Appetite suppressants 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?
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.
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
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.
Locations for physicians prescribing Saxenda and other weight loss medications
King Of Prussia Weight Loss & Sleep Center: 987 Old Eagle School Rd, Ste 712, Wayne, PA, 19087 Ph: 215-676-2334
NYC Insurance Weight Loss & Sleep Center: 2003, Bath Avenue, Brooklyn, NY, 11214 Ph: 1-718-946-5500.
W8MD medical weight loss program at Vida Sleep Center of Dr. Felix Roque’s office at 543, 45th Street, Union City, New Jersey. 543 45th St, Union City, NJ 07087. Phone: (201) 766-6469. This center bills out of network for insurance.
Prescription medications for weight loss – Phentermine review
Most people tend to over simplify weight loss and resort the over simplistic approach of “eat less, and exercise more”. If you are overweight or obese and ever tried losing significant portion of your body weight, you would have probably realized that it is never that simple. And if it is, this country or the world for that matter, should not be dealing with this epidemic of obesity, and diabetes, some dubbed as diabesity.
In reality, there are over 50 different neurochemicals that affect the appetite center leading to weight gain and using certain tools such as an appetite suppressant medication might be an option to consider for many in addition to a low calorie diet and exercise. Let us review the old and time tested weight medication or diet pill – Phentermine.
Some of the questions related to the weight loss medication Phentermine we would try to answer in this blog are noted below:
- Does phentermine really work for weight loss?
- Is Phentermine safe to take for losing weight?
- How much weight will I lose when I take Phentermine?
- How much does Phentermine cost?
- Is Phentermine safe to take for help losing weight?
- What are the common side effects of Phentermine?
- Can Phentermine be taken together with other weight loss medications such as Topiramate, Metformin, Bupropion, or other diet pills?
- Where can I find a weight loss doctor that is familiar with Phentermine and other appetite suppressant medications in New York, New Jersey or Pennsylvania area?
Before looking at the answers to the above questions, let us review what the bariatric weight loss physicians or weight loss doctors in the country choose for their patients to help them lose weight. According to most estimates, over 95% of all weight loss physicians use Phentermine alone or in combination with other medications to help their patients lose weight.
In fact, Phentermine is so commonly used for helping patients lose weight by weight loss doctors all over the world that we can Phentermine is to the weight loss physicians what Metformin is to the endocrinology doctors treating diabetes!
What is Phentermine?
As the name suggests, Phentermine, is an amphetamine based stimulant medication that helps improve one’s metabolism and is used medically as an appetite suppressant.
In the United States, Phentermine is approved as a short term adjunct therapy for obese or overweight adults with certain comorbid conditions to curb appetite, increase metabolism and assist in losing weight in addition to a reduced calorie diet and exercise program.
It is typically prescribed by physicians specializing or with an interest in obesity medicine for individuals who are at increased medical risk due to their weight. In this context, it is also important to note that the distribution of the body weight such as central or abdominal distribution of the weight poses a higher risk than otherwise.
How long can one use Phentermine for weight loss?
When the US FDA approved Phentermine in 1959, the data was limited on this medication and therefore, approved Phentermine on a short term basis, usually few weeks generally interpreted as about 3 months. Although most people would like to see Obesity much like flu that will get better in a short time, the reality unfortunately, is that obesity is a long term disease and the treatment approaches should also be long term.
Realizing the importance of the long term approach to obesity, rather than a short term approach, the US FDA approved some of the newer weight loss medications such as the combination of Phentermine and Topiramate (Qsymia), Belviq, Contrave etc. for longer term use although the original indication for Phentermine remains unchanged. Most bariatric physicians that use Phentermine on a longer term basis are using the medication off label whenever the benefit of losing weight are considered higher than the risks associated with the medication.
What are the common side effects of using Phentermine?
Generally speaking, phentermine appears to be relatively well tolerated.
The common side effects of Phentermine may include the following
Common (>1% incidence) adverse effects include dry mouth, restless feeling which improves over time in most people.
- Contraindicated in cardiac disease such as advanced arteriosclerosis, pulmonary hypertension, uncontrolled high blood pressure or hypertension, arrhythmias) and cerebrovascular disease or stroke.
- Pregnant, planning to become pregnant, or are breast-feeding
How does Phentermine work for weight loss?
Phentermine works on the brain to reduce hunger and on the cells to increase metabolism to burn more fat.
Combination of Phentermine with other weight loss medications
Phentermine is now increasingly being used as one of the main component in the new combination for weight loss such as Qsymia(A sustained release combination of Phentermine and Topiramate) and many weight loss physicians use Phentermine with other weight loss medications including Bupropion, Metformin, Diethylpropion, Belviq, etc although it varies based on the individual weight loss physicians training, experience and the patients clinical situation.
Out of the many combination weight loss medications, the most effective combination in our opinion is the combination of Phentermine and Topiramate which works on multiple fronts by reducing cravings, increasing metabolism and reducing hunger.
In our opinion and in the opinion of many weight loss physicians that are familiar with Phentermine, it is a relatively well tolerated medication and best works together with a reduced calorie diet, exercise under careful medical supervision.
Cost and availability of Phentermine
Although the cost varies based on the pharmacy, location, and various other factors, most W8MD medical weight loss centers offer Phentermine included in the cost of the program administration fee that varies from $45.00-$60.00 biweekly for up to two appetite suppressant medications when medically appropriate. Compared to many other physician weight loss programs, the W8MD medical weight loss program is not only affordable, but also one of the most cost effective weight loss programs in the area. Check out our great weight loss program reviews online and watch our You Tube weight loss channel.
Trade names for Phentermine
- Adipex P (immediate release)
- Ionamin (slow-release resin, discontinued in the US)
- Pro-Fast SA
- Qsymia (with topiramate)
- PhenObestin 37.5
- Phentermine Trenker
- Suprenza (orally disintegrating tablet)
If you are trying to lose weight and need a medication to help suppress the appetite, reduce cravings and increase metabolism, you probably want to consider one of the most commonly prescribed appetite suppressant medications by weight loss doctors called Adipex or Phentermine.
Although Phentermine or Adipex can be used on its own, many weight loss physicians do use it in combination with other diet pills, such as the combination of Phentermine with Topiramate like in the new diet pill, Qsymia, for additional help to reduce food cravings and for synergistic effect on weight loss.
Phentermine weight loss diet pill – How does Phentermine work?
Phentermine, like it’s cuisine, Phendimetrazine(Bontril) is an Amphetamine based medication that helps you lose weight by helping your metabolism go up. Phentermine helps burn fat and also helps reduce hunger, and increase your resting metabolic rate so that your body is able to reduce caloric intake and increase metabolism so you can lose weight.
How commonly is Phentermine prescribed for weight loss?
Despite the many new weight loss medications now available such as Qsymia (Phentermine and Topiramate), Belviq(Lorcaserin), Saxenda(Liraglutide) and Conrave, Phentermine continues to be the most commonly used and most used weight loss medication or diet pill by most weight loss doctors, also called Bariatricians or obesity medicine doctors.
Combination of Phentermine with other weight loss medications
Although Phentermine can be used alone to help fight obesity and burn fat, it is increasingly being used with other weight loss medications or diet pills including Topiramate like in Qsymia.
What is Phentermine?
Related to the broad class of medications generally known as Amphetamines, Phentermine(Adipex) is the most widely used weight loss medication or diet pill in the United States.
Most popular weight loss drug for most weight loss doctors
A 2008 survey of prescribing practices found that 98% of bariatric medicine specialists(medical weight loss doctors) used appetite suppressants or diet pills in treating obesity and that 97% of those prescribed phentermine as their first choice.
What is Phentermine used for?
Phentermine is used for a limited period of time to speed weight loss in overweight or obese people defined as those weight a body mass index of over 25 in addition to diet and exercise as prescribed and supervised by a licensed and experienced weight loss physician.
How does Phentermine work for weight loss?
Phentermin is an anorectic medication that increases the metabolism and reduces hunger by decreasing appetite.
There are three main actions of Phentermine:
- Phentermine works on the hypothalamus portion of the brain that eventually help stimulate the adrenal glands to release norepinephrine, a neurotransmitter or chemical messenger that signals a fight-or-flight response, reducing hunger.
- Phentermine works also outside the brain, as well, to release epinephrine or adrenaline, causing fat cells to break down stored fat, but the principal basis of efficacy is hunger-reduction.
- Phentermine also releases serotonin and dopamine, but to a much lesser extent than that of norepinephrine.
FDA approval history of Phentermine
As one of the first medications to be approved by the FDA for weight loss, phentermine has been around for over 50 years. Approved in 1959, phentermine hydrochloride is now manufactured by several pharmaceutical companies includingn Gate Pharmaceuticals under the brand name Adipex-P and the less popular brand name Ionamin from Medeva Pharmaceuticals. Phentermine is also currently sold as a generic. Phentermine is a schedule IV drug under the Convention on Psychotropic Substances. In the United States, it is classified as a Schedule IV controlled substance under the Controlled Substances Act. In contrast, amphetamine preparations are classified as Schedule II controlled substances.
Combination of Phentermine with Topiramate Extended Release (Qsymia)
Phentermine is being studied in combination with other medications for obesity. The first such combination is the appetite suppressant phentermine/topiramate (Qsymia formerly Qnexa). In 2012, the FDA approved its sale in the United States and is currently one of the most effective weight loss combinations when the patients are able to tolerate the medication.
Extended release formulation of Phentermine
Phentermine comes as tablets and extended-release capsules. It usually is taken as a single daily dose in the morning or three times a day 30 minutes before meals.
Duration of therapy of Apidex – P or Phentermine
Originally approved for short term therapy for obesity, phentermine is used for treatment of obesity. However, the FDA has been questioned by many weight loss physicians and physician groups, most notably, the American Society of Bariatric Physicians, as to the rationale in limiting the use of Phentermine for short term use when obesity itself is recognized as a chronic or long term process. Realizing this folly in the original labelling of Phentermine, the US FDA has stated that the newer combination medications such as Qsymia (Phentermine and Topiramate) are approved for long term use although the indication for Phentermine alone remains unchanged. Most weight loss physicians use Phentermine longer term as an off label indication based on idividual patient situation.
Side effects of Phentermine
Generally speaking, phentermine is relatively well tolerated especially in smaller doses and when used under proper clinical supervision with physicians familiar with use of Phentermine.
Common side effects of Adipex – P or Phentermine
Common (>1% incidence) adverse effects include:
- Xerostomia (dry mouth)
- Urinary frequency
- Facial oedema
- Unpleasant taste
- Changes in libido
Less common or rare (<1% incidence) adverse effects include:
- Valvular heart disease (in combination with dexfenfluramine and fenfluramine; causal relationship unclear)
- Primary pulmonary hypertension
- Increased seizure activity in people with epilepsy
- Withdrawal symptoms on stopping
- Ischaemic events
Cautions and Contraindications for use Phentermine
Phentermine use is contraindicated in those who are:
- Known hypersensitivity or idiosyncratic reaction to sympathomimetic amines
- Taking amphetamine (i.e., Adderall, Dexedrine, Vyvanse), dexfenfluramine, fenfluramine, furazolidone, guanadrel, guanethidine, or have taken a monoamine oxidase inhibitor (MAOI) (e.g., phenelzine) in the last 14 days
- Concomitant treatment with drugs that increase blood pressure
- Peptic ulcer
- Prostatic hypertrophy
- Contraindicated in cardiac disease (e.g. advanced arteriosclerosis, pulmonary hypertension, uncontrolled hypertension, arrhythmias) and cerebrovascular disease (stroke)
- Pregnant, planning to become pregnant, or are breast-feeding
- Those receiving serotonergic medications such as the selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitor, tricyclic antidepressant, due to the potential for serotonin syndrome to be precipitated by the cotreatment.
Drug interactions for Phentermine
Medicines which may interact with phentermine, such as dexfenfluramine, fenfluramine, furazolidone, or MAOIs (e.g., phenelzine) are contraindicated because of the risk of serious side effects, such as increasing headache, high blood pressure, slow heart rate, elevated temperature, or possibly fatal lung problems, may be increased. Guanadrel (Hylorel) or guanethidine (Ismelin) effectiveness may be decreased by phentermine. Antacids may decrease the excretion of phentermine. Carbonic anhydrase inhibitors (acetazolamide, dichlorphenamide, methazolamide) may decrease the excretion of phentermine.
Adipex P (immediate release), Ionamin
Cost of Phentermine at W8MD Weight Loss Clinics – Lowest Cost Adipex
The cost of Phentermine varies. At most W8MD weight loss locations, when and if Phentermine was determined to be a medication appropriate for a particular patient by the weight loss physician after the initial history and physical examination, it may be included in the biweekly program cost of $50.00 includes up to two diet pills, depending on the particular W8MD weight loss center. As most other weight loss clinics that offer Adipex charge much more, for most people, the W8MD weight loss clinics that offer Adipex for appetite suppression ends up being one of the lowest cost weight loss prescription medication for them. Contact the individual location for more information.
W8MD weight loss physicians are familiar with use of Prescription Adipex or Phentermine and other weight loss medications and can offer this as one of the options to lose weight for eligible patients when medically appropriate in addition to a reduced calorie diet and appetite suppression!
As Adipex lowers the food cravings, increases the fat burning, and metabolism, most patients on Adipex are able to lose weight faster compared to those that do not take this prescription diet pill.
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