Weight Loss Medicine: Is It Worth It?

Most people already know that, to lose weight healthily, the best way is to combine a balanced diet with physical activity. But there is no denying it: many people wish they could count on the help of a "magic formula" that made weight loss happen faster and without much suffering!

And it is generally thinking about this that some people end up resorting to weight loss medicines. But do they actually provide safe weight loss? What are the risks of relying on the help of this type of medicine? Anyway, is it worth betting on them?

Below you will find the main information on weight loss drugs and the opinion of an endocrinologist on the subject.

What are the medicines that provide weight loss?

When talking about weight loss drugs, sibutramine is probably the first name that comes to mind. For a period of time, its sale has been prohibited, but now it can be purchased again at pharmacies, provided it is prescribed by a doctor.

Fernando Moreno Sebastianes, an endocrinologist and metabologist with a PhD from USP-São Paulo, explains that besides sibutramine there is only orlistat (better known as Xenical) approved for weight loss in Brazil.

The endocrinologist points out that some medications, widely used in the past, such as femproporex, amfepramone and mazindol, were suspended from the market some years ago and are no longer sold in Brazil.

Still according to Sebastianes, there are also many herbal remedies that promise to help with weight loss, although, for the most part, they have not undergone adequate studies to confirm the supposed benefit.

In other countries, there are two more options for treating obesity: lorcaserin and also a combination in the same tablet of topiramate and phentermine. However, these drugs are not yet released for sale in Brazil ?, adds Fernando Sebastianes.

How do weight loss drugs work?

Fernando Sebastianes explains that sibutramine is a drug with action on the central nervous system, acting mainly in the control of satiety. "Most drugs act this way, although at different points from the complex pathways that regulate hunger and satiety," he says.

The endocrinologist adds that most drugs have minimal effect of "speeding up metabolism," which is not the primary mechanism by which they work.

Orlistat has a slightly different mode of action, where about 30% of ingested fats are eliminated in faeces. This drug does not increase satiety ("does not reduce appetite?)", Explains the professional.

Drugs That Have Weight Loss As A Side Effect

It is noteworthy that there are drugs that can have the side effect of weight loss. "However, they are not approved exclusively for weight loss, but rather for treating other conditions," says Sebastianes, who cites a few examples:

• Migraine sufferers with frequent and overweight attacks may benefit from treatment with topiramate as it helps in preventing migraine attacks and can aid in weight loss.

• Those who are very anxious or depressed and overweight can benefit, for example, from bupropion.

• Those with diabetes mellitus and weight loss difficulties may benefit from metformin, liraglutide, or even a new drug called dapaglifozine.

The endocrinologist points out that any prescription of any of these drugs for obesity-only treatment characterizes the off-label use of medication (practice of prescribing drugs registered for an indication not included in the product label), allowed by the CFM, but must be well explained to the patient by the doctor.

These are just a few options we have. But it is worth noting that it is essential to always consult an endocrinologist before starting the use of any medication for weight loss ?, adds Sebastianes.

Side Effects of Weight Loss Remedies

According to Sebastianes, most medications are relatively safe as long as prescribed after a good medical evaluation. "But like any drug, side effects can occur," he says. He cites a few examples below:

• Headache
• Altered bowel habit (constipation or diarrhea)
• Palpitations
• Blood pressure
• Insomnia
• Dry mouth
• Irritability
• Mood change
• Depression
• Anxiety
• Tingling
• Spots on the skin
• Memory change

The endocrinologist adds that, in very rare cases, even seizures are side effects that can occur with one or more of these drugs."That's why medical evaluation is important before using them," he says.

How Can You Buy Weight Loss Drugs?

Most weight loss drugs have their sale under control, meaning they are only sold on prescription. This is the case of sibutramine and orlistat.

Herbal medicines do not require a prescription. However, we know that they can also have side effects. For example, those with arrhythmias should avoid green tea as it can aggravate the condition. Therefore, I do not encourage the use of any of these drugs without first consulting a doctor ?, highlights the endocrinologist Sebastianes.

In which cases are weight loss drugs indicated?

Fernando Sebastianes explains, in general, in which cases weight loss drugs are indicated.

Obesity: This is a disease, as is diabetes mellitus, whose treatment is based on the elaboration of an eating plan, physical activity and, in some cases, medications and even bariatric surgery.

BMI (body mass index)> 30 kg / m2: The endocriologist explains that, usually, drugs are indicated in cases of patients with BMI (body mass index)> 30 kg / m2, with difficulty in weight loss, only with improvement in diet and exercise.

Obesity-associated diseases: The presence of obesity-associated diseases (diabetes, hypertension, sleep apnea, etc.) may lead to drug treatment in patients with BMIs even below 30.

Anyway, is it worth sticking to weight loss medicines?

Many people comment that they have difficulty losing weight, so they want to adhere to drugs that promise faster weight loss. But is this really the way?

Unless one fits one of the above cases (being obese, having a BMI greater than 30kg / m2, suffering from an obesity-associated disease), the recommendation is usually to follow a balanced diet and to engage in physical activity to lose weight. This is not counting on the help of medicines, but rather with the guidance of a nutritionist and preferably a physical educator.

Often the desire to lose weight is due solely to an aesthetic issue. That is, the person wants to lose a few pounds because they are not feeling well with their body. However, in these cases, medications are hardly recommended. The best way, no doubt, is to look for a nutritionist and move on to healthy lifestyle habits.

It is also noteworthy that weight loss medicines do not always offer lasting results, especially when the person does not understand that? parallel to the use of the drug? You need to change your eating habits to achieve good results.

There are not many reports of people taking a certain drug for this purpose for a while and soon after regaining weight or even gaining more pounds than they had lost during the regime.

Therefore, it is noteworthy, a person should never adhere to a weight loss medicine without consulting a doctor before. This should be an alternative only when presented by a professional.

"My advice to people who have a hard time losing weight and thinking about sticking to the drugs is to look for an endocrinologist who can better evaluate case by case," advises Sebastianes.

The endocrinologist adds that there are now even more accurate ways to analyze how much weight a person needs to lose weight. Through, for example, the bioimpedance test can measure the amount of fat, water and body musculature. Achieving a good weight means achieving a good body composition with adequate levels of fat and muscle. Thus, it is possible to perform a more personalized treatment to the needs of each patient and, according to the current medical history, medications may or may not be indicated ?, concludes Fernando Sebastianes.

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