NEW Anti-Obesity Medicines

Now that everyone acknowledges obesity is a disease, anti-obesity medicines must be viewed from a new perspective. Physicians like Dr. Hendricks who specialize in the medical treatment of Overweight and Obesity have long agreed that anti-obesity medicines should be a part of the treatment for most patients. Guidelines for treatment of Overweight and Obesity suggest that the treatment components of good medical programs for treating obesity include diet, lifestyle intervention, AND pharmacotherapy. In addition to the older drugs including phentermine, diethylpropion, and phendimetrazine there are now FOUR NEW prescription anti-obesity drugs available: Saxenda (liraglutide), Contrave (naltrexone/bupropion), Belviq (lorcaserin), and Qsymia (phentermine/topiramate). Dr. Hendricks has experience with each of these.

Optimum Treatment Should Include Prescription Medicines

Obesity treatment specialists, also known as Bariatric Physicians or Obesity Medicine specialists, in addition to using the newest drugs, also use a variety of older drugs and drug combinations for treatment that they have found to be safe and effective even though some have not been formally ‘approved’ by the FDA. The most commonly used medicine for treatment is phentermine. Phentermine, approved by the FDA in 1959, is used by 99% of Bariatric Medicine specialists as the first choice drug for treating overweight and obesity. These specialists, having collectively used phentermine long-term for over fifty years, are convinced the drug is both effective and safe. The same is true for diethylpropion and phendimetrazine, two drug that also date to 1959.

In addition to these old standby drugs these medical specialists also use topiramate (Topomax), metformin (Glucophage), bupropion (Wellbutrin), zonisamide (Zonigran), exenatide (Byetta, Bydureon) liraglutide (Victoza), naltrexone, and 5-Hydroxytryptophan/Carbidopa as single agents or in combination with other drugs. Combinations of drugs sometimes are more effective than single agents. Commonly used combinations for treating overweight and obesity include phentermine combined with topiramate, phentermine with bupropion, phentermine with diethylpropion, phentermine with metformin, and phentermine with 5-HTP/Carbidopa. In patients with diabetes phentermine can be combined with exenatide or liraglutide. Naltrexone with bupropion is another useful combination. Some specialists are combining lorcaserin (Belviq) and phentermine and some are adding additional phentermine to Qsymia. Patients with high insulin levels or signs of insulin resistance should be treated with metformin to accelerate weight loss. Metformin is a diabetes drug but U.S. Obesity Medicine Specialists use it in patients without diabetes because it improves weight loss.

Benefits of Anti-Obesity Medications

Anti-obesity medicines improve weight loss. Of course weight loss is induced by a diet – a lower caloric intake, or more specifically by a lower intake of carbohydrate calories. Patients who are prescribed an anti-obesity medicine lose more weight at a faster pace. Why? Because their eating behavior changes and they eat less than before. Once we thought this eating less was just suppression of appetite but now we know it’s more complicated.  A daily dose of an anti-obesity medicine actually helps you control and change your eating behavior. Food cravings may subside or disappear, you may be satisfied with less food, and you may have better control over your stress or emotional eating. Of course not everyone has the same problem eating behaviors and no everyone reacts the same to the medicines but these are some of the effects our patients n these medicines report. In fact, our research indicates there are at least 12 separate problem eating traits that benefit from the medicines. Actually we believe there are quite a few other problem eating behaviors that can be helped with the medicines. We are continuing our research into how our patients respond to anti-obesity drugs and now have evidence that these drugs help patients improve their eating behaviors. These beneficial changes occur quickly as soon a patient starts taking any anti-obesity drug and continue as long as the patient takes the drug. Patients on maintenance who have been on phentermine for as long as 25 years still have beneficial changes in eating behaviors.

Risks of Anti-obesity Medicines

Risks of anti-obesity medicines should be viewed within a real-life context. Anyone overweight or obese is at a higher risk for developing diabetes, hypertension, heart failure, some cancers and a long list of other serious medical problems. Remaining overweight or obese is much, much, much more risky than is taking any of the medicines. The majority of the potential bad health outcomes touted by the FDA, many pharmacists and many doctors either have never occurred or occur at rates of 1 per million or less.

For example: everyone quotes the risk of developing increased blood pressure by taking phentermine – this is said to be a common occurrence. Our published data shows that patients treated with phentermine most commonly develop lower blood pressures and that hypertensive patients require lower doses of anti-hypertensive medicines or even get off them entirely. In brief – the risks are greatly overemphasized. Yes, there are a few real risks but once these are understood most patients choose to take the medicines. We believe it should your choice to take or avoid the risk in question, once you have complete information. Ask us.

Who is the regional expert?

Ed J. Hendricks, M.D. is an Obesity Medicine Specialist with long experience and expertise in treating obesity with anti-obesity medicines. Dr. Hendricks served on the FDA advisory panel of experts for anti-obesity and endocrine drugs (FDA EMDAC) from 2010 to 2015. His reputation as an anti-obesity drug expert is both national and international. His research on anti-obesity medicines has been published in widely read medical journals including Obesity, the International Journal of Obesity, Obesity Surgery, and the American Journal of Therapeutics. His research papers have been cited as references in multiple professional journals. His commentary on anti-obesity medicines has been published in the journal Circulation, the International Journal of Cardiology, Yonsei Medical Journal, the American Journal of Emergency Medicine, the journal Neurologist, the journal Diabetes, Obesity and Metabolism, and the Journal of the American Pharmacy Association. He has lectured on anti-obesity drugs throughout the United States and in the United Kingdom, Australia, New Zealand, Singapore, Hong Kong, and Seoul.

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