The Best Weight Loss Medication
This is a very short video on anti-obesity medications or pharmacological agents that reduce weight or help control weight. Slimming pills that make you lose weight, essentially.
Before we get into this list of drugs and combo drugs, it's important to note that these drugs do not work on their own and they do require lifestyle modifications and diet changes to be effective. These weight loss pills and clinical trials have not been tested on their own without diet and lifestyle modifications.
That is why it's important to know that these weight loss drugs are not magical pills that will help you lose weight. They're really for use in conjunction with lifestyle modifications.
Let's begin with Phentermine. Phentermine is a drug that was approved for weight loss by the FDA in 1959. The mechanism of action for Phentermine is that it releases norepinephrine. Phentermine is especially good for short-term use, which is about three to six months, in contrast with the other drugs that we're gonna be talking about, which are all good for long-term use.
The drug has not been approved for long-term years like the other drugs. Remember, Phentermine is only four shirt for short-term use!
Phentermine is very cheap. You need to have a doctor's prescription to buy Phentermine.
Orlistat is the next drug we're going to talk about. It was approved by the FDA in 1999. The mechanism here is that in inhibits lipase. Lipase is an enzyme that breaks down fat, fatty molecules that you ingest.
Orlistat inhibits lipase that is both released from the pancreas and gastric lipase, both sources of lipase.
If you can't break down fat, you're going to decrease the amount of fat that you absorb too, which is the mechanism by which it makes you lose weight.
Some side effects of not breaking down and absorbing fat are that you get GI disturbances. It can cause cramps, fecal incontinence, diarrhea (specifically steatorrhea, which is an oily greasy fatty stool that tends to float). You also sometimes become deficient in fat-soluble vitamins, which are the vitamins D, E, A and K (DEAK vitamins). If you use Orlistat it is advised to take multivitamins with that in order not to become deficient in those vitamins.
The drug is good for patients that are at risk for coronary artery disease or coronary vascular disease because increased fat contents in the blood can cause vessel problems and clots in the arteries.
Orlistat is available over the counter.
Phentermine / Topiramate
The next we're going to talk about a combo drug - Phentermine / Topiramate. We already talked about Phentermine. Its mechanism was to secrete norepinephrine. Now let's add topiramate, which mechanism is that it blocks sodium channels and it also modulates GABA receptors to increase the action of GABA.
This combo drug was approved in 2010 and it combines Phentermine and Topiramate. Topiramate is also used for seizures ( simple, complex and tonic clonic seizures) as well as to prevent migraines.
Some side effects that you might get from using these drugs are pretty much the side effects of both of the drugs individually. Although both drugs are given at lower doses, so, hopefully, that would mediate the side effects. You might get mental sedation and kidney stones from using this combo drug.
The next is Lorcaserin, which was approved in 2012. Its mechanism is that it agonizing a serotonin receptor, specifically the 5-HT2C receptor.
Side effects are dizziness, dry mouth, GI disturbances, specifically nausea, vomiting, diarrhea, fatigue, and headaches.
The next is Bupropion and Naltrexone. This is a combo drug that was approved for weight loss in 2014. Bupropion's mechanism is to increase more epinephrine and dopamine levels. And Naltrexone mechanism is that it's an opioid antagonist, the same receptor that morphine some, other painkillers might activate is antagonized by naltrexone.
This weight loss drug can cause anxiety and headaches. This combo is particularly good for patients who are also struggling with smoking cessation because bupropion is an antidepressant that specifically approved for smoking cessation.
If somebody struggling to quit smoking and they're afraid of the weight gain sometimes associated with people who quit smoking, you can try this combo on them to help stop the smoking and to prevent further weight gain and, hopefully, promote weight loss.
Liraglutide is the last one approved most recently in 2015 for weight loss. The mechanism here is that it agonizes the GLP-1 receptor (GLP-1 analog). And that if you remember has a variety of effects on the human body. It is an endogenous molecule that is released by the guts.
Liraglutide is administered by a subcutaneous injection. And because it's subcutaneous might be less attractive than the other weight-loss drugs on this list.
Side effects of Liraglutide are pancreatitis, nausea, and vomiting.