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Weight Loss Prescription DrugsWeight loss medications have a long history. Among the first pharmaceuticals to be used for weight loss were thyroid hormone and digoxin, with disappointing results. Most currently available weight loss drugs are FDA approved for short term use up to 3 months. Sibutramine (Meridia) and orlistat (Xenical) are the only prescription weight loss medications approved for longer term use in patients who are significantly obese. However, their safety and effectiveness have not been established for use beyond 2 years. Weight loss medications promote an average loss of 5 to 20 pounds. Some persons using medication lose more than 10 percent of their initial body weight. Maximum weight loss usually occurs within 6 months of starting medication treatment. Weight then tends to level off or increase gradually during the remainder of treatment. Prescription weight loss pills should be used only by patients who are at increased medical risk because of their weight. Weight loss drugs are approved only for those with a body mass index (BMI) of 30 and above, or 27 and above if they have obesity-related conditions, such as high blood pressure, dyslipidemia (abnormal amounts of fat in the blood), or type 2 diabetes. A BMI of 18.5 to 24.9 is considered healthy. Lipase Inhibitors Orlistat (Xenical) acts in a quite different way from popular appetite suppressants. It inhibits the absorption of fat from the intestine. Instead of fat being absorbed into the body, fat is excreted in the stool. Since fat is excreted rather than absorbed, caloric and fat intake is reduced. Xenical (orlistat) blocks absorption of around 30% of ingested dietary fat. People taking this medication may expect to reduce body weight by an average of 10%. There is evidence that treatment with Xenical reduces the risk of diabetes, hyperlipidemia and hypertension. Side effects are confined to the gastrointestinal tract, are minor and short term and are controlled by diet. Appetite suppressants (Anorectics) Most available weight loss drugs approved by the Food and Drug Administration are appetite suppressant medications. Appetite suppressants promote weight loss by decreasing appetite or increasing the feeling of being full. These weight loss medications make you feel less hungry by increasing one or more brain chemicals that affect mood and appetite. Phentermine and sibutramine (Meridia) are the most widely prescribed appetite suppressants in the U.S. Appetite suppressants are usually prescribed for the short term treatment of obesity. Their appetite reducing effect tends to decrease after a few weeks, and so these drugs are useful only during the first few weeks of treatment and can help you to lose weight while you are making changes in diet and lifestyle. Noradrenergic Agents/Amphetamines Medications similar to amphetamines (phentermine, diethylpropion, and phendimetrazine) are central nervous system stimulants and work by causing a release of norepinephrine. These medicines have potential for tolerance and dependance. Phentermine (Adipex-P, Fastin, Ionamin, Zantryl) was approved by the FDA in 1959 for short-term treatment of obesity. Diethylpropion (Tenuate, Tenuate Dospan) has chemical structure similar to antidepressant bupropion. Like phentermine, diethylpropion is approved only for short-term treatment of obesity. Benzphetamine (Didrex) is less commonly prescribed anti-obesity medication. Noradrenergic/Serotonergic Agent Sirbutamine (Meridia), the only drug in this class, was approved by the FDA in 1997. Sibutramine enhances satiety by increasing the activity of brain chemicals called norepinephrine and serotonin. It has been approved by the FDA for weight loss and the maintenance of weight loss when combined with a reduced-calorie diet. Treatment with sibutramine may also improve lipid balance in people with high blood cholesterol levels and improve glycaemic control in people with type 2 diabetes. Non-Controlled Weight loss prescription drugs
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