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Weight-loss pills, potions, and drugs: what works.

It's a fact: Taking a couple of pills or drinking a flavored concoction to lose weight instead of eating less and exercising more is tempting, and there are hundreds of products from which to choose. However, if you're thinking about taking one of these products, consider your options carefully--the vast majority are not regulated by the FDA, and there is scant, if any, evidence that they are effective.

"Weight-loss products--prescription or over-the-counter--should be used under the guidance of a physician, and patients should understand that a realistic benefit of prescription medications will achieve a loss of five to 10 percent of body weight," says Rekha Kumar, MD, MS, a weight-loss specialist at the Weill Cornell-affiliated Center for Weight Management and Metabolic Clinical Research.

Weight-loss products. Weight-loss products fall into one of three categories: FDA-approved, over-the-counter (OTC) substances, FDA-approved prescription medications, and herbal supplements that are not evaluated or approved by the FDA.

"The drug orlistat, which inhibits fat absorption, is an FDA-approved product," explains Dr. Kumar. "The OTC version of orlistat, a 60-milligram (mg) dose, is Alli; in the higher-dose, 120-mg prescription form, it is Xenical."

One study showed that patients who took orlistat and also participated in a behavioral intervention program lost 11 to 22 pounds (approximately eight percent of their total body weight), compared to a six- to 13-pound loss in a control group who did not take orlistat. Some subjects reported side effects, such as diarrhea and flatulence.

The FDA has approved three prescription medications for long-term use, according to Dr. Kumar; they are Qsymia, Belviq, and Contrave. All three drugs work in similar ways to help decrease your appetite and make you feel full after eating smaller amounts.

In clinical trials that tested Qsymia and Belviq, between 50 and 62 percent of the study participants lost at least five percent of their weight after taking the medication for one year.

The FDA has approved four drugs for short-term use (up to 12 weeks) that suppress appetite: phentermine, benzphetamine, diethylpropion, and phendimetrazine.

Possible side effects of prescription weight-loss medications, which range from irritating to potentially harmful, include increased blood pressure and heart rate, nervousness, insomnia, dry mouth, constipation, headache, nausea, cramps, gas, diarrhea, dizziness, anxiety, and seizures.

Herbal supplements. "There are a few herbal remedies and ingredients that may help people with metabolic disease, but, currently, there is little science supporting their use," says Dr. Kumar. "We don't have reliable clinical trials that test their safety and efficacy."

For example, green coffee bean extract, once touted as a fat-burning formula, lost credibility when a study that supported its use for weight loss was retracted because of falsified data in October 2014.

FDA-APPROVED WEIGHT-LOSS MEDICATIONS

APPROVED FOR LONG-TERM USE

* Orlistat (Xenical, Alli *)

* Lorcaserin (Belviq)

* Phentermine and topiramate (Qsymia)

* Naltrexone and bupropion (Contrave)

* Alli is the only drug available without a prescription.

APPROVED FOR SHORT-TERM USE

* Phentermine (Adipex, Suprenza)

* Benzphetamine (Didrex)

* Diethylpropion (Tenuate)

* Phendimetrazine (Bontril)
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Title Annotation:PREVENTION
Publication:Women's Nutrition Connection
Date:Jan 1, 2015
Words:486
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