Diet pills weight loss medication review
In September 2014, the US FDA approved a new weight loss medication called Contrave, a sustained release combination of the popular mood stabilizer, Bupropion(Wellbutrin) and a narcotic de-additiction medication called Naltrexone.
FDA has previously approved two new weight loss medications in 2012, Lorcaserin(Belviq) and Qsymia(Phentermine and Topiramate) after a gap of 10 years when it kept denying all the weight loss medications for one reason or the other.
The urgency in which the FDA cleared these three new weight loss medications reflects the growing concern about the epidemic of obesity that is threatening the health of the nation. According to the available obesity statistics from the Centers for Disease Control, obesity and overweight status already affect up to two thirds of the entire adult population of the the United States.
Alarming obesity statistics
- More than one-third (34.9% or 78.6 million) of U.S. adults are obese.
- Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death.
- The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight.
This article is a comprehensive review of the various weight loss medications(diet pills), their side effects, how they work, expected weight loss, cost of these diet pills, availability etc.
Before going in to the details of the various diet pills, let me remind you that obesity is not a short term disease like the flu but a long term medicatal conditon. Therefore, the treatment strategies for the long term management of this chronic condition should also be on a longer term basis.
Is this the cause of your weight gain?
I am also compelled to make a statement about how we got here to begin with when it comes to the problem of obesity. Despite the efforts from the various government agencies such as the United States Department of Agriculture that has been making recommendations on healthy foods through the failed food pyramid, now changed to food patterns, the waist lines of the average American has been expanding.
Is it possible that we are fighting the wrong war? What if obesity is just a proxy to a bigger and more sinister metabolic problem called insulin resistance which eventually leads to metabolic syndrome (a third of the US population has metabolic syndrome), prediabetes and diabetes.
The traditional thinking that obesity is a result of eating too much falls flat on its face as the whole population is gaining weight, not just a few individuals who might be intentionally overeating as the population acts as its own control and the population is not on a mission to gain weight. It is this metabolic process called insulin resistance that drives the metabolic starvation, overeating, weight gain and eventual risk of over 50 different medical problems.
Although there are a wide variety of other causes for weight gain, the process of insulin resistance that affects up to 71 percent of the population is one of the major contributors. This insulin resitance is a direct result of the failed
food pyramid that assumed fat and cholesterol are the problem and grains(read starch) is the solution, as starch needs insulin and over time of getting overeposed to insulin, the body becomes resistant to insulin. Learn more on insulin resistance here and watch these must watch youtube videos and Tedtalk.
Treatment options for treatment of obesity
Here are the 5 proven measures to treat obesity.
- Very low calorie diets with or without meal replacements.
- Appetite suppressants or diet pills
- Physical activity or exercise
- Correction of known causes of weight gain
- Bariatric weight loss surgery
The purpose of this article is to review the weight loss medications. So, let us focus on this topic.
How will these weight loss medications work?
The actual mechanism of action depends on the type of weight loss medication. Some of their stimulants that increase the body’s resting metabolic rate (RMR), also called basal metabolic rate or BMR. Other drugs suppress the appetite by making you less hungry. Yet others, make you not crave certain foods while others reduce food intake.
Who should consider diet pills or weight loss medications?
BMI estimates overweight and obesity based on your height in relation to your weight. Your doctor may prescribe you a medication to treat your obesity if you are anadult with
- a BMI of 30 or greater OR
- a BMI of 27 or greater and you have obesity- related medical problems, such as high blood pressure, type 2 diabetes, or high cholesterol.
What are the benefits of taking diet pills or weight loss medications?
When combined with changes to eating and physical activity, prescription drugs may helpsome people lose weight (usually less than 10 percent of their body weight). Results vary by drug and by person. Losing weight may helpimprove your health by lowering blood sugar,blood pressure, and triglycerides (other fats in the blood).
Weight loss of 5 to 10 percent can also improve inflammation profiles and improvehow patients feel and their mobility. Most weight loss takes place in the first 6 monthsof starting the medicine.
After that time, you may lose weight more slowly or begin to regain weight. What are the concerns?Because obesity drugs are used to treat a condition that affects millions of people, the chance that side effects may outweigh benefits is of great concern.This is why one should never take a weight lossmedicine only for cosmetic benefit.
Also check the new weight loss medication Contrave information.
By far, the most effective weight loss medication in our experience has been the combination medications, especially the combination of Phentermine and Topiramate. According to many studies, this combination effectively blocks both the appetite and cravings in most people and studies have shown it to lead to about 9% weight loss in a year, more than twice as much as the competition such as 4.5% percent weight loss expected with Belviq, or 5% weight loss expected with the new Contrave.
Phentermine-topiramate (Qsymia) In July 2012, the FDA approved the drug combination phentermine and topiramate, sold as Qsymia (pronounced kyoo-sim-EE-uh) to treat obesity in adults.
Qsymia combines two FDA-approved drugs:
- phentermine, a medicine approved to suppress appetite.
- topiramate, a medicine approved to control seizures.
It may also be used to preventmigraine headaches. It is in an extended-release form in Qsymia.Although phentermine when used as a single agent is approved for only a few weeks, the combination has been studied for 2 years and found to be safe for use.
Additionally, the doses used in Qsymia are much lower than the usual doses of phentermine and topiramate when prescribed separately. Qsymia is available in three doses: a starting dose,a recommended dose, and a higher dose.
After 1 year of treatment with Qsymia, 62 percent of patients who were prescribed the recommended dose lost at least 5 percent of their weight. If after 12 weeks on the higher dose, you do not lose at least 5 percent of your body weight, it is unlikely that the drug will work for you.Side effects. Common side effects include tingling of hands and feet, dizziness, taste alterations(particularly with carbonated beverages), trouble sleeping, constipation, and dry mouth. Serious but rare side effects include allergic reactions(such as rash, hives, difficulty breathing), thoughts of suicide, memory problems, mood problems(such as anxiety, depression, panic attacks), and changes to your vision. Rare side effects associatedwith topiramate include kidney stones and acuteglaucoma.
Qsymia must not be used during pregnancy because it may cause harm to the baby. People with an overactive thyroid gland,glaucoma, or who have recently taken certain antidepressant drugs known as MAOIs should not use Qsymia, although the drug was studied in patients taking SSRI and other antidepressants without adverse events.
Other Appetite Suppressants or diet pills
These drugs promote weight loss by increasing one or more brain chemicals that affect appetite.You may feel less hungry or feel full sooner when taking these drugs. They are FDA approved onlyfor a short period of time (up to 12 weeks). Some doctors may prescribe them for longer periods of time (see the box “What is ‘off-label’ use?”).Several appetite suppressants may be used topromote weight loss in adults. They include
- phentermine (sold as Adipex-P, Oby-Cap, Suprenza, T-Diet, Zantryl)
- benzphetamine (sold as Didrex)
- diethylpropion (sold as Tenuate, Tenuate Dospan)
- phendimetrazine (sold as Adipost, Bontril PDM, Bontril Slow Release, Melfiat)Among these types of drugs, phentermine is the one used most often in the United States.Side effects.
Common side effects of appetite suppressants include dry mouth, difficulty sleeping, dizziness, headache, feeling nervous,feeling restless, upset stomach, and diarrhea or constipation. Severe side effects may include chest pain, fainting, fast heartbeat, shortness of breath,confusion, and swelling in your ankles or feet.
People with heart disease, high blood pressure, an overactive thyroid gland, or glaucoma should notuse these drugs. These medications are controlled substances because of their potential for abuse.
Off label weight loss medications may include
- bupropion, a drug used to treat depression
- metformin, a drug used to treat type 2 diabetes
- Victoza, a diabetes injectable medication.
How can W8MD Medical Weight Loss Centers help?
When clinically appropriate, W8MD offers the various diet pills or appetite suppressants along with a reduced calorie diet and exercise including but not limited to the following:
- Contrave (Buprion and Naltrexone) – Brand new weight loss medication
- Phentermine and Topiramate (Qsymia) – New weight loss medication (Most popular and most effective)
- Lorcaserin (Belviq) – New weight loss medication
- Phentermine (Adipex)
- Topiramate (Topamax)
- Phendimetrazine (Bontril)
- Diethylpropion (Tenuate)
- Xenical and others
With locations in multiple states including New York, New Jersey, Pennsylvania with more centers being added on a regular basis, with physicians trained and experienced in the new field of obesity medicine and most W8MD centers accepting insurance for the physician weight loss visits, you have nothing to lose but your unwanted pounds with W8MD!
“Wonderful doctor. Speaks to me with respect and great knowledge on weight loss. Fabulous results after 2 months, I’ve lost 30 pounds. Highly recommend.” – Mike B. on Yelp
“Dr. Tumpati takes his time with you to explain everything, very thorough” – Carolann Z.
Saxenda for weight loss
On December, 23rd, 2014 the United States FDA approved Saxenda(liraglutide) 3mg, a powerful new injectable weight loss medication. At a lower dose of 1.2mg and 1.8mg, liraglutide(Victoza) has been FDA approved for treatment of diabetes and the medication has long been know to help people lose weight. The good news is that at a higher dose of 3mg, liraglutide has been shown to melt pounds faster and more efficiently than any of the other weight loss medications currently on the market.
Although physicians have been using Victoza off label for weight loss for a long time, Saxenda is specifically approved for weight loss and a person does not need to a diabetic to try this new medication. Approved for anybody with a body mass index of 30 or over with at least one weight related comobordity such as diabetes, high blood pressure, cholesterol problems, sleep apnea etc.
The drug is also approved for adults with a BMI of 27 or greater (overweight) who have at least one weight-related condition such as hypertension, type 2 diabetes, or high cholesterol (dyslipidemia).
When approving this new weight loss medication Saxenda, 2nd in the year 2014 after Contrave, the FDA’s acting deputy director, James Smith, MD said “obesity is a public health concern and threatens the overall well-being of patients,”
“Saxenda, used responsibly in combination with a healthy lifestyle that includes a reduced-calorie diet and exercise, provides an additional treatment option for chronic weight management.
Compared to its rival medications including the other new weight loss medications Contrave, Belviq and Qsymia, over 50% of patients who tried Saxenda lost 5% or more of their body almost twice as effective as the other weight loss medications.
New class of weight loss medications
Saxenda is a glucagon-like peptide-1 (GLP-1) receptor agonist and should not be used in combination with any other drug belonging to this class, including Victoza, a treatment for type 2 diabetes. Containg the same active ingreding liraglutide, Saxenda and Victoza contain the active ingredient (liraglutide) at different doses (3 mg and 1.8 mg, respectively).
Although the same ingredient as in the diabetes medication Victoza albeit at a higher dose, Saxenda is not indicated for the treatment of type 2 diabetes, as the safety and efficacy of Saxenda for the treatment of diabetes has not been established.
Studies supporting use of Saxenda for weight loss
The safety and effectiveness of Saxenda were evaluated in three clinical trials that included approximately 4,800 obese and overweight patients with and without significant weight-related comborbid conditions. All patients received counseling regarding lifestyle modifications that consisted of a reduced-calorie diet and regular physical activity in addition to Saxenda.
Fabulous weight loss results
Results from a clinical trial that enrolled patients without diabetes showed that patients had an average weight loss of 4.5 percent from baseline compared to treatment with a placebo at one year.
In this trial, 62 percent of patients treated with Saxenda lost at least 5 percent of their body weight compared with 34 percent of patients treated with placebo. Results from another clinical trial that enrolled patients with type 2 diabetes showed that patients had an average weight loss of 3.7 percent from baseline compared to treatment with placebo at one year. In this trial, 49 percent of patients treated with Saxenda lost at least 5 percent of their body weight compared with 16 percent of patients treated with placebo.
12 week trial of Saxenda for weight loss
Patients using Saxenda should be evaluated after 16 weeks to determine if the treatment is working. If a patient has not lost at least 4 percent of baseline body weight, Saxenda should be discontinued, as it is unlikely that the patient will achieve and sustain clinically meaningful weight loss with continued treatment.
Warnings and precautions
Saxenda has a boxed warning stating that tumors of the thyroid gland (thyroid C-cell tumors) have been observed in rodent studies with Saxenda but that it is unknown whether Saxenda causes thyroid C-cell tumors, including a type of thyroid cancer called medullary thyroid carcinoma (MTC), in humans. Saxenda should not be used in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (a disease in which patients have tumors in more than one gland in their body, which predisposes them to MTC).
Side effects of Saxenda
Serious side effects reported in patients treated with Saxenda include pancreatitis, gallbladder disease, renal impairment, and suicidal thoughts. Saxenda can also raise heart rate and should be discontinued in patients who experience a sustained increase in resting heart rate.
In clinical trials, the most common side effects observed in patients treated with Saxenda were
- low blood sugar (hypoglycemia), and
- decreased appetite.
Other related medications are also in the pipeline including once a week dosing type medications and are awaiting the FDA approval.
Liraglutide, with diet and exercise, maintained weight loss achieved by caloric restriction and induced further weight loss over 56 weeks. Improvements in some cardiovascular disease-risk factors were also observed. Liraglutide, prescribed as 3.0 mg per day, holds promise for improving the maintenance of lost weight.
Other similar weight loss medications
AstraZeneca’s evenatide (Byetta, Bydureon), has also been found to aid weight loss although not yet approved directly for weight loss. Recently, the FDA approved albiglutide (Tanzeum), GlaxoSmithKline’s GLP-1 contender, that is dose once a weeek injected subcutaneously.
Impressive weight loss results
When used along with diet and exercise, Liraglutide, maintained weight loss achieved by caloric restriction and induced further weight loss over 56 weeks in a research study which also showed improvements in some cardiovascular disease-risk factors were also observed. Liraglutide, prescribed as 3.0 mg per day, holds promise for improving the maintenance of lost weight.