Diets And Weight Loss

There are two basic types of weight loss drugs -- prescription drugs, which have been around for years, and now, with the release of Alli, over-the-counter medication. Other over-the-counter weight loss remedies are considered dietary supplements; they do not undergo the same type of FDA approval process as drugs.

"Approved weight loss drugs must prove they are safe and effective with strong scientific evidence in order to pass the stringent FDA approval process," says Aronne, former president of the North American Association for the Study of Obesity (NAASO).

In the prescription drug category, there are basically three choices, Xenical (orlistat), Meridia (sibutramine), and phentermine.

Xenical (orlistat) is a fat blocker that prevents fat from being completely absorbed in the gastrointestinal tract. Prescription strength is 120 milligrams; over-the-counter Alli is the same drug at half strength, or 60 milligrams.

Fat blockers reduce fat absorption and, as a result, some people are plagued with oily discharge, fatty stools, gas, and/or inability to control bowel movements. These side effects are the result of the fat not being absorbed by the body. Eating a low-fat diet reduces the risk of potential side effects. But if your diet is already low in fat, you may see less of an impact from the medication, as there is less fat to block.

Xenical or Alli is safe for almost anyone because the drug is not absorbed, says Kushner. "I frequently prescribed it to cardiovascular patients because it is so safe," he says.

Patients must be willing to stick to a low-fat diet. These drugs have a built-in feedback system. "If you eat a high-fat diet, you will experience the side effects, so to avoid the unpleasant effects, you need to reduce the fat in your diet," says Aronne.

Not only do these drugs block fat, they have the potential to block other nutrients.

"Take a once-daily multivitamin mineral for nutritional insurance to help compensate for any losses and don't take it at the same time as the medication," says Dawn Jackson-Blatner, a spokesperson for the American Dietetic Association.

Meridia (sibutramine) helps reduce hunger by working on the appetite control center in the brain that makes you feel full.

"Meridia can help add 5%-10% additive weight loss that you would not get with diet and exercise alone" says Aronne.

Kushner prescribes Merida to patients who struggle with cravings and have trouble knowing when to stop eating. Aronne says that younger patients who are at a low risk for heart disease are good candidates.

Side effects include dry mouth, constipation, and insomnia. Meridia should not be used by anyone with cardiovascular risk factors.

"We recommend regular blood pressure checks for anyone on Merida," says Blatner.

Phentermine is generic, the least expensive of the medications, and has been on the market the longest. Once a part of the famed fen-phen combination weight loss drug, Phentermine works to decrease appetite.

It is the most widely used weight loss drug. While it's officially approved only as a short-term drug, some doctors use it as long term therapy.

"I use phentermine for people with strong appetites. [It] seems to work best on reducing hunger and the number of eating episodes. I also like it because it is generic, and inexpensive for patients who do not have insurance coverage," says Kushner.

Side effects may include depression, insomnia, increased blood pressure, irritability, and nervousness.

While these are the only medications approved for weight loss, some people also lose weight on prescribed medications used to treat other conditions such as depression, seizures, and diabetes.

Insurance coverage of these weight loss medications varies. Some companies will cover them completely, some partially, and some not at all.

Source: webmd.com