Weight-loss medications of any type are only appropriate for people with a BMI of 30 or above, or a BMI of 27 or above accompanied by weight-related medical conditions such as diabetes mellitus or hypertension. Amphetamine drugs were formerly prescribed to combat obesity, but their well-documented side effects, including insomnia, anxiety, and tolerance (the need to take higher and higher doses to continue to produce the same effect), made them less popular by the late 1970s.
A renewed scientific and commercial interest in weight-loss medications was prompted by the approval by the Food and Drug Administration (FDA) of the appetite suppressant dexfenfluramine (sold under the brand name Redux) in 1996. Dexfenfluramine was the first weight-loss medication approved in the United States in over 20 years and the first ever approved for maintaining weight loss. Although never approved for long-term use by the FDA, a combination of two drugs, phentermine and fenfluramine, or phentermine and dexflenfluramine, popularly known as fen-phen, was used by millions of Americans to promote weight loss. Fenfluramine and dexfenfluramine were eventually associated with valvular heart disease, and the manufacturer withdrew these medications from the marketplace in 1997.
The FDA has approved two medications, sibutramine and orlistat, for long-term use in the treatment of obesity. Sibutramine (sold under the brand name Meridia) increases fullness, making the required dietary changes for weight loss and the maintenance of weight loss easier to accomplish. Unlike dexfenfluramine and fenfluramine, sibutramine does not appear to be associated with valvular heart disease, although a small number of patients may develop significant increases in blood pressure. Orlistat (sold under the brand name Xenical) works by blocking the absorption of fat. Scientists are also investigating the hormone leptin, which plays a role in obesity in mice, as a possible treatment for obesity in humans.
Over a six-month period, weight-loss medications may result in a 10-percent body weight reduction. Weight loss slows or stops after six months, and discontinuing medication usually causes weight regain. The continued use of medications keeps most of the lost weight from returning for two years. Many experts recommend that medications for weight control be used continuously, like medications for diabetes mellitus and hypertension. Unfortunately, few studies have examined the consequences of long-term use of weight-control medications.
A renewed scientific and commercial interest in weight-loss medications was prompted by the approval by the Food and Drug Administration (FDA) of the appetite suppressant dexfenfluramine (sold under the brand name Redux) in 1996. Dexfenfluramine was the first weight-loss medication approved in the United States in over 20 years and the first ever approved for maintaining weight loss. Although never approved for long-term use by the FDA, a combination of two drugs, phentermine and fenfluramine, or phentermine and dexflenfluramine, popularly known as fen-phen, was used by millions of Americans to promote weight loss. Fenfluramine and dexfenfluramine were eventually associated with valvular heart disease, and the manufacturer withdrew these medications from the marketplace in 1997.
The FDA has approved two medications, sibutramine and orlistat, for long-term use in the treatment of obesity. Sibutramine (sold under the brand name Meridia) increases fullness, making the required dietary changes for weight loss and the maintenance of weight loss easier to accomplish. Unlike dexfenfluramine and fenfluramine, sibutramine does not appear to be associated with valvular heart disease, although a small number of patients may develop significant increases in blood pressure. Orlistat (sold under the brand name Xenical) works by blocking the absorption of fat. Scientists are also investigating the hormone leptin, which plays a role in obesity in mice, as a possible treatment for obesity in humans.
Over a six-month period, weight-loss medications may result in a 10-percent body weight reduction. Weight loss slows or stops after six months, and discontinuing medication usually causes weight regain. The continued use of medications keeps most of the lost weight from returning for two years. Many experts recommend that medications for weight control be used continuously, like medications for diabetes mellitus and hypertension. Unfortunately, few studies have examined the consequences of long-term use of weight-control medications.
