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For a medicine to cause weight loss, it must reduce energy consumption, increase energy expenditure, and/or interfere with energy absorption. The medications most often prescribed for weight loss are appetite suppressants that reduce feelings of hunger or increase feelings of fullness. Appetite suppressants usually work by increasing levels of catecholamine or serotonin, two brain chemicals that affect mood and appetite.
All prescription weight-loss drugs have potential side effects. Those that affect catecholamine levels, including phentermine (Ionamin, Obenix, Fastin, and Adipex-P), diethylpropion (Tenuate), and mazindol (Sanorex), may cause sleeplessness, nervousness, and euphoria.
Most appetite suppressants are approved by the FDA only for short-term use. Although it comes with side effect warnings, one drug orlistat (Xenical) is approved for longer-term use. Orlistat lowers calorie consumption by blocking fat absorption in the intestines; it prevents about 30% of the fat in food from being digested. Similar to the fat substitute olestra, body image The mental representation TERMS a person holds about her or his body at any given moment in time, consisting of perceptions, images, thoughts, attitudes, and emotions about the body. A variety of commercial weight-loss programs are available. These programs yield mixed results, but most provide nutritional counseling and support for people who are serious about losing weight. over.
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Orlistat also reduces the absorption of fat-soluble vitamins and antioxidants. Therefore, taking a vitamin supplement is highly recommended if taking orlistat. Side effects include severe liver injury, diarrhea, cramping, and other gastrointestinal problems if users do not follow a low-fat diet. Because of the side effect warnings, the FDA requires substantial safety information on the label. In 2007, the FDA approved Alli, a lower-dose version of orlistat that is sold over the counter.
All of these medications work best in conjunction with behavior modification. Appetite suppressants produce modest weight loss about 5-22 pounds above the loss expected with nondrug obesity treatments. Individuals respond differently, however, and some experience more weight loss than others. Weight loss tends to level off or reverse after four-six months on a medication, and many people regain the weight they’ve lost when they stop taking the drug.
Prescription weight-loss drugs are not for people who just want to lose a few pounds. The latest federal guidelines advise people to try lifestyle modification for at least six months before trying drug therapy. Prescription drugs are recommended only in certain cases: for people who have been unable to lose weight with nondrug options and who have a BMI over 30 (or over 27 if two or more additional risk factors such as diabetes and high blood pressure are present). For severely obese people who have been unable to lose weight by other methods, prescription drugs may provide a good option.