Posted on April 27, 2018 at 12:01 PM by Iowa Weight Loss Specialists
Iowa Weight Loss Specialists has provided me an opportunity to work with both bariatric surgery patients and non-surgery patients. A large part of my practice is medical weight loss, using behavior modifications and medications to improve patients’ health and overall quality of life.
Weight loss medications can help increase weight loss to 5-10% of a person’s total body weight and in some patients more. 5% may not seem like much but can have a big impact on a person’s overall health. Just 5% of weight loss can decrease the chances of a person developing diabetes by greater than 50% (2)! At Iowa Weight Loss Specialists our current average is 10% at one year. Medications can also be a helpful tool after weight loss surgery to help with additional weight loss or maintenance.
Weight loss medications are tools that can help by decreasing appetite, decreasing food cravings, increasing satiety (fullness), or decreasing absorption. Medications are often overlooked as helpful tools to help patients with obesity. Also, it’s important to point out that many patients have never been on weight loss medications.
A few of the common questions I get in my clinic about medications are listed below:
Q: “Are weight loss medications safe”?
A: When prescribed by an experienced practitioner the medications are safe, although not all medications are appropriate for everyone. All anti-obesity medications must show at least a 5% reduction in weight and pass a safety profile to be approved by the FDA. The FDA also needs to see the medication show improvements in BP, blood sugars, and lipids (1). Many patients have tried over the counter supplements that have not been tested or verified by the FDA and have no data supporting effectiveness.
Q: “My PCP says they don’t prescribe weight loss medication”.
A: Unfortunately, not everyone sees obesity as a disease that needs to be treated similarly to other disease states such as diabetes or HTN. The bonus is once obesity is treated and addressed other health conditions can improve. Many family practitioners are not comfortable with prescribing weight loss medications and that is why it is important to have experienced weight loss providers with a comprehensive team comprised of dietitians, mental health clinicians, exercise specialist, and bariatric surgeons to address the multifactorial disease of obesity.
Q: “What weight loss medications are available and how do they work”?
Belviq-is a 5-HT2c agonist that decreases food consumptions by increasing satiety (fullness) (1).
Contrave- combination medication of bupropion and naltrexone. Contrave can help with decreasing appetite and works in the reward center of the brain to help control food cravings. (4). Bupropion stimulates hypothalamic POMC and reduces food intake and increases energy expenditure (1).
Orlistat (Xenical)-reduces the absorption of fat in the gut. (1).
Phentermine- is the most prescribed anti-obesity medication. It is a sympathomimetic amine and suppresses appetite and may have other metabolic effects. It also can help with food cravings (1).
Qysmia- combination medication of Topiramate and Phentermine. Qysmia can help decrease appetite and food cravings. It may also change the taste of some foods making it easier to comply with dietary changes (1).
Saxenda-increases glucagon-like-peptide (GLP-1) that helps regulate appetite and decrease overall calorie consumption (1)(3).