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Weight Loss With Medication

There's no magic bullet yet -- but for people with obesity, weight loss drugs can be a helpful part of treatment.

How Do Medications Help? continued...

Xenical works very differently. It isn't absorbed by the system. Instead, it binds to fat cells in the gastrointestinal tract and prevents them from being absorbed, just like the ingredient Olestra used in some low-fat foods. The usual dose can reduce the amount of fat that's absorbed by about 30%.

The FDA has approved the use of weight loss drugs in people with a BMI of 30 or as low as 27 in some people who have illnesses related to obesity, like diabetes or heart disease. The BMI is a measurement based on height and weight. According to the National Institutes of Health, a normal BMI ranges from 18.5 to 24.9, 25-29.9 is overweight, and anything above that is obese.

Other drugs may be helpful in some cases. For instance, Wyatt has had good success with the generic drug phentermine, which suppresses appetite like Meridia. However, the FDA has not approved phentermine for long-term use. That's not because it was found unsafe -- it's just that no one has funded a study of its long-term effectiveness. And because studies are expensive, no pharmaceutical company will want to spend the money testing a generic drug that it doesn't exclusively own.

Modest Results

As much as people may dream of the pill that lets them lose weight without diet or exercise -- the claim of countless hucksters and infomercials -- none of these drugs works that way. Studies have shown that these drugs really only work in conjunction with lifestyle changes.

The amount of weight that people lose on weight loss drugs varies: Some people have great success and some don't. On average, people don't lose more than 10% of their baseline weight -- that's a 20-pound weight loss for a person who is 200 pounds. Generally, people lose the most weight in the first three to six months on the drugs and then plateau.

A 10% weight loss may not sound like a lot. But experts stress that modest weight loss -- even 5% -- can make a big difference in your risk of developing disease. Many studies have shown the effectiveness of weight loss drugs in reducing health risks. For instance, a recently published study of Xenical found that it could cut the risk of type 2 diabetes by 37%.

How Long Would Someone Need to Use Them?

Studies have shown that if a person on one of these medications doesn't lose 4 pounds in the first four weeks, then it can probably be stopped; it's unlikely that the drug is going to work. If someone does have success with a drug, it should probably be taken long term. Weight loss drugs are not a quick fix. Instead, they're more like medication for high blood pressure or diabetes, Wyatt says. Obesity really is a chronic disease.

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