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    A Role for Weight Loss Drugs

    Weight loss drugs Weight loss drugs work, too, the studies show. But they have a much more modest effect than surgery -- a weight loss of about 10 pounds after one year of treatment. And the long-term health effects of these drugs is unknown, the studies show.

    "The medicines are useful, but they do have a lot of side effects that patients have trouble dealing with," Khaitan says. "And none are approved for long-term use. So when patients stop taking the drugs, they regain weight. So should patients use them? That depends. If a patient has a BMI over 40, if they lose 20 to 30 pounds on a diet and weight loss medications, they will notice some improvement in their health. But they will not be able to achieve the same weight loss as they would with weight loss surgery."

    Most people think weight loss drugs are little magic bullets that make fat melt away. Sadly, that's not the case. Like surgery, the drugs work only for patients who follow strict diet and exercise programs, says guidelines author Vincenza Snow, MD, director of clinical programs for the American College of Physicians.

    "People need to know they'll have to continue diet and exercise even if they undergo weight loss treatment," Snow tells WebMD. "People need to be aware of the very modest effects of all weight loss drugs. Even so, these small amounts of weight loss can produce good physiological effects. You may not get the figure you want, but those are good things to happen. We want to make sure doctors and patients are very clear about the modest efficacy -- and that there is no long-term data on efficacy or safety."

    In other words, Snow says, there's no way -- yet -- to know for sure whether the gains a person gets from weight loss drugs will last over time. And there's no way -- yet -- to know the long-term effects of these drugs.

    "We have no evidence one way or the other to say what will happen if you do continue to take obesity drugs for more than one or two years -- we don't know, it is a total black box," Snow says. "These are not cheap drugs. It would be pretty sad if patients were taking these drugs over the long term, spending money, not getting any weight loss, and getting side effects we don't know about yet."

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