Do Weight-Loss Drugs Work?

Only a few are proven, so don’t be fooled

Drugs Can’t Do It All

A healthy diet and regular exercise are key to losing weight and keeping it off!

A New Option

This summer’s big diet news was the appearance of Alli, the first FDA-approved over-the-counter weight-loss drug. Alli is a lowdose version of the prescription drug Xenical, with similar side effects (see below). It promises modest weight losses of 10 pounds over six months.

Considering Weight-Loss Surgery?

Lehigh Valley Hospital’s weight-loss surgery program was recently approved as a Level 1A program by the American College of Surgeons. It’s one of just two weight-loss surgery programs at this level of accreditation in Pennsylvania and fewer than 25 nationally. For information, visit lvh.org or call 610-402-CARE.

Whether you’re concerned about the health risks of being overweight or just want to look better in your clothes, you’ve probably considered taking a weight-loss drug. There are dozens available— from over-the-counter pills and herbal supplements to prescription medications. But do they work?

Most over-the-counter products aren’t worth buying, says weight-loss specialist Theresa Piotrowski, M.D., of Lehigh Valley Hospital and Health Network. However enticing the ads may be, nonprescription weight-loss aids like Hoodia and Dexatrim don’t have a track record of effectiveness because they aren’t regulated by the FDA. “If the ads sound too good to be true or feature patient testimonials, there’s a 99 percent chance it’s not effective,” Piotrowski says.

Especially worrisome, she says, are over-the-counter drugs with potentially dangerous side effects. These include the stimulant ephedra (derived from a Chinese herb). Ephedra was pulled from the market in 2004 after being linked to several cardiac-related deaths and cases of permanent disability. But some ephedra products—and supplements containing ephedra-like compounds, such as bitter orange—are still available on the Internet.

“The only really safe and effective weight-loss products are those prescribed by a physician,” Piotrowski says. They come in two classes:

Stimulants such as sibutramine (Meridia) and phentermine (various brand names). These drugs stimulate the appetite-regulating part of the brain, producing a “full” sensation. Side effects include elevated blood pressure, so stimulants aren’t recommended long-term or for people with heart disease.

Digestive prohibitors such as orlistat (Xenical). These drugs prevent the body from absorbing fat from foods and can be used longer-term. Side effects include abdominal discomfort and diarrhea.

Even reputable drugs like these should only be taken if you’re seriously overweight, says Michael Columbus, a registered pharmacist with the hospital. You’re in that category if you have a body-mass index (BMI) of 30 or more (27 or more if you have obesity-related risk factors like diabetes). “A lot of people just want to lose enough to look good in a swimsuit,” he says. “These drugs aren’t designed for that.”

Typically, using diet drugs will result in a 10-15 percent drop in body weight over a year. They work best when combined with a reduced-calorie diet, regular exercise and other types of behavior modification.

“Up to 85 percent of the time, people don’t eat because they’re hungry,” Piotrowski says. “It’s just emotional eating to deal with boredom or depression. These drugs are tools, and they will only work long-term if you’re also willing to change your lifestyle and behavior.”

Want to Know More about over-the-counter, weight-loss supplements how to calculate BMI or Lehigh Valley Hospital’s weight management program? Call 610-402-CARE or click above.

Published from Healthy You Magazine, September-October 2007

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