Question

What oral medications are there to help one lose weight?

Answer

Three types of medication have been tried. Bulk fillers such as guar gum lead to reduced food intake if taken in sufficient quantity. There are drugs related to amphetamine which have a very significant anorectic effect, such as phentermine (dexfenfluramine and fenfluramine have been withdrawn following reports that they cause valvular heart disease). There are anti-obesity drugs which act on the gastrointestinal tract. For example, Orlistat is a pancreatic lipase inhibitor which reduces the absorption of dietary fat.

But there is just no substitute for diet if somebody is serious about losing weight. The diet should provide 500-1000 kcal per day less than the maintenance energy requirements. It must provide essential nutrients. Foods that are not restricted are fruit and vegetables and wholegrain cereals. Protein intake should be adequate to avoid unnecessary loss of lean tissue. It is probably useful to establish a formal pattern of eating meals at specific times and to avoid snacking and grazing. Since most of us eat more or less automatically, it may help to keep a food diary to see what you eat and also if anything precipitates binge eating. It may be helpful to join a weight loss group.

Links

• Overweight Health Center portal