Patients ask me almost daily for advice regarding weight-loss medications. In general, diet changes and implementing an exercise routine stand tantamount to any medication. However, consistency is key. You did not gain weight overnight, neither can you “lose 25lbs in a week;” any such claim is a lie and trying to sell you something.
The body naturally metabolizes sugar much faster and easier than stored fat in your body – hence why when people initially eliminate sugar, they experience disgrunlting fatigue for 2 weeks, before their body switches over to burning fat.
Common medication include:
- Wellbutrin. This is an antidepressant often used in smoking cessation and as an adjunct when trying dual therapy for depression. Studies show modest improvements in appetite suppression and weight loss.
- Contrave (wellbutrin/naltrexone). The mechanism of action here isn’t clear, but studies do show benefit in aiding weight loss. Because this is a newer combination drug, however, the single pill can cost around $140/month. I would suggest asking your physician to write two separate prescriptions (split up this drug) as a cheaper way around the big pharma game.
- Phentermine. This is a controlled substance, in the same family as Adderall, that increases focus and suppresses the appetite. This drug isn’t meant to be taken longer than 3 months, and in general is contraindicated if you have heart problems (like hypertension). Studies show increased weight loss/benefit when this drug is combined with another medication called topiramate.
- Orlistat. This drug prevents enzymes in your gut from digesting and absorbing fats, so you defecate a large portion of the fat you consume. Not usually well-tolerated, because it causes diarrhea, excess gas, and abdominal discomfort.
This is not a comprehensive list, but a great starting place, to use as a quick guide when initiating this conversation with your doctor.
-Danielle Kelvas, MD