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Weight Loss Pills
For obese people who have difficulty losing weight through diet
and exercise alone, there are a number of FDA-approved prescription
drugs that may help. "On average, individuals who use weight-loss
drugs lose about 5 percent to 10 percent of their original weight,
though some will lose less and some more," says the FDA's Colman.
All of the prescription weight-loss drugs work by suppressing the
appetite except for Xenical (orlistat). Approved by the FDA in 1999,
Xenical is the first in a new class of anti-obesity drugs known
as lipase inhibitors. Lipase is the enzyme that breaks down dietary
fat for use by the body. Xenical interferes with lipase function,
decreasing dietary fat absorption by 30 percent. Because the undigested
fats are not absorbed, fewer calories are available to the body.
This may help in controlling weight. The main side effects of Xenical
are cramping, diarrhea, flatulence, intestinal discomfort, and leakage
of oily stool.
Meridia (sibutramine), approved by the FDA in 1997, increases the
levels of certain brain chemicals that help reduce appetite. Because
it may increase blood pressure and heart rate, Meridia should not
be used by people with uncontrolled high blood pressure, a history
of heart disease, congestive heart failure, irregular heartbeat,
or stroke. Other common side effects of Meridia include headache,
dry mouth, constipation and insomnia.
Other anti-obesity prescription drugs that were approved by the
FDA many years ago based on very short-term, limited data include:
Bontril (phendimetrazine tartrate), Desoxyn (methamphetamine) and
Ionamin and Adipex-P (phentermine). They are "speed"-like
drugs that should not be used by people with heart disease, high
blood pressure, an overactive thyroid gland, or glaucoma. These
drugs are approved only for short-term use, such as a few weeks.
"There is no magic pill for obesity," says David Orloff,
M.D., director of the FDA's Division of Metabolic and Endocrine
Drug Products. "The best effect you're going to get is with
a concerted long-term regimen of diet and exercise. If you choose
to take a drug along with this effort, it may provide additional
help."
Prescription weight-loss drugs are approved only for those with
a BMI of 30 and above, or 27 and above if they have other risk factors,
such as high blood pressure or diabetes.
People should contact a doctor before using any kind of drug, including
a weight-loss drug.
Until recently, weight-control drugs containing the active ingredient
phenylpropanolamine (also used as a nasal decongestant) were available
over-the-counter (OTC). However, based on evidence linking this
ingredient to an increased risk of bleeding in the brain (hemorrhagic
stroke), the FDA asked drug manufacturers to discontinue marketinsg
products containing phenylpropanolamine. In addition, the FDA issued
a public health advisory in November 2000, warning consumers to
stop using products containing this ingredient.
The FDA is proposing to classify phenylpropanolamine as "not
generally recognized as safe" and is proceeding with regulatory
actions that will likely remove this ingredient from the market.
Although cough-cold products were reformulated using other nasal
decongestant ingredients, there is no currently available active
ingredient that is generally recognized as safe and effective for
use in an OTC weight-control drug product.
Some dietary supplement makers claim their products work for weight
loss. These products are not approved by the FDA before they are
marketed. Under existing laws, manufacturers have the responsibility
for ensuring that their dietary supplement products are safe and
effective.
Many weight-loss products claim to be "natural" or "herbal,"
but this does not necessarily mean that they're safe. These ingredients
may interact with drugs or may be dangerous for people with certain
medical conditions. If you are unsure about a product's claims or
the safety of any weight-loss product, check with your doctor before
using it.
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