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Tipping the Scale in Your Favor: Losing Weight Part 2
Continuing with our column from last week, let’s discuss when medication use for weight loss is appropriate and what your options are. Taking what we learned last week about Body Mass Index (BMI), be sure to calculate your BMI using the formulas that we have posted on our Facebook page. A BMI below 18.5 is considered underweight, 18.5 to 24.9 is considered normal weight, 25 is overweight, and 30 is considered obese. Those with a BMI of 40 or higher are considered extremely obese, and gastric surgery may be an option at this point. Medications for weight loss can be considered in people with a BMI of 30, or those with a BMI of 27 with at least one obesity related condition (diabetes, high blood pressure, high cholesterol, etc.). If you fall into one of those two categories, you may be a candidate for medication use to assist in your weight loss.
It’s important to note that medications alone are not recommended. You should follow an appropriate diet and exercise regimen along with medication use. Also, no medication is without risks. It is always important to discuss any medication or over the counter item you take with your doctor or pharmacist to make sure it is appropriate for you and doesn’t interact with your other medications. Let’s discuss the 3 main medications used for weight loss and some of the risks:
Alli (OTC)/Xenical (Rx)- Also known as Orlistat, these medications stop the enzymes in your stomach and pancreas that break down fats allowing you to absorb them, essentially allowing them to pass right through your body without being processed. These fats passing through your body lead to its main side effects: loose stools, gas, stomach cramps, and incontinence when eating meals containing excessive fat. It may also decrease the absorption of certain vitamins found in fats, so it is also important for you to take a multivitamin while on this medication. In controlled trials of Xenical, nearly three-fourths of patients achieved and maintained at least a 5% weight loss, which was about 7.5 pounds on average.
Phentermine and Qsymia (Phentermine/Topiramate)- By far the most commonly used weight loss medication, Phentermine is available alone or now in combination with topirmate. Phentermine is approved to be used short term (less than 3 months). Phentermine suppresses appetite by increasing norepinephrine and dopamine in your brain. These chemicals help promote a feeling of fullness while increasing the amount of calories your body uses. Topiramate is a seizure medication that is believed to promote weight loss by decreasing your appetite. You should not stop the medication abruptly as it could result in a possible seizure, and Phentermine should be avoided in people with heart conditions since its stimulant effect can worsen certain heart issues. When taken together in the extended release form called Qsymia, controlled trials showed at least a 10% weight loss, which was about 25-30 pounds in the average trial participant.
Belviq (Lorcaserin)- Belviq is a new medication recently approved for weight loss. It works on serotonin in your brain to make you feel full and decrease your urges to eat. The average weight loss among trail participants was at least 13 pounds, however less than half of those in the study were able to lose at least 5% of their body weight. There may be heart risks involved with this medication and it is undergoing further research to determine these risks. If you take depression medication Belviq should also be avoided as this can increase your risk for serotonin syndrome.
As we near the end of the first month of 2015, hopefully you are on a great start to reaching your weight loss goals for this year! As always, if you have questions or would like more information, feel free to contact us at Edmonson Drug.
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Your Family Pharmacist,
Samuel Warnell, Pharm. D.