If you are an American, you can identify. In 2019, almost everybody has at least 10 pounds to lose.
Most weight loss aspirations rev up concurrent with the beginning of a new year after the holiday gorge-fest or during summer when we choose voluntarily to shed our clothes and plunge into bodies of water with complete strangers.
Our vanity notwithstanding, corpulence amongst the U.S. citizenry has become a serious problem. The CDC estimates that obesity, defined as having a Body Mass Index of 30 or more, affects more than 93 million people in America.
We are all aware of the remedy. Eat less, move more. That still doesn’t make it easy to do.
Trust me, as a pharmacist I would love to dispense a magic pill that would transform Chris Christy’s physique into Chris Hemsworth’s overnight, but I haven’t seen a commercial for this yet.
Fortunately there are a few prescription options that exist to help those individuals with health problems related to their obesity.
Orlistat is available both by prescription and over the counter (in a lower dose as Alli). Orlistat works to reduce the body’s absorption of fat from food. The idea is that the captured fat is to be eliminated in the stool at the user’s discretion, but oily leakage sometimes occurs along with gas and diarrhea.
Phentermine is a stimulant designed to curb appetite. It should only be used in people with no history of cardiovascular disease, glaucoma, high blood pressure or overactive thyroid. Phentermine can cause dry mouth, constipation, insomnia, rapid heartbeat and headache and should really be used for no more than 12 weeks.
The drug Qsymia combines phentermine and an anti-seizure/migraine medication topiramate in a medication that works to decrease appetite. Side effects include those listed for phentermine in addition to tingling of the hands and feet.
Contrave is a popular weight loss option that pairs the anti-depressant bupropion with naltrexone, a drug used in alcohol and opioid dependence. Patients start slow with this medication and titrate up to the final dose over a period of weeks. The main reason for the titration is due to some nausea/stomach upset that can accompany Contrave therapy.
Patients already taking bupropion, those who are on chronic pain medication or those with a history of seizures should not take Contrave.
Finally, Saxenda is a once daily injection of a drug that is used to treat Type 2 Diabetes at a lower dose. You may feel full sooner and have less of an appetite while on Saxenda but nausea, stomach upset and injection site irritation may occur as well.
Many otherwise healthy people who are overweight or obese will be advised to pursue lifestyle changes including diet modification, exercise, getting better sleep, etc. before weight loss medications are considered.
Lifestyle changes are still vital to weight loss success in those taking medication. Aim to get 30 minutes of daily exercise and eliminate intake of fast food, soda, candy and sweets.
Small changes can make a big difference and when combined with an appropriate weight loss medication if indicated can influence overall health in a positive way.