For the first time in 13 years, The Food and Drug Administration (FDA) has approved two new weight-loss medications. Belviq and Qsymia. How effective are weight-loss medications? How safe? And, are they the answer for everyone?
“Belviq and Qsymia are approved as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in obese and certain overweight adults”, reports Morgan Liscinsky, of the FDA’s Office Of Public Affairs.
These medications join FDA-approved Orlistat (Xenical), “available by prescription for obesity management, including weight loss and weight maintenance, and is also available as an over-the-counter product (Alli) for weight loss in overweight adults.”
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Belviq works by activating a particular serotonin receptor in the brain, which then causes a person to eat less and feel full after eating smaller amounts of food. Qsymia is a combination of two FDA-approved drugs, Phentermine and Topiramate. Phentermine works by decreasing appetite and according to the FDA, “The precise way Topiramate affects weight is not known.”
Xenical (orlistat) works by preventing dietary fats from being absorbed by your body.
Among the medications approved by the FDA for short-term weight loss (i.e., a few weeks) are: Diethylpropion, and Phendimetrazine. These are stimulants approved for obesity as short-term additions (a few weeks) to restricting calories, for patients who have not responded to diet and/or exercise alone.
A common thread to any of the approved weight-loss medications is the recommendation that they be used in “addition to a reduced-calorie diet and exercise.”
Registered dietician and nutrition professor at Boston University Joan Salge Blake agrees. Any weight-loss medication she says, “needs to be coupled with a diet that is calorically reduced but balanced and a lifestyle that is active.”
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Blake notes that we need not only a reduced calorie diet, but a balanced diet: "one that stays with you for the rest of your life.” She indicates that our diets tend to be calorie dense but not necessarily nutrient dense, and that less than half of Americans meet the minimum recommendation to get 2.5 hours of exercise or physical activity a week.
“There really needs to be a whole approach here,” she says. She cautions that with regard to the weight-loss drugs, “They are by no means a magic bullet.”
Weight-loss medications also come with potential side effects. Back in 1997, the FDA pulled one diet drug combination from the market after it was shown to cause heart valve damage. Some other diet drugs have been linked to increased risk of heart attack and stroke.
These newer medications contain the following warnings:
The most common side effects of Belviq in non-diabetic patients, as reports the FDA, include: headache, dizziness, fatigue, nausea, dry mouth, and constipation, and in diabetic patients are low blood sugar (hypoglycemia), headache, back pain, cough, and fatigue.
Qsymia’s common side effects include: tingling of hands and feet, altered sense of taste, dizziness, trouble sleeping, constipation, and dry mouth.
The most common side effects of Xenical include problems with the bowel which I will abstain from listing here due to their extreme grossness factor (a 10 out of 10).
Diethylpropion can cause chest pain, palpitations, anxiety, insomnia, tremor, diarrhea, rash, and increased sweating.
Phendimetrazine can cause: palpitations, restlessness, insomnia, agitation, tremor, diarrhea, and increased sweating.
Do weight-loss medications work?
Check out some of the stats by the FDA:
Average weight loss in patients treated with Belviq compared with placebo ranged from 3.0 percent to 3.7 percent. Approximately 47 percent of patients without type 2 diabetes mellitus who were treated with Belviq lost at least 5 percent of their baseline body weight compared with about 23 percent of patients treated with placebo. In patients with type 2 diabetes, approximately 38 percent of patients treated with Belviq and 16 percent treated with placebo lost at least 5 percent of baseline body weight.
Treatment with the highest dose of Qsymia resulted in an average percent weight loss of 8.9 percent compared with placebo. Approximately 62 to 69 percent of patients treated with Qsymia lost at least 5% of their baseline body weight compared with about 20 percent of patients treated with placebo.
Average percent weight loss difference between Xenical-treated patients and placebo-treated patients was 3%. Fifty-seven percent of patients treated with Xenical and 31% of patients treated with placebo lost at least 5% of their baseline body weight.
Conclusion? It is necessary to weigh the pros and cons and to balance the scales of medication, diet, and exercise, when it comes to the ultimate effectiveness of taking weight loss medications.
What do you think?
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- How to Diet on a Dime
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Anna Katzman is a Clinical Nurse Specialist in psychiatry, certified in child and adolescent mental health. She is a regular contributor to GalTime. You can visit her blog for additional information.