You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Medicine may help you lose a small amount of
weight. But without permanent changes in eating and exercise habits, most
people gain weight again after they stop taking the medicine.
You
must decide whether the benefit of taking a certain medicine outweighs its side
effects. Side effects of weight-loss medicines include headaches, nausea, bowel
problems, and increased blood pressure.
Weight-loss medicines are expensive and may not be covered by
your health insurance.
Most weight-loss
medicines work by making you feel less hungry or making you feel full sooner,
so you don't eat as much.
Weight-loss medicines include:
Sibutramine(Meridia).This medicine makes you feel full
sooner.
Orlistat(Xenical).This drug prevents some of the fat calories you eat from
being absorbed in your intestines. A weaker version of it, sold as
Alli, is available without a prescription.
Phentermine. This drug keeps
you from feeling as hungry. It is approved only for short-term use.
Weight-loss medicines are used along with diet changes
and more physical activity. Without those lifestyle changes, you will gain the
weight back if you stop taking the medicine.
Medicine doesn't work for everyone. If you don't lose weight within 4
weeks of starting the medicine, it will probably not help you.1
Weight-loss drugs are safer than they used to be, but
they still have side effects that are sometimes serious. And experts don't know
how safe or effective they are beyond 2 years of use.2
Side effects of weight-loss medicines
Sibutramine (Meridia)
Orlistat (Xenical)
Phentermine
Increased blood pressure and heart rate
Headache
Dry
mouth
Constipation
Sleep problems
Changes in bowel habits, including:
Oily or fatty stool. The oil seen
in a bowel movement may be clear, orange, or brown.
Stool or oily
matter that leaks out when you pass gas, oily matter that leaks out even when
you're not passing gas, and an urgent need to go to the bathroom. Research
shows that this happens to 22 to 27 out of every 100 people. This means that 73
to 78 out of 100 do not have this side effect.3
Being unable to control bowel movements.
Sometimes these side effects go away after a few
weeks. But often they don't. They're the main reason people stop taking this
medicine.
Nervousness
Irritability
Sweating
Nausea
Headache
Dry
mouth
Constipation
Sleep problems
Possible
addiction
Most of these side effects are mild, and they
usually improve with continued treatment.
If you are under a lot of
stress, have an emotional illness such as
anxiety or
depression, or have an alcohol or drug problem, you
need treatment for that problem before you use weight-loss medicine. If you
don't treat it, you will have a harder time losing weight.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I was
concerned about taking a weight-loss medication. I was worried about those
stimulant diet pills that people took years ago that had such a questionable
reputation. But after struggling to lose not even 5 lb (2.27 kg) over the past
8 months, I am now ready to see whether medications can add anything to the
good habits I've tried to establish. I know the medication isn't going to be a
magic bullet, but I hope it can give me that little extra help I seem to need.
John, age
50
I realize that I didn't gain my extra
weight in just a few months, and I don't expect to be able to lose it all
quickly. I want to get back to eating a more balanced diet again, and set a
good example for my kids so that they don't develop poor eating habits as they
grow up. I plan to start taking them for walks and introducing them to lots of
outdoor activities that we can do together. I don't want to be on pills for the
rest of my life; I need a long-term solution.
George, age 45
My sister
has been taking a weight-loss medication for about 4 months now, and she has
been on a low-fat diet. We have been walking together 3 times a week. She has
lost about 10 lb (4.54 kg) already. I don't think I've lost any weight yet,
even though I have been watching what I eat, too. I think if the medication
gives me a little help towards losing those first few pounds, I have the good
habits and will power to keep the weight off on my own.
Susan, age 42
I know
several people who have taken appetite suppressants, and while they worked well
for some people, they didn't seem to work at all for others. And the side
effects of Xenical sound pretty unpleasant to me. I have made a few changes in
my diet, and I am walking twice a week. I'm going to give myself at least a
year of a balanced diet and exercise before I consider whether I want to try
taking a medication.
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take weight-loss medicine
Reasons not to take weight-loss medicine
I am desperate to lose weight, and I think medicine will help me.
I don't like the idea of taking medicine.
More important
Equally important
More important
I have tried diet and exercise, and I just can't seem to lose weight.
I want to keep trying diet and exercise before I start taking medicine.
More important
Equally important
More important
I'm not worried about the cost of medicine.
I don't think I can afford the cost of medicine.
More important
Equally important
More important
I think losing a little bit of weight is worth the side effects of medicine.
I don't think the side effects are worth the small amount of weight I might lose by taking medicine.
More important
Equally important
More important
Along with taking medicine, I'm willing to work hard to make permanent changes in my eating and exercise habits.
Medicines aren't worth it to me if I'll just gain the weight back without permanent lifestyle changes.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking weight-loss medicine
NOT taking weight-loss medicine
Leaning toward
Undecided
Leaning toward
What else do you need to make your decision?
Check the facts
1.
Weight-loss medicine is all I need to lose lots of weight permanently.
TrueNo, that's wrong. Medicine will probably help you lose just a small amount of weight. And unless you make permanent changes in your eating and exercise habits, you will likely gain back the weight after you stop taking the medicine.
FalseYou're right. Medicine will probably help you lose just a small amount of weight. And unless you make permanent changes in your eating and exercise habits, you will likely gain back the weight after you stop taking the medicine.
I'm not sureIt may help to go back and read "Key points to remember." Medicine will probably help you lose just a small amount of weight. And without permanent lifestyle changes, you will likely regain the weight after you stop taking the medicine.
2.
I may suffer unpleasant side effects if I take weight-loss medicine.
TrueThat's right. Side effects of weight-loss medicines include headaches, nausea, bowel problems, and increased blood pressure. Some people stop taking the medicine because the side effects are too unpleasant.
FalseSorry, you're wrong. Side effects of weight-loss medicines include headaches, nausea, bowel problems, and increased blood pressure. Some people stop taking the medicine because the side effects are too unpleasant.
I'm not sureIt may help to go back and read "What are the risks and side effects of weight-loss medicines?" Some people stop taking the medicine because the side effects are too unpleasant.
3.
I am just a little overweight, so weight-loss medicine is probably a good choice for me.
TrueNo, that's not right. Weight-loss medicine is usually only for people whose BMI is at least 30 (27.5 if you are Asian or 27 if you have a health problem related to your weight).
FalseYes, you're right. Weight-loss medicine is usually only for people whose BMI is at least 30 (27.5 if you are Asian or 27 if you have a health problem related to your weight).
I'm not sureIt may help to go back and read "Why might your doctor recommend weight-loss medicine?" The medicine is usually only for people whose BMI is at least 30 (27.5 if you are Asian or 27 if you have a weight-related health problem.)
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
Medicine may help you lose a small amount of
weight. But without permanent changes in eating and exercise habits, most
people gain weight again after they stop taking the medicine.
You
must decide whether the benefit of taking a certain medicine outweighs its side
effects. Side effects of weight-loss medicines include headaches, nausea, bowel
problems, and increased blood pressure.
Weight-loss medicines are expensive and may not be covered by
your health insurance.
FAQs
What are weight-loss medicines?
Most weight-loss
medicines work by making you feel less hungry or making you feel full sooner,
so you don't eat as much.
Weight-loss medicines include:
Sibutramine(Meridia).This medicine makes you feel full
sooner.
Orlistat(Xenical).This drug prevents some of the fat calories you eat from
being absorbed in your intestines. A weaker version of it, sold as
Alli, is available without a prescription.
Phentermine. This drug keeps
you from feeling as hungry. It is approved only for short-term use.
Weight-loss medicines are used along with diet changes
and more physical activity. Without those lifestyle changes, you will gain the
weight back if you stop taking the medicine.
Medicine doesn't work for everyone. If you don't lose weight within 4
weeks of starting the medicine, it will probably not help you.1
What are the risks and side effects of weight-loss medicines?
Weight-loss drugs are safer than they used to be, but
they still have side effects that are sometimes serious. And experts don't know
how safe or effective they are beyond 2 years of use.2
Side effects of weight-loss medicines
Sibutramine (Meridia)
Orlistat (Xenical)
Phentermine
Increased blood pressure and heart rate
Headache
Dry
mouth
Constipation
Sleep problems
Changes in bowel habits, including:
Oily or fatty stool. The oil seen
in a bowel movement may be clear, orange, or brown.
Stool or oily
matter that leaks out when you pass gas, oily matter that leaks out even when
you're not passing gas, and an urgent need to go to the bathroom. Research
shows that this happens to 22 to 27 out of every 100 people. This means that 73
to 78 out of 100 do not have this side effect.3
Being unable to control bowel movements.
Sometimes these side effects go away after a few
weeks. But often they don't. They're the main reason people stop taking this
medicine.
Nervousness
Irritability
Sweating
Nausea
Headache
Dry
mouth
Constipation
Sleep problems
Possible
addiction
Most of these side effects are mild, and they
usually improve with continued treatment.
If you are under a lot of
stress, have an emotional illness such as
anxiety or
depression, or have an alcohol or drug problem, you
need treatment for that problem before you use weight-loss medicine. If you
don't treat it, you will have a harder time losing weight.
Why might your doctor recommend weight-loss medicine?
Your doctor may recommend weight-loss medicine if:
Your BMI is at least 30 (27.5 if you are
Asian).
Your BMI is at least 27 and you have other problems related
to your weight, such as:
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I was concerned about taking a weight-loss medication. I was worried about those stimulant diet pills that people took years ago that had such a questionable reputation. But after struggling to lose not even 5 lb (2.27 kg) over the past 8 months, I am now ready to see whether medications can add anything to the good habits I've tried to establish. I know the medication isn't going to be a magic bullet, but I hope it can give me that little extra help I seem to need."
— John, age
50
"I realize that I didn't gain my extra weight in just a few months, and I don't expect to be able to lose it all quickly. I want to get back to eating a more balanced diet again, and set a good example for my kids so that they don't develop poor eating habits as they grow up. I plan to start taking them for walks and introducing them to lots of outdoor activities that we can do together. I don't want to be on pills for the rest of my life; I need a long-term solution."
— George, age 45
"My sister has been taking a weight-loss medication for about 4 months now, and she has been on a low-fat diet. We have been walking together 3 times a week. She has lost about 10 lb (4.54 kg) already. I don't think I've lost any weight yet, even though I have been watching what I eat, too. I think if the medication gives me a little help towards losing those first few pounds, I have the good habits and will power to keep the weight off on my own."
— Susan, age 42
"I know several people who have taken appetite suppressants, and while they worked well for some people, they didn't seem to work at all for others. And the side effects of Xenical sound pretty unpleasant to me. I have made a few changes in my diet, and I am walking twice a week. I'm going to give myself at least a year of a balanced diet and exercise before I consider whether I want to try taking a medication."
— Carla, age 40
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take weight-loss medicine
Reasons not to take weight-loss medicine
I am desperate to lose weight, and I think medicine will help me.
I don't like the idea of taking medicine.
More important
Equally important
More important
I have tried diet and exercise, and I just can't seem to lose weight.
I want to keep trying diet and exercise before I start taking medicine.
More important
Equally important
More important
I'm not worried about the cost of medicine.
I don't think I can afford the cost of medicine.
More important
Equally important
More important
I think losing a little bit of weight is worth the side effects of medicine.
I don't think the side effects are worth the small amount of weight I might lose by taking medicine.
More important
Equally important
More important
Along with taking medicine, I'm willing to work hard to make permanent changes in my eating and exercise habits.
Medicines aren't worth it to me if I'll just gain the weight back without permanent lifestyle changes.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking weight-loss medicine
NOT taking weight-loss medicine
Leaning toward
Undecided
Leaning toward
5. What else do you need to make your decision?
Check the facts
1.
Weight-loss medicine is all I need to lose lots of weight permanently.
True
False
I'm not sure
You're right. Medicine will probably help you lose just a small amount of weight. And unless you make permanent changes in your eating and exercise habits, you will likely gain back the weight after you stop taking the medicine.
2.
I may suffer unpleasant side effects if I take weight-loss medicine.
True
False
I'm not sure
That's right. Side effects of weight-loss medicines include headaches, nausea, bowel problems, and increased blood pressure. Some people stop taking the medicine because the side effects are too unpleasant.
3.
I am just a little overweight, so weight-loss medicine is probably a good choice for me.
True
False
I'm not sure
Yes, you're right. Weight-loss medicine is usually only for people whose BMI is at least 30 (27.5 if you are Asian or 27 if you have a health problem related to your weight).
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.
3.
Use the following space to list questions, concerns, and next steps.
Credits
Author
Kathleen M. Ariss, MS
Editor
Susan Van Houten, RN, BSN, MBA
Associate Editor
Pat Truman, MATC
Primary Medical Reviewer
Adam Husney, MD - Family Medicine
References
Citations
Klien S, Romijin JA (2008). Obesity. In HM Kroneberg
et al., eds., Williams Textbook of Endocrinology, 11th
ed, pp. 1563–1587. Philadelphia: Saunders.
Yanovski SZ, Yanovski JA (2002). Drug therapy:
Obesity. New England Journal of Medicine, 346(8):
591–602.
Arterburn DE, et al. (2008). Obesity in adults, search
date February 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevience.com.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Klien S, Romijin JA (2008). Obesity. In HM Kroneberg
et al., eds., Williams Textbook of Endocrinology, 11th
ed, pp. 1563–1587. Philadelphia: Saunders.
Yanovski SZ, Yanovski JA (2002). Drug therapy:
Obesity. New England Journal of Medicine, 346(8):
591–602.
Arterburn DE, et al. (2008). Obesity in adults, search
date February 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevience.com.
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