For many people, any weight loss drug seems to be a fraud. It is too good to be true, as plausible as an effective enlargement cream or alchemy kit at home.
However, weight loss drugs - such as xenical and meridia - exist. They also work. And pharmaceutical companies around the world are working even more. They are not for cosmetic use, so light overweight people care about the swimsuit season should not sign up. Its effects are also modest, usually resulting in a loss of no more than 10% of a person's body weight. Unlike some hopes, they do not replace diet and exercise; Weight loss drugs only work in conjunction with changes in lifestyle.Plant Based For Weight Loss - Weight Loss With Medication
But this simple way of thinking is increasingly under fire from experts. It's not the whole story.
"Lifestyle is a big factor in why people earn weight," Wyatt tells WebMD. "But there is a reason definitely a genetics and physiological as well. Because of differences in physiology, some people will have difficulty losing and maintaining weight than others."
George A. Bray, MD, Professor of Medicine at the State University of Louisiana, agrees that the traditional vision of obesity - as essentially a moral failure - is wrong.
"People are massively overweight because they have no [hormone]" weak "leptin? Question Broy." No, and in fact some kind of neurochemical desertion probably underlies more obesity. "
"It's cruel and harmful to categorize Americans overweight and obese as" lazy "or" weak "or" weak, "he says," and conclude that all they need to do is just move away from the table. "/ p>. obesity is a killer. So is it enough for a doctor to tell a chronically obese person to lose weight and leave it on it? Wyatt and Bray both point out that we routinely use medications for other conditions that can be controlled by changes in diet and exercise. For example, diabetes and high blood pressure can be helped substantially by changes in your lifestyle. But doctors still prescribe medication for both conditions. It would be highly unlikely that your doctor refused to give you diabetes medication simply because you could control the disease with more exercise and a more rigorous diet, but not. Everyone knows that permanent lifestyle changes are very difficult to do, says Wyatt. We do not punish diabetics or people with high blood pressure, retaining medicine, "says Wyatt." So why could we punish people with obesity? If you have a medication that will facilitate for people to lose weight, why not use it? " Wyatt and Bray stress that anyone who needs to lose weight should try changes in the lifestyle first. But for those who do not seem to do it with exercise and diet alone, weight loss drugs could help. at the most basic level, your weight is determined by the balance between the amount of energy you receive and the amount you spend - the food you eat and the calories you burn. If you burn more calories than eating, you will lose weight; If you eat more than burning, you will win. 
leptin is just one of the many different mechanisms that regulate weight. Any kind of abnormality on these systems can make it harder for a person to lose weight and keep it off.
Wyatt notes that from an evolutionary point of view there is an advantage to build excess fat. For most human history, people were subject to periodic drives. Those who have maintained excess fat may have been more likely to survive a hunger than those who did not. The problem is that this evolutionary adaptation - which may have saved the life of our former ancestors during difficult times - is hurting us now.
This does not mean that having a predisposition to be obese means that you will be obese. The fact that Americans are heavier now than they were a generation that proves that genes are not all history. They are the changes in our environment that made the biggest difference, says Wyatt.
A genetic predisposition to obesity will only enter game when the environment is right. Get obese was unlikely when our ancestors were eking out of Savannah. But when we live in a society of sedentary jobs, sedentary entertainment, and cheap, abundant and colossal meals available at numerous places near you, which genetic predisposition can make a big difference.
The two drugs currently approved by the FDA to treat long-term obesity are xenical and meridia. They work in different ways. Meridia affects certain chemicals in the brain and makes people feel full without eating so much.
xenical works very differently. It is not absorbed by the system. Instead, it binds to fat cells in the gastrointestinal tract and prevents them from being absorbed, as well as the ingredient olastra used in some foods with low fat. The usual dose can reduce the amount of fat that is absorbed at about 30%.
The FDA approved the use of weight loss drugs in people with a BMI of 30 or as low as 27 in some people who have diseases related to obesity, such as diabetes or heart disease. BMI is a measure based on height and weight. According to national health institutes, a normal BMI ranges from 18.5 to 24.9, 25-29.9 is overweight, and anything above is obese.
Other drugs may be useful in some cases. For example, Wyatt had a good success with Generic Phentermine, which suppresses appetite as meridia. However, the FDA did not approve Phentermine for long-term use. This is not because it was found unsafe - it is only that no one financed a study of its long-term effectiveness. And because studies are expensive, no pharmaceutical company will want to spend money by testing a generic drug that does not exclusively own.
As much as people can dream of the pill that allows them to lose weight without diet or exercise - the claim of countless hucksters and infomercials - none of these drugs works that way. Studies have shown that these drugs really work only in conjunction with changes in lifestyle.
The amount of weight that people lose in weight loss drugs varies: some people have great success and others do not. On average, people do not lose more than 10% of basal weight - this is a weight loss of 20 pounds for a person who is 200 pounds. Generally, people lose the greatest weight in the first three to six months in drugs and then plateau.
A 10% weight loss may not seem much. But experts emphasize this modest weight loss - up to 5% - can make a big difference at their risk of developing diseases. Many studies have shown the effectiveness of weight loss drugs in reducing health risks. For example, a recently published Xenical study discovered that it could reduce the risk of type 2 diabetes at 37%.
Studies have shown that if a person in one of these medicines does not lose 4 pounds in the first four weeks, it can probably be interrupted; It is unlikely that the drug is going to work. If someone succeeds with a drug, it should probably be carried in the long run. Drugs of weight loss are not a quick solution. Instead, they are more like medication for high blood pressure or diabetes, says Wyatt. Obesity is really a chronic disease.
"The physiology that causes someone to become obese does not go away," says Wyatt. Stopping drugs usually means that the weight will return. And losing weight does not matter as much as maintaining it. If you lost 20 pounds, but it has recovered everything within the year, will not help all this.
Long-term treatment does not mean that people will necessarily lead the same weight loss drug every day for the rest of their lives. Instead, it is possible that someone can switch between Xenty, Meridia or other drugs.It may also be possible that people make breaks in treatment. "Weight is not like blood pressure," says Wyatt. "If you stop taking your blood pressure medication, it climbs within a few days. Weight recovery takes longer." So far, studies have not shown advantages to use weight loss drugs periodically. But as researchers learn more about how best to use these medicines, it may be a possible form of treatment in the future, says Wyatt.
One of the biggest concerns for anyone who considers a weight loss drug is their safety. Fear is understandable. The very annulled combination of weight loss drugs called Fen-Phen - Phentermine and another drug, phenfluamine - was found to cause hazardous damage to heart valves in some people. As a result, both phenfluamine and redux, another similar weight loss medicine, were drawn from the shelves in 1997. On its own, Phentermine is considered safe and still used.
Being cautious about any weight loss drug is a good policy. None of these drugs exists for a long time and therefore we can not be sure of their long-term effects.
That said, security records for xenic and meridia are good and the risk of side effects is low. Meridia can cause headaches, dry mouth and an increase in wrist and blood pressure.
Xenical can cause gastrointestinal side effects such as stains, an urgent need to go to the bathroom and an increase in the number of intestinal movements. These side effects tend to disappear over time and are aggravated by eating a high-fat meal. Xenical can also reduce the amount of vitamins that your body absorbs, then you may need to make a multivitamine to compensate.
But the researchers did not find side effects such as Fen-Phen.
"Any medication carries risk," says Wyatt. "But at this point, I think [Xenical and Meridia] are as safe as any other medication we have been routinely prescribed." In fact, because of the Fen-Phen debacle, it thinks that weight loss drugs can be maintained at an even greater level of safety than other types of medications.
Wyatt also notes that the small risks of these medicines should be compared to real risks of obesity, such as high blood pressure, diabetes, stroke and heart disease. For people who are very obese, another way to frame the choice can be to compare the low risks of weight loss drugs with the highest risks of bariatric surgery, often called stomach stapling.
A number of medications are now in several stages of development with more specific targets. Many are designed to affect some of the hormones - such as leptin - which play a role in appetite and weight regulation.
Wyatt has modest hopes for new weight loss drugs in the immediate future. "I do not see any of the new drugs like obvious blockbusters," she says. It points out that we may need combinations of new drugs to have a substantial effect. The problem is that there are so many different mechanisms that affect our weight that just targeting one may not be enough.
Bray says we'll have to wait. "Until we get data from the long-term trials of these drugs," he says to WebMD, "We simply will not know how safe or effective they are."
"We are really only in the early stages of using weight loss drugs," says Wyatt. "It's like when we started using drugs for high blood pressure, and they did not work well and caused many side effects. But we're going to have better drugs, and how we do, doctors will use them more and more."
So stopped some unforeseen innovative, weight loss drugs will not be "the response" to obesity soon. But along with diet and exercise, they can be an important part of the solution.
