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Diet medications: What to know about weight loss prescription and OTC drugs

Can you resist temptation?
Can you resist temptation?
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Should you consider taking a diet drug, either prescription or over the counter? Although two new weight loss drugs are available, some physicians are recommending caution because of possible heart risks, reported Live Science on Feb. 10.

The two weight-loss drugs recently approved by the FDA are proving effective at helping people shed pounds. However, the potential exists for these medications to boost the risk of heart disease and related cardiovascular concerns, cautions a new editorial published in the Feb. 10 issue of the Journal of the American Medical Association (JAMA) Internal Medicine.

In addition, experts are warning about side effects that include memory and attention problems as well as increased acid in the body fluids. The drugs are lorcaserin hydrochloride (brand name Belviq, manufactured by Eisai Inc.) and phentermine-topiramate (brand name Qsymia, manufactured by Vivus, Inc.).

"In our view, approving the drugs for marketing without more definitive evidence [of heart safety] is an unnecessary gamble," wrote the editorial authors Dr. Steven Woloshin and Dr. Lisa M. Schwartz, of the Dartmouth Institute for Health Policy and Clinical Practice.

The JAMA editorial revealed that no evidence exists that protocols for the studies have been submitted - this despite the fact that the submission was required eight to 16 months ago.

"Even if they were done on time, the studies weren’t planned to be finished until four or five years from now," Woloshin said. That means "there's a really long time when these questions will be open," Woloshin added.

In addition, neither drug has been approved by the European Medicines Agency (EMA), reported RTT News on Feb. 12. EMA rejected the drugs because it felt they were too dangerous, with concerns such as:

  • Belviq: Side effects include valvular heart disease and euphoria
  • Qsymia: Side effects include metabolic acidosis, increased heart rate, anxiety, insomnia, and elevated creatinine levels

While Arena Pharma withdrew its application for a marketing authorization for Belviq in Europe last May, Qsymia was rejected by the EMA twice. The agency cited concerns about the drug's long-term effects on the heart and blood vessels and about the long-term psychiatric effects and cognitive effects.

How do these drugs compare to over-the-counter versions in terms of how they benefit weight loss? Here are the differences:

  • An older option, Xenical, prevents your body from digesting the fat from food. It requires a prescription.
  • However, an over-the-counter version is available, called Alli. It blocks absorption of 25% of consumed fat. It can cause bowl changes, so it's important to follow the diet recommended with the pills. It's sold in drug stores and also online, such as Alli Weight-Loss Aid, Orlistat 60mg Capsules, 90-Count Starter Pack (click for more information).
  • Belviq activates a serotonin receptor in the brain. As a result, you can eat less and feel full with less food.
  • Qsymia combines an appetite suppressant and a medication to help you feel full.

A new review in The Journal of the American Medical Association showed that:

  • Those who took Qsymia lost up to 9.3 percent of their body weight in a year.
  • Those on Belviq lost on average about 3.2 percent over the placebo.
  • Those on Xenical lost slightly less than that.

However, "people respond differently to all these meds," said Ronald Sha, MD, medical director at the Duke Diet and Fitness Center. Talk to your doctor for his or her advice.

Then there are other weight loss supplements, such as green coffee bean extract, raspberry ketones and yacon syrup. The problem with those: None are regulated, which means that it's up to the consumer to find pure versions of the supplements that they seek.

And although many of these diet products soar in popularity after being shown on the "Dr. Oz Show," Dr. Mehmet Oz carefully refrains from endorsing any brands himself. Learn more about yacon syrup by clicking here and get the details on garcinia and green coffee by clicking here.

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