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The Belly Fat Burden: Reducing Your Waist Circumference

When diet and exercise aren't helping you lose belly fat, medications and surgery may do the job.
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WebMD Feature

You've probably read the health news: Belly fat -- a big waistline -- can raise your risks for heart disease, diabetes, and stroke.

And belly fat can be a sign of something more: Metabolic syndrome, a group of health problems that include too much fat around the waist, elevated blood pressure, blood sugar, triglycerides, and low "good" HDL cholesterol -- all boosting your risks of disease.

Making matters worse, losing belly fat can sometimes seem daunting. For many people, diet and exercise don't always work. Luckily, we've got options like FDA-approved weight loss medications and even surgery.

"All fat is challenging to get off, period," says Howard J. Eisenson, MD, medical director of Duke Diet & Fitness Center at Duke University Medical Center. But "belly fat is not particularly tenacious fat to get rid of... it actually comes off fairly easily. Frankly, if you reduce calories and exercise more, you will lose weight everywhere -- including your abdomen."

While Eisenson considers diet and exercise the most effective weight loss strategies, he acknowledges that there's a role for medical treatments.

Keeping the weight off is what's most difficult, he says. "Very commonly, people start to gain the weight back. A year out, and they have regained 30% to 50% of the weight they lost. If a drug can help people keep off what they've lost, that's meaningful."

Fortunately there are a few weight loss drugs that help in that regard.

Losing Belly Fat With Weight Loss Drugs

Meridia, Phentermine, and Xenical are the most commonly used FDA-approved drugs for treating obesity. They are used for people with a BMI of 30 and above, or those who have a BMI of 27 and other obesity-related medical conditions. Both drugs are considered "moderately effective" in weight loss, with an average of 5 to 22 pounds over a one-year period.

Meridia works by increasing brain chemicals like serotonin, norepinephrine and dopamine so people feel full sooner after they eat. Xenical binds to fat cells in the gastrointestinal tract to prevent them from being absorbed, so the body eliminates about 30% of fat that is consumed.

"Xenical and Meridia tend to help for about [the] first six months on average," says Eisenson. "Then their main benefit is as a weight loss maintenance aide, which is not a trivial thing. That's how Xenical and Meridia work best... helping people keep the weight off."

The drugs work best when combined with lifestyle changes, research suggests. In one study, obese men and women lost far more weight by changing eating and exercise habits -- and taking Meridia -- compared to those who relied on either lifestyle modification or medication alone.

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