Recently, we wrote about the AMAs decision to label Obesity as a disease, and some of the benefits that this may have for patients; namely, that this decision could potentially lead to insurance reimbursement for programs and medications promoting healthy weight. With insurance reimbursement comes incentive for research and ultimately, pharmaceutical development. In fact, within the last year, two medications have been released on the market specifically for this purpose – Qysmia and Belviq.
Belviq has shown some promise – trials have shown only slight (and not statistically significant) increased risk for issues with heart valves over placebo (not even .5%). While it does hold some potential for recreational use, that is minimal as well, as those side effects only occur at high-doses and seem to be minimal (1).
Qysmia, which is actually a combination of phentramine and topiramate, was released earlier in the year, is the first diet-pill approved by the FDA in over a decade. Sales have thus far not been promising, and the drug has not passed muster world-wide – the EU did not approve its sale or use. As for the drug itself, both components have known issues, particularly for women of child-bearing age, but the FDA did approve it, and it could be a valuable tool in promoting weight loss.
These medications must be prescribed by a physician, and they work in combination with a balanced diet and exercise plan. They are not intended to be used for a pesky pound or two at beach season, but only for patients with a significant amount of weight to lose. Typically, significant means BMI >35, or BMI >30 with related medical issues, such as type 2 diabetes, or high blood pressure.
There are plenty of other weight loss drugs, supplements, pills and herbs available on the market. Many lack any real research to back up the claims. Others may be more sinister in nature – marketed as an all-natural product or herbal supplement, all the while containing less friendly ingredients. Sibutramine and Phenolphthalein are common offenders (2).
Sibutramine has been shown to suppress appetite – hence its diet-pill marketing. However, it can also cause damage to the heart and undesirable alterations in blood pressure. This is of particular concern for individuals who already have an existing heart condition, or who are at risk, such as those who are overweight or struggling to control blood pressure. Phenolphtalein is a laxative, and there are concerns about its safety, particularly as related to its potential carcinogenicity.
There’s a lesson here: Be a critical consumer, do your homework to determine potential risks. Consult with your physician before taking any medications or supplements. And remember, even FDA approved medications are intended for use with a balanced diet and exercise.
- Les, MS RD LD
(1) http://www.forbes.com/sites/davidkroll/2013/05/11/why-does-arenas-obesity-drug-have-abuse-potential/
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