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decision pointShould I use prescription medicines to treat obesity?

 

Key points

Many people seek medical help in dealing with obesity. While medicines often promote weight loss, they may have side effects, and the weight loss may be temporary. Consider the following when making your decision:

  • If you are losing weight, even as little as 0.5lb per week, you may not get enough additional benefit from medicine to outweigh the cost and side effects.
  • You will likely gain weight back after you stop using medicine.
  • Weight-loss medicines generally are used only if you have tried a weight management program, including diet and exercise, for at least 6 months, and your body mass index (BMI) is 30 or more. If you are Asian, your health may be at risk with a BMI of 27.5 or more.1 Talk to your doctor if your BMI is 27 to 30 and you have a condition that is made worse by being overweight. These conditions include high blood pressure, type 2 diabetes, high cholesterol, coronary artery disease, joint problems, and sleep apnea.
  • If you are under severe stress, have an emotional illness such as anxiety or depression, or have an alcohol or drug problem, you need treatment for this condition before using medicine. If you don't treat it, it will make losing weight more difficult.
  • It is not known whether it is safe for you to take medicines for obesity for longer than 2 years.

This Decision Point concerns obesity in adults. If you have a child that you think needs medicine to lose weight, consult your health professional.

 

What is obesity?

Obesity is a complex disease in which having too much body fat puts you at risk for health problems. Obesity is measured by body mass index (BMI). A BMI of 30 or more is considered obese.

What are the risks of obesity?

Being obese increases your risk for many health problems, including heart disease, high blood pressure, type 2 diabetes, and joint problems. Losing even 5% to 10% of your body weight may help reduce your risk. This means, for example, losing 25lb if you weigh 250lb.2 Weight loss reduces blood pressure and cholesterol levels and helps reduce blood sugar levels in people who have type 2 diabetes.3

If you need more information, see the topic Obesity.

 

Your choices are to:

  • Take medicines that either suppress your appetite or prevent fat from being absorbed.
  • Not take medicines.

The decision about whether to use medicines takes into account your personal feelings and the medical facts.

Deciding about using medicines to treat obesity
General reasons to take medicines General reasons not to take medicines
  • You have tried diet and activity and have lost little or no weight.
  • Medicines generally help people lose weight for 1 to 2 years.
  • Your self-esteem may improve due to weight loss.
  • Losing weight reduces the severity or risk of related health problems such as high blood pressure, type 2 diabetes, high cholesterol, coronary artery disease, or sleep apnea.

Are there other reasons you might want to use medicines?

  • If you are losing even as little as 0.5lb per week through diet and activity, you may not get enough additional benefit from medicines to outweigh the cost and side effects.
  • It is not known whether it is safe to take weight-loss medicines for longer than 2 years.
  • Weight gain usually occurs after you stop using these medicines, especially if you have not made any lifestyle changes.
  • Medicine does not work for everyone. If you do not lose weight within 4 weeks of using medicine, it will probably not help you.4
  • Medicine is expensive if insurance does not cover it.

Are there other reasons you might not want to use medicines?

 

These personal stories may help you make your decision

 

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about taking medicine for obesity. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

My body mass index (BMI) is 30 or more.

Yes No Unsure
My BMI is 27 or higher, and I am at risk for a condition that my weight makes worse. Yes No Unsure
Other medicine that I'm taking may interfere with medicine for obesity. Yes No Unsure
I have the finances and/or insurance to pay for medicine. Yes No Unsure
Taking medicine is fine with me. Yes No Unsure
I believe that medicine can help me. Yes No Unsure
I worry about the side effects of weight-loss medicine. Yes No Unsure

Use the following space to list any other important concerns you have about this decision.

 

 

 

 

 

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to use or not use medicines for obesity.

Check the box below that represents your overall impression about your decision.

Leaning toward using medicine

 

Leaning toward NOT using medicine

         

 

Citations

  1.  Purnell JQ (2005). Obesity. In DC Dale, DD Federman, eds., ACP Medicine, section 3, chap. 10. New York: WebMD.

  2.  American Gastroenterological Association (2002). AGA technical review on obesity. Gastroenterology, 123(3): 882–932. [Erratum in Gastroenterology, 123(5): 1752.

  3.  National Heart, Lung, and Blood Institute, National Institutes of Health (2000). The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (NIH Publication No. 00-4084). Available online: http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf.

  4.  Klien S, Romijin JA (2008). Obesity. In HM Kroneberg et al., eds., Williams Textbook of Endocrinology, 11th ed, pp. 1563–1587. Philadelphia: Saunders.

 

Author Jeannette Curtis
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer Matthew I. Kim, MD - Endocrinology & Metabolism
Last Updated April 16, 2009

WebMD Medical Reference from Healthwise

Last Updated: April 16, 2009
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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