About Anti-Obesity Medications (aka appetite suppressants)

With obesity now considered a disease, anti-obesity medicines are finding their rightful place. When indicated, they can be an effective and reasonable treatment option.

Four new prescription medications are now available: Saxenda, Contrave, Belviq and Qsymia. While effective, they can be expensive. For this reason, Dr. Gilson often leans towards generics such as phentermine, approved by the FDA in 1959. It is the first choice of 99% of Obesity Medicine specialists, often in combination with toperimate. Fifty years of experience has proven both drugs to be effective and safe.

Are there real benefits?

Yes. Anti-obesity medicines will help most people lose weight. Their use declined in the 90’s as a result of documented heart problems, the “fen-phen” era. Even now they remain stigmatized by being called “appetite suppressants”. This label implies they are a crutch for the weak willed. That’s untrue. The effect of anti-obesity medications on appetite and metabolism are much more complex.

Patients who use anti-obesity medications not only lose more weight, but do so at a faster pace than those who don’t. Why? Because these medications change your “set point”. This is the weight your brain thinks you should weigh. Yes, a control center in your brain works every hour of every day to keep your weight where “it” wants it to be the same, despite your best efforts. With a built in thermostat like that, don’t you think you might need all the help you can get?

Are there risks in taking anti-obesity medications?

Hippocrates didn’t say it but, “there’s a risk to every medication, and the less medication the better.” But keep things in perspective. People with weight issues have an above average risk of developing e.g. diabetes or hypertension.  The risk of being overweight is much greater than the risk associated with anti-obesity medications.

Patient information sheets may list endless side effects, but most occur rarely, many at rates of 1 per million or less. For example, developing increased blood pressure by taking phentermine is said to be common. Yet studies have shown that patients treated with phentermine usually develop lower blood pressure.

In summary, the risk of taking anti-obesity mediation is overemphasized. As with life in general, there are risks to everything, but they are often outweighed by benefits. Anti-obesity medications not only are effective for weight loss, but for maintenance as well.