I have been trying to lose weight for years on end. Weight loss is a battle for me in a war I never win. I have tried many different diets, lose weight for a while, but then gain it back. I seem to suffer from yo-yo dieting. I get into exercise for a while but fall out of it and can’t get motivated for periods of time. I am a 53-year-old male and want to lose about 35 lbs. I have a busy work week and my hours vary. What is your opinion regarding diet pills to help me lose weight?Sincerely,
Weight Loss Warrior
Dear Weight Loss Warrior,
Losing weight can be an uphill battle, and gaining weight an uncontrollable landslide. Yo-yo dieting is due to emotional eating patterns that are habit formed. Stress is a stimulant to emotional eating. It may take more than a diet for you to lose weight—you need ammunition.
Getting emotional support from a therapist, dietician or a support group may help. Working with a personal trainer can keep you motivated and consistent with exercising. The use of medication as a weight-loss strategy is an interesting option to consider. Below are some considerations to think about in using this technique.
There are many medications that reduce appetite, boost metabolism, balance hormones and encourage weight loss. Some medications are FDA approved specifically for weight loss and some are not, but can cause weight loss.
Metformin is a diabetic medication used for blood glucose (sugar) control. A side effect is weight loss, however it is not FDA approved for weight loss. Some doctors will prescribe Metformin for patients who are borderline diabetic and overweight, in order to address both of these concerns.
Liraglutide (Victoza or Saxenda) is another diabetic medication that enhances weight loss efforts. Saxenda is FDA approved for weight loss.
Ozempic is a diabetic medication that contains semaglutide, which is FDA approved for weight loss.
Qsymia is a brand-name weight loss medication approved by the FDA. This medication has two component FDA approved medications: phentermine (a stimulant type of amphetamine or anorectic) and topiramate (treats migraines and epilepsy). Both work by reducing appetite.
Lomaira/Adipex-P (phentermine) is an appetite suppressant and may boost metabolism.
Ionamin (phentermine resin) is part of a class of drugs called CNS stimulants and anorexiants, which reduce appetite.
Bontril (phendimetrazine tartrate) is an appetite suppressant.
Orlistat (Xenical or Alli) is a medication (over the counter and by prescription) that can help with weight loss if following a reduced-calorie and -fat diet. This medication works by blocking chemicals (enzymes) in the gut that digest fat. This medication had been used to improve serum lipid profiles in obese patients with cardiovascular risk and diabetes.
Didrex (benzphetamine hydrochloride) is a controlled amphetamine substance prescribed to help obese patients lose weight.
Tenuate (diethylpropion) is used along with a doctor-approved, reduced-calorie diet, exercise and behavior modification program. This medication is for people who are significantly overweight /obese and are at risk for comorbidities due to being overweight. It may work to reduce appetite, increasing the amount of energy used and by affecting certain parts of the brain. This medication is an appetite suppressant and part of a class of drugs called sympathomimetic amines.
Contrave is a medication that has proven to promote weight loss, improve triglyceride and cholesterol levels as well as treat depression. It works in the brain’s hypothalamus, the “thermostat” that controls appetite, body temperature and how the body burns energy. Contrave is a combination of Wellbutrin (bupropion, an antidepressant) and naltrexone (anti-craving medication) and FDA approved for weight loss.
LDN-Low Dose Naltrexone increases dopamine and serotonin levels in the brain that are triggered by incessant snacking or overeating. This drug breaks the ongoing cycle of sugar/carbohydrate cravings and improves mood.
Invokana (canagliflozin) and Farxiga (dapagliflozin) are in the same class of medications: sodium-glucose co-transporter 2 (SGLT-2) that treat diabetes and in some individuals cause weight loss. However these medications are not FDA approved for weight loss.
There are other medications currently being studied for weight loss. It is best to discuss the option of taking weight loss medications with your doctor. Many drugs have side effects and/or should not be taken with other medications. Some medications should be taken with food and others in between meals. Certain medications need to be increased slowly to reach a specific dosage and others weaned off slowly to avoid negative reactions. Some of the above medications are taken orally and others by injection.
Note: medications that suppress appetite can lead to not eating adequate nutrients such as carbohydrates and fluids. This can lead to ketosis (breaking down protein for an energy source, which leads to undesired ketones in the body with noticeable bad breath), dehydration and weakness.
As a professional dietician-personal trainer who is experienced in helping people succeed with weight loss and weight management, my technique is to develop a “personalized diet and exercise plan” that works for you. I focus on: forming healthy eating habits, meal planning, portion size control, exploring reasons for emotional eating and offering solutions to avoid destructive behavior patterns. With your individualized fitness program, you will learn how to exercise properly, efficiently, and consistently to ensure results.
If you wish to take weight loss medications, keep in mind, while medicated appetite is suppressed you will lose weight. However, once the medication is stopped, even weaned off slowly, it will be challenging to keep the weight off. It is recommended to learn and develop healthy eating habits and make exercise a consistent part of your life.
For more information about weight control and how to do it, reach out to Nutrition Transformations. Together we will work on improving your diet, fitness level, youthfulness and maintenance of your new, improved you!
Yours in good health,
Jenn Chapler MS RD CDN
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