Health x Wellness

Weight Loss Medications – Worth the Risk?

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Chances are you know someone who is unhappy about their weight and is trying to shed a few kilograms. While the cornerstone of weight loss is still diet control, exercise and behavioral change, there may be some who just failed miserably despite having done everything. 

Short of surgeries such as gastric bypass or sleeve gastrectomy, weight loss medications may also be prescribed by doctors specifically for some patients who may benefit from them. After all, surgeries always carry risks. 

Weight loss medications are not a panacea or a guarantee for weight loss either. They are meant to be used concurrently with diet control, exercise and behavioral change. The benefit of these medications is that when they are used in conjunction with diet control and exercise, the combination results in weight loss more quickly than with just diet and exercise alone. This has a positive mental effect on the patients and encourages them to stick to these changes. Eventually, these medications will be weaned off. Weight loss medications are prescription medicines with side effects and risks. They require a doctor’s prescription.  

Who may take weight loss medications? 

Weight loss medications are certainly not for everyone. They are indicated for use in people who are obese (body mass index [BMI] ≥ 30). These medications might also be helpful for people who are overweight (BMI ≥ 27 ) and who also have other health conditions such as diabetes, high cholesterol, heart disease, high blood pressure, or obstructive sleep apnea. 

Do they work? How well do they work? 

Prescription-only weight loss medications do work. They have been shown to produce significant weight loss when compared with placebo. Studies also show that the addition of weight-loss medications to lifestyle changes results in greater weight loss than lifestyle changes alone. 

How well do they work? That depends. Is the patient modifying his or her lifestyle, keeping up a healthy and sustained diet, and keeping to a sustained exercise regime? Weight loss medications also affect patients differently – some may work better for one person but not others. This is largely due to your genetics. Your doctor will be able to work closely with you to determine the best medication and regime for you. The main aim of a healthy weight loss should not be for purely aesthetic reasons, but to help patients achieve a healthy BMI and the health effects gained from it. 

How do they work? 

There are a variety of weight loss medications, each with its distinct mechanism of action.  

Some medications work by decreasing appetite, some work by increasing feelings of fullness, and some do both. Some work by blocking absorption of specific macronutrients such as fat.  

Phentermine is a typical appetite suppressant and can also increase your metabolism. Liraglutide is a type 2 diabetes drug that mimics a satiety hormone to signal to your brain that you are already full. Orlistat is a medication that blocks the patient’s body from absorbing a portion of the ingested fats. Some combination medicines such as a combination of Naltrexone and Bupropion in an extended release formulation block certain signaling pathways in your body and this can result in feelings of fullness and increased metabolism. 

Each medication has its own list of side effects, but the more common side effects we see include nausea, constipation, diarrhea, headaches, lethargy, dry mouth or insomnia – to name a few. Your doctor is in the best position to choose the medications for you and if needed, to change you to a different one should there be significant side effects. 

How should weight loss medications be used? 

Patients who are prescribed these drugs are monitored closely for weight loss response and side effects. If a patient does not lose at least 5% of his or her starting weight after 3 months of the full dose of the medication, that medication should be stopped and other medications or methods should be considered.  

Weight loss will continue only as long as the drugs are taken. Weight loss can also plateau after a few months of using these medications. It is therefore paramount that patients develop healthy habits such as healthier diet options and keeping up an exercise routine while taking the medications so as to achieve the most amount of weight loss in the initial phase.  

Managing expectations 

The amount of weight loss could be less than what many people expect – about 5 to 10% of the starting weight on average.  

However, people vary in their response to weight loss medications. Like any other medications taken for chronic conditions such as high blood pressure, weight loss medications do not work after they are stopped, so a gradual weight gain is likely after discontinuing the drug if the patient makes no behavioral changes. Weight-loss drugs are not an easy answer to weight loss, but they can be a tool to help you adopt the lifestyle changes you need to lose weight and improve your health. 

Speak to your doctor to find out if you are suitable for weight loss medications and to discuss what medication as well.  

Article attributed to Dr. Chester Lan.

Dr Chester Lan is the resident doctor at DTAP Clinic Holland V, he believes in holistic care individualised to each patient. This patient-centric approach, along with his friendly persona, has earned him the trust of many of his patients. He sees patients from all age groups over a variety of sub-specialties and understands that building trust and rapport, along with good communication, is the key to a successful patient-doctor relationship.



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