This week, another weight loss drug, Qsymia, has been approved by the U.S. Food and Drug Administration. The drug is a combination of a stimulant (Phenetermine) and an anti-seizure medication called topiramate. The stimulant decreases appetite and the anit-seizure medication has the side effect of weight loss.
This medication is approved for adults who have a 30 or greater body mass index (BMI) and those with a BMI of 27 or greater with one weight-related condition. So we are talking obesity, not just 10-20 pounds overweight.
And of course, there are the side effects– fast heart rate and metabolic acidosis (creates highly acidic blood that can end in coma or death in severe cases; damage d bones and kidney stones; heart damage and birth defects–pregnant women should not use this medication).
So here is the question:
Is it worth the risk to take a medication to lose weigh? Here are four reasons to consider:
1) The risk is high. I’m been working in the area of weight loss for almost 30 years now and this makes me very uneasy. Medication approaches to weight loss have come and gone, many with serious side effects. I remember the fen-Phen scare because I was in practice and we had to decide if we were recommending this as a weight loss approach. After looking at a year or two of the data after the drug was released in the market, my practice opted not to use these medications. We made the right decision because the drug was eventually pulled from the market place because of serious consequences.
I know the argument is that there are risks from obesity but these are known risks and can be worked on in treatment. I helped a 600 plus pound man lose over 300 pounds with therapy, exercise and nutritional guidance. It was very tough but it can be done.
2) Medications do not continue to work once the person stops taking them. What I have seen in practice is that once the person stops the medication, the weight gain typically returns.
3) You still have to learn to modify your diet and exercise. Weight loss is a total person venture. You must address body, soul and spirit for long term maintenance. Anyone can lose weight but keeping it off is another story.
4) You still have to learn how not to use food in unhealthy ways and develop a healthy relationship with eating. This is the message of my book, Press Pause Before You Eat.
So the bottom line for me is that I will not recommend this approach right now. And while we are constantly looking for the magic pill that will make those pounds melt away, medications continue to pose serious risks. There are too many unanswered questions about long-term affects for me. But everyone has to make up his or her mind.
Read more at Dr. Linda's blog Doing Life Together on Beliefnet.