Weight Loss Pharmacotherapy
Weight Loss Drugs - Sibutramine &
Orlistat
Currently there are few pharmacotherapy options available for long term
weight loss usage. Medications that have been approved by the FDA for
treatment of "clinically significant" obesity (BMI > 30 or
BMI 27-29 with one or more obesity-related disorders.) include sibutramine
and orlistat. Sibutramine (Meridia) has the potential complication of
hypertension and increased heart rate. Orlistat (xenical) is a pancreatic
lipase inhibitor which inhibits the absorption of up to 30 percent of
dietary fat. Steatorrhea, bloating and distension, and anal leakage are
potential complications, and one must be alert for possible fat-soluble
vitamin deficiencies. Reported weight losses with these medications combined
with a low-calorie diet average 2-10 kg per year, and if the medications
are discontinued weight gain results.
Weight Loss Drugs - Amphetamine
Amphetamine-like derivitives: mazindol, phentermine, benzphetamine, phendimetrazine
are available only for short-term weight loss use. When weight loss drugs
are prescribed they should be only as part of a comprehensive treatment
plan including behavior therapy, diet, and physical exercise.
Weight Loss - Herbal Pills
Herbal pills for weight loss do not have standardized amounts of active
ingredients and have been reported to have harmful effects. Certain over-the-counter
weight loss preparations containing propanolamine (Dexatrim and related
compounds) have no proven efficacy for short- or long-term weight loss
and are being recalled because of the incidence of hemorrhagic stroke.
Ephedrine plus caffeine, and fluoxetine have been tested for weight loss,
but not approved and over-the-counter and herbal preparations are currently
not recommended.
Source: American Dietetic Association
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