increased blood pressure and heart rate, insomnia, dizziness |
| Orlistat | Blocks absorption of fat | Intestinal cramps, gas, oily spotting |
Safety of weight-loss drugs
Safety has been a concern with some weight-loss medications. For example, sibutramine (Meridia) was approved in 1997 for weight loss but was removed from the market in 2010 because follow-up studies showed an increase in the risk of serious heart events, including nonfatal heart attack and stroke.
In the same year, the FDA conducted a safety review of orlistat because of rare reports of serious liver injury in people taking it. No cause and effect relationship was established between orlistat and the risk of liver injury. However, Xenical and Alli labels now advise people taking orlistat to be alert to signs and symptoms that could indicate liver injury, such as itching, loss of appetite, yellow eyes or skin, light-colored stool, or brown urine.
Factors to consider
If you meet the criteria for prescription weight-loss drugs, you and your doctor will need to evaluate the potential benefits against the possible risks of taking the medicine. Cost also is a consideration. Not all health insurance plans cover prescription weight-loss drugs.
As you consider weight-loss drugs, make sure that you make every effort to exercise, change your eating habits and adjust any other lifestyle factors that have contributed to your excess weight.
Weight-loss drugs aren't the easy answer to weight loss, but they can be a useful tool to help you make the necessary diet and lifestyle changes. Keeping off the pounds you've lost, however, is an ongoing concern. And many people, despite their efforts, still regain the weight.
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- Prescription medications for the treatment of obesity. National Institute of Diabetes and Digestive and Kidney Diseases. http://win.niddk.nih.gov/publications/prescription.htm#meds. Accessed Dec. 7, 2011.
- Bray GA, et al. Drug therapy of obesity. http://www.uptodate.com/home/index.html. Accessed Dec. 7, 2011.
- Padwal RS, et al. Drug treatments for obesity: Orlistat, sibutramine and remonabant. Lancet. 2007;369:71.
- Rucker D, et al. Long term pharmacotherapy for obesity and overweight: Updated meta-analysis. BMJ. 2007;335:1194.
- Meridia (sibutramine): Market withdrawal due to risk of serious cardiovascular events. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm. Accessed Dec. 7, 2011.
- Completed safety review of Xenical/Alli (orlistat) and severe liver injury. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm213038.htm. Accessed Dec. 7, 2011.
- Xenical (prescribing information). San Francisco, Calif.: Genentech USA, Inc., 2010. http://www.gene.com/gene/products/information/xenical/. Accessed Dec. 7, 2011.
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