Are new weight-loss drugs right for you?

The FDA on Tuesday approved Qsymia, the newest drug in a small arsenal of weight-loss medications available to the obese and dangerously overweight. This announcement comes on the heels of the June approval of Belviq, the first weight-loss drug approved in more than a decade. Though these new drugs certainly offer fresh options for those struggling with weight-loss, they may not be the magic bullet you’re hoping for. Here are a few things you should know if you are considering a prescription weight-loss drug:

  • you must be an adult with a body mass index (BMI) of 30 or more (obese) or 27 (overweight) or more with at least one weight-related medical condition, such as high blood pressure or type 2 diabetes before your doctor will even consider prescribing a weight-loss drug. A 5-foot-7-inch person who weighs 192 has a BMI of 30; that same person has a BMI of 27 if they weigh 173.
  • the FDA requires a drug to show at least a 5% weight-loss over a placebo as one criterion for approval.
  • treatment with medication is likely to be lifelong.
  • insurance does not always pay for weight-loss medication
  • there is the risk of serious side-effects

Oh yeah, those pesky side-effects. In fact, both of these drugs were denied earlier petitions for approval because the FDA found the amount of weight lost wasn’t worth the elevated risk of side-effects. Qsymia, formerly known as Qnexa, can cause a rapid heart-rate, and increase the risk of metabolic acidosis, a condition that can cause kidney stones and damage bones, or in severe cases, cause coma and even death. Belviq, also known as Lorcaserin, carries an increased risk of heart valve problems and cancer. Both drugs also carry dangerous risks for pregnant women.

What this means is that weight-loss drugs are an option, though they should never be your first and only option. Lifestyle changes including diet and exercise should always be the first thing you try, and should accompany any other treatments you eventually decide on. In fact, if you think about it, exercise might just be your “magic bullet.” Let’s see, exercise is:

  • available right now
  • cheap
  • effective
  • carries few risks or unwanted side-effects
  • increases your “metabolism”
  • burns fat as fuel
  • allows you to eat more
  • is “natural”

That sounds much better to me than birth defects, cancer, and heart problems.

Of course I also don’t have a BMI of 30, type 2 diabetes, chronic joint pain (wait, I do have some of that), high blood pressure, or a host of other weight-related ailments. I realize that more than one-third of adults in this country are obese, and that many of them are in a desperate situation. They feel they have tried it all, and nothing works. For those people, with their doctor’s blessing, Qsymia or Belviq might be the one thing that turns it all around.

I’ll certainly be watching to see what happens.

Btw, if you are a science-geek and want more information on the FDA approval process, check out this guideline for developing products for weight management. For a comparison of Qsymia and Belviq, read this article on WebMD.

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