The use of medication/drugs to lose weight

The use of drugs to help weight loss only has value if it results in making a patient healthier as the cosmetic effect of 5-10% weight loss is negligible. Medications for obesity result in weight loss by helping people decrease their overall calorie intake. The programs work best when used regularly and in conjunction with daily exercise and a reduced calorie meal.

There are mainly two classes of drugs:

those that act on the gut and decrease the absorption of fat in the diet,
And those that act on the brain and either increase fullness or reduce the drive to eat.

Medications can be prescribed to those who have a BMI of > 30kg/m² or those who have a BMI > 27 kg/m² (Sibutramine) or a BMI of > 28kg/m² (Orlistat) and have one or more existing co-morbidities such as heart disease or diabetes. None of these medications are currently licensed for use in pregnant and lactating women.

After medication has been started patients will be weighed at regular intervals and if at 3 months they have been able to loose more than 5% of their weight, the medication will be continued. If at least 5% weight loss has not been achieved then the medication will be stopped and another drug can be tried or another treatment method can be attempted.

The two anti-obesity drugs currently available for prescription in the UK are:

Orlistat (Xenical)
The fat in the diet is broken down (digested) in the body into its simplest form so that it can be absorbed. The body does this with the help of enzymes called lipases. The excess fat or calories in the diet is thus absorbed by the body and stored as body fat. This results in weight gain. When orlistat is taken with meals (120mg with each meal), it attaches itself to the lipases and blocks their action. This effect stops some of the fat in the diet from being digested (roughly 30% of the fat in the diet). The undigested fat cannot be absorbed and is excreted in the stool and therefore often causes significant diarrhoea. Significant weight loss does however not occur while patients have diarrhoea, as 70% of the fat ingested is still absorbed. Weight loss will be optimal if a patient reduces the fat in their food to the point where they stop having diarrhoea. This way the total number of calories consumed and absorbed will be reduced which results in weight loss.

It is essential to follow a low fat, calorie restricted diet while taking the medication. Orlistat is also beneficial to help maintain weight loss.

To support you whilst taking orlistat there is a patient support programme, qualified staff will contact you on a regular basis to discuss your progress and advise you as necessary in addition you will receive information through the post containing useful tips on diet exercise etc. You will also receive a pedometer to encourage you to increase your activity levels to the recommended 10,000 steps a day and tape measure to use to reinforce your weight loss.
www.mapassist.co.uk

Sibutramine (Reductil)
Sibutramine works by acting on appetite control centres in the brain to decrease appetite and enhance fullness. As a result, a patient feels more satisfied with less food. If a patient chooses to act on these signals and stops eating sooner they will decrease the total calorie intake and this would result in weight loss.
Sibutramine is available as a capsule; the starting dose is 10 mg dose once daily in the morning. The capsule should be taken whole and swallowed with a glass of water. It doesn’t matter if you have eaten or not when you take this medicine. If you haven’t lost about 4 pounds (2kgs) of weight during the first four weeks of taking Sibutramine, your doctor may want to increase your dose of this medicine to 15mg per day provided no adverse effects. Some of the side-effects associated with sibutramine are constipation, nausea, a dry mouth, difficulty sleeping, feeling or being sick, a fast or fluttering heart beat, light-headedness, pins and needles, headaches, anxiety, sweating, diarrhoea, mood change, sexual problems, skin rash, problems with menstrual periods, problems with taste or blurred vision. A number of these effects improve with time Sibutramine is not suitable in people with history of heart disease, strokes, uncontrolled hypertension above 145/90 and those who take medication for depression. It is advised that all patients on sibutramine have their blood pressure checked every 2 weeks for the first 3 months and 3 monthly thereafter. Sibutramine may have to be discontinued if blood pressure increases 10mmHg above baseline it is therefore important that you have regular blood pressure checks with your Nurse or Doctor.
www.changeforlifeonline.com

Drugs available over the counter

Alli has recently become available to buy from the chemist without a prescription.
The drug is orlistat (Xenical) but is a lower dose than what is available as a prescription only medicine.
The dose is 60mg three times a day; Alli is not a magic slimming pill. It's a weight loss capsule designed to be used with a support programme to help boost your weight loss.
It works in exactly the same way as the prescription dose by stopping some of the fat you eat from being absorbed, so for every 2 lb (1 kg) you lose from eating healthily, adding Alli can help you lose 1 lb (1/2 kg) more.

Alli is the first pharmacy-only weight loss aid licensed throughout Europe.
http://www.alli.co.uk/index.html

Remember: It is important to follow a healthy, low calorie diet while taking any weight loss medication in conjunction with an increase in physical activity to achieve the desired weight reduction.

If you would like further information on the use of medications to lose weight or would like to book a FREE consultation with a specialist nurse or dietician then call Vita Clinics on 0800 849 4050.

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