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Published: Tuesday, 30 June 2015 13:30

Written by 340B Editor

After completing two months of 2015, how are those New Year’s resolutions coming? I am certain shedding extra pounds is one of the more popular resolutions folks make. I am a firm believer that diet and exercise is the best way for all of to maintain a healthy weight, but in cases where justified, there may be patients that need extra help achieving their weight loss goals.

Prescription weight loss medications should be reserved for patients with a BMI of 30 or greater in whom diet and exercise strategies have failed, or for those who have a BMI of 27 or greater and are having health problems due to their weight. It is important to remember that these medications work best when combined with diet and exercise, so teaching your patient about making healthy choices is still vital to success in both losing weight and improving health outcomes.

Most weight loss medications work by making patients feel full and thereby decreasing their appetite. Medications that work in this way include lorcaserin, phentermine, benzphetamine, phendimetrazine, diethylpropion, and combination products like Qsymia (phentermine and topiramate) and Contrave (naltrexone and ER bupropion). The weight loss drug orlistat works by blocking the absorption of fat from the foods we eat. Newly approved Saxenda, which shares the same active ingredient with Victoza, is the first GLP-1 agonist to be approved solely for weight loss and not for diabetes. It also works to suppress appetite, but comes in an injection rather than a tablet, which could be an important consideration in choosing this agent for patients. Other things to take into consideration when deciding between agents are the recommended length of treatment, cost, side effects, monitoring parameters, and contraindications that are associated with the different medications. Also, phentermine, phendimetrazine, benzphetamine, and diethylpropion have abuse potential, and are therefore classified as controlled substances. No one medication is the best choice for every patient, and finding the drug that will be the best fit for your patient can improve safety and their chance for success.

So, do these medications work? They have the potential to, combined with diet and exercise, help patients lose about 5 to 10 percent of their total body weight in a year. This is not to say that every patient will respond to these medications, or that they will respond to each one in the same way. Finding the right medication for the individual patient is important, and a change in lifestyle is also necessary to ensure success in both losing weight and improving their overall health.

1.“Prescription weight-loss drugs: Can they help you?” The Mayo Clinic. 10 Oct. 2014. Web. Retrieved from: http://www.mayoclinic.org/healthy-living/weight-loss/in-depth/weight-loss-drugs/art-20044832?pg=2
2.“Prescription medication for the treatment of obesity”. U.S. Department of Health and Human Services. 12 Dec. 2014. Web. Retrieved from: http://www.win.niddk .nih.gov/publications/prescription.htm
3.“FDA approved weight-management drug Saxenda”. U.S. Food and Drug Administration. 23 Dec. 2014. Web. Retrieved from: http://www.fda.gov/News Events/Newsroom/PressAnnouncements/ucm427913.htm
4.Drug Monographs. UpToDate. Retrieved from: http://www-uptodate-com.liboff.ohsu.edu/contents/search