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The New Weight-Loss Strategy: Just Don’t Gain Weight
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Are the New Weight-Loss Pills the Solution?
After a 13-year dry spell, the Federal Food and Drug Administration (FDA) has approved two new weight-loss pills in less than a month. Are either of these new pills a magic bullet for dieters—or even a helpful weapon to add to their fat-fighting arsenal?
The latest FDA-approved pill is called Qsymia, a mix of the appetite-suppressing phentermine (not to be confused with Fenfluramine, a now-illegal ingredient in the infamous weight-loss drug known as fen-phen) and topiramate, an anticonvulsant. While Qsymia was officially approved on Tuesday, this drug combination has been prescribed off-label for years, says Stephen Gullo, Ph.D., president of the Institute for Health and Weight Sciences in New York City. Still, Qsymia, which was formerly known as Qnexa, is meant for a very specific type of patient and could have serious side effects. (Read our take on the first drug, Belviq, here.)
How does Qsymia work?
Phentermine is a well-known appetite suppressant that’s used for short-term weight loss. Topiramate (an anti-seizure medication) makes people feel fuller after eating. Doses are determined by a person’s Body Mass Index (BMI) and change over the course of treatment.
In two year-long studies with approximately 3,700 total obese and overweight participants, patients had an average weight loss of 6.7 to 8.9 percent over placebo groups. In addition, approximately 62 to 69 percent of patients lost at least five percent of their body weight, compared with about 20 percent of patients treated with placebo.
Qsymia, like its recent predecessor Belviq, requires a lifelong commitment. “People in this weight category have a chronic problem and therefore, they need a chronic solution,” says Dr. Gullo. In other words, the pills may help people lose weight but there are no promises the weight loss will stick once someone goes off the drugs.
Who should take Qsymia?
Qysmia is meant for obese people (BMI of 30 or greater), or overweight people (BMI of 27 or greater) with at least one weight-related health problem, like high blood pressure, type 2 diabetes, or high cholesterol. Calculate your BMI here. (Learn more about how your BMI can affect your health.)
People with hyperthyroidism or heart problems are advised against taking Qsymia because it can cause an increase in heart rate. Pregnant women are also steered away from the drug because of the risk of birth defects, including cleft palate. Women who choose to take the medication must first take a pregnancy test. They’re also expected to use contraception and to take monthly pregnancy tests just to be safe.
When will Qsymia be available?
Vivus, the makers of Qsymia, say the drug will be available before the end of 2012. However, it will only be available by mail through specially certified pharmacies.
Even once it’s on the market, more studies of Qsymia will be conducted to determine its long-term risks, particularly its potential effects on heart health. “I would wait a year or two to see if there were any reported significant effects,” says Dr. Gullo.
Which diet pill is the best, Qsymia or Belviq?
Experts are split on this one. Dr. Gullo is partial to Qsymia (over Belviq) because its ingredients have been used together (off-label) for weight loss for many years. Other experts are concerned about Qsymia’s possible risks, especially heart problems and birth defects. But Belviq has risks too, including a potential for dependence.
Dr. Gullo recommends that people who take either pill see their doctor often. He also emphasizes that taking these pills is not an excuse to eat poorly. People prescribed these medications should follow a weight-loss focused diet (about 1200 calories a day) and exercise regularly (about 30 minutes, 3 to 4 times a week).
Unfortunately, for those who hoped the Fat-Melting Fairy had arrived in the form of these new weight-loss pills, Dr. Gullo brings us back to reality. “I don’t think the cure for obesity will be magically found in either of these drugs,” he says.
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photo: Vivus, Inc.
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FDA Approves New Weight-Loss Pill Lorcacerin
Wish you could tell your growling belly to shut up? Now there’s a drug for that–and it couldn’t have come at a better time.
As U.S. obesity rates near 35 percent of the adult population, the Federal Food and Drug Administration (FDA) has approved a new prescription weight-loss pill called lorcacerin, and marketed under the name Belviq. The drug safely turns off the natural signals your body sends to your brain to remind you to eat enough food to maintain your current weight. Sounds swell, right? Here are the questions you should be asking before asking your doc for a prescription:
Does it really work? And how much weight will I lose? How quickly will the weight come off?
Whoa, whoa, whoa. First, the drug is intended to be combined with a reduced-calorie diet and exercise, so it won’t just whip you into shape unless you make some changes. While the drug itself will curb hunger, it won’t, for instance, keep an emotional eater from downing a tub of ice cream like it’s her job, says Holly Herrington, registered dietician at the Center for Lifestyle Medicine at Northwestern Memorial Hospital in Chicago.
“Drugs like this are tools to help in weight loss. They are never intended to be the end all be all,” says Herrington. “The one thing we have seen over and over again in studies that causes weight loss is increasing exercise and choosing healthier foods.”
In multiple studies totaling nearly 8,000 people who took Belviq, participants lost an average of between 3 and 3.7 percent of their body weight over the course of a year. Better yet, about 47 percent of non-diabetics who took Belviq lost upwards of 5 percent of their weight.
I just have a few stubborn pounds to lose. Can I take lorcacerin?
The drug is only recommended for those who are obese (i.e., your body mass index is pushing 30 or greater), or overweight (i.e., you have a BMI of 27 or greater) and suffering from at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol. Calculate your BMI here.
A high BMI can increase your risk of heart disease, type 2 diabetes, breast cancer, headache, and sleep apnea. “We’ve seen that even a small decrease in weight can improve these conditions,” says Herrington. Learn more about how your BMI can affect your health.
If you have an increased risk for heart disease, or you’re planning on popping out a kid in the near future, you’d do best to lay off–even if you have a high BMI.
Are results guaranteed?
If you don’t lose weight in the first three months, you might want to call it quits, as continued use is unlikely to cause weight loss, according to the FDA.
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Is it really safe?
Potential side effects of Belviq include depression, migraines, and memory lapses–but no anal leakage, a much scoffed-about side effect of the only other FDA-approved prescription drug for long-term weight loss: Orlistat.
While the uncomfortable side effects of orlistat (sold as Xenical) make it seldom prescribed, it is available in small doses as the OTC drug Alli, which doesn’t block hunger, but prevents the body from absorbing dietary fat, Herrington says. Unfortunately, fat that’s eaten but not absorbed has to come out some way, making the drug infamous for causing diarrhea. The risks of Belviq are believed to be far gentler.
photo: iStockphoto/Thinkstock
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