Weight Loss: The No-Diet Approach

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Neither drug is approved for use in children. Contrave , an extended-release form of two previously approved drugs, naltrexone and bupropion, was approved in September In clinical trials , 36 to 48 percent of patients lost at least 5 percent of their body weight compared to a placebo. With Saxenda , approval in December , the average weight loss that patients in clinical trials experienced was 4.

Qsymia is a combination of two drugs , phentermine and extended-released topiramate. Phentermine acts to suppress the appetite, and topiramate is an anti-seizure medicine, but in this case it is used because it may help people feel full. Qsymia is used for weight control in two groups: The Qsymia dose is taken once daily in morning; patients should avoid an evening dose as it may keep them awake. Qsymia may cause birth defects , so do not use Qsymia if you are pregnant or planning a pregnancy.

Women will need a negative pregnancy test before starting Qsymia and each month while on therapy. Use an effective birth control to prevent pregnancy; discuss your birth control options with your health care provider.

Do not use Qsymia if you have glaucoma, thyroid disease or use monoamine oxidase inhibitor drugs. You can check for drug interactions here, and be sure to ask your pharmacist about possible drug interactions with prescription, vitamin, or herbal or dietary supplements.

If you have not lost a certain percent of your weight after 12 weeks, your doctor may decide to stop Qsymia treatment, but you may need to stop treatment slowly. Do not stop treatment on your own; always talk to your doctor first.

Common side effects with Qsymia may include. Due to the possibility of drug interactions when you take Qsymia with other prescription, over-the-counter or herbal weight loss medications, talk to your doctor or pharmacist before you combine any medications. Belviq and Belviq XR lorcaserin are serotonin 2C brain receptor agonists that helps people feel full after eating less. Belviq and Belviq XR are both available by prescription in your pharmacy, and are classified as a C-IV controlled substance, meaning it has a lower level for abuse or drug dependence.

Belviq and Belviq XR are approved to be used in the same two patients groups as Qsymia: Patients taking Belviq should not exceed a dose of 10 mg two times a day. Patients using the longer-acting Belviq XR take the 20 mg dose once-a-day.

Exceeding the normal dose of lorcaserin may lead to psychiatric side effects. Like Qsymia, the safety of taking Belviq with other weight loss drugs is not known. There is the possibility of dangerous drug interactions with Belviq because it acts on the serotonin system in the brain. It is important to have a thorough drug interaction review with your doctor or pharmacist, reviewing over-the-counter, vitamin and prescription drugs, when you start Belviq and any time a new medication is added or stopped.

Common side effects may include headache, nausea, dizziness, fatigue, dry mouth, and constipation. As with Qsymia, low blood sugar may occur in type 2 diabetic patients.

Do not use weight loss drugs of any type in pregnancy. Contrave was FDA-approved in September Contrave is an extended-release form of two previously approved drugs, naltrexone ReVia, Vivitrol and bupropion Wellbutrin, Zyban. Naltrexone is approved to treat alcohol or opioid dependence, while bupropion is used for depression, seasonal affective disorder and as an aid to quit smoking.

Contrave is used in obese or overweight adults with at least one weight-related condition such as high blood pressure or type 2 diabetes. Safety and side effect concerns include behavioral changes, suicidal thoughts, seizure risk, and added effects with alcohol, among others. Do not drink alcohol with Contrave. Liraglutide is also approved at a lower dose for use in type 2 diabetes brand name Victoza , but the two drugs should not be used together or with any other glucagon-like peptide-1 GLP-1 receptor agonist.

As with the other prescription weight loss products, Saxenda is for obese or overweight patients based on their BMI with at least one weight-related condition such as hypertension, type 2 diabetes, or high cholesterol. Again, the average weight loss was 4.

Alli should be used in conjunction with diet and regular exercise to promote weight loss. Alli decreases the absorption of dietary fat by about 25 percent and therefore reduces the number of calories absorbed. However, clinical trials have only shown it to be modestly effective; in general, a weight loss of 3 to 5 pounds per year would be expected over and above what you might lose from dieting and exercise alone. Alli is taken as one 60 mg capsule three times a day.

Take Alli with a meal that contains no more than 15 grams of fat to help limit stomach side effects. It is also recommended to take a daily multivitamin at bedtime to help offset the loss of any fat-soluble vitamins. Those with diabetes, thyroid disease or taking a blood thinner should consult with their doctor before using Alli. Side effects with Alli often hinder its use: Symptoms of liver injury include yellow skin or eyes, itching, brown urine and stomach pain.

Each weight loss treatment should be individualized based on the patient, but a recent study meta analysis published in the Journal of the American Medical Association JAMA looked at this question. In the study, researchers analyzed findings from 28 clinical trials with over 29, participants. Five approved drugs for obesity were evaluated: Qsymia , Victoza and Xenical , along with Belviq and Contrave. All active agents were associated with significant excess weight loss compared with placebo at 1 year.

However, in some cases a significant number of people dropped out because of side effects. In addition, data looking at long-term effectiveness is still needed. Qsymia phentermine and topiramate XR: Typically, people lost the most weight with Qsymia, roughly 19 pounds more, compared to those taking a placebo. Xenical orlistat or Belviq loracserin: You have lost more than 10 pounds 4. What to Expect at Your Office Visit.

You will be asked questions about your medical history and symptoms, including: How much weight have you lost? When did the weight loss begin?

Has the weight loss occurred quickly or slowly? Are you eating less? Are you eating different foods? Are you exercising more? Have you been sick? Do you have any dental problems or mouth sores?

Do you have more stress or anxiety than usual? Did you make yourself vomit? Do you have occasional uncontrollable hunger with palpitations , tremor, and sweating? Have you had constipation or diarrhea? Do you have increased thirst or are you drinking more?

Are you urinating more than usual? Have you lost any hair? What medicines are you taking? Do you feel sad or depressed? Are you pleased or concerned with the weight loss?

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