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The Skinny on Prescription Diet Drugs Nancy Rosenberg, Medical Writer Published Publishing Information Published by CBSHealthWatch.com Read an Excerpt The Skinny on Prescription Diet Drugs Use caution when deciding whether or not to use prescription diet aids. What if you could eat moderate amounts of almost anything you wanted and still lose weight? Sound too good to be true? New prescription diet aids promise just that, but sorting the truth from the hype can be quite a challenge. The Costs of Being Overweight "Obesity is now an epidemic," says Arthur Raines, M.D., a physician in Dallas who specializes in weight management. "Studies show that overweight people are less likely get into college, get hired, or get married. They are also more likely to have serious health problems." "People need to understand is that there is no magic pill that can make them lose weight," says Raines. "What prescription diet aids do is make it easier for people to make changes in their lifestyle." There are basically two different approaches to medically supervised weight loss: fat blockers and appetite suppressants. Fat Blockers "Xenical is the only 'fat blocker' on the market today," says Dr. Raines. Xenical (orlistat) works by chemically blocking about one-third of the fat you eat from being digested. The undigested fat cannot be absorbed and is eliminated in bowel movements. The side effects, however, can be unpleasant. Oily bowel movements and even bowel leakage are usually cited, along with bloating and gas. Some patients report oily spotting and an urgent need to go to the bathroom. "The side effects, though unpleasant, need to be put into perspective," says Raines. "Only one-third of patients report having side effects at all, and, in those who do, they usually subside in about two weeks." Appetite Suppressants Appetite suppressants are another avenue for medically supervised weight loss, says Raines. There are several types of appetite suppressants, but all work by sending signals to the brain that the body is not hungry. Some make you feel full, faster. They can only be taken in 12-week cycles, but they can be taken in conjunction with Xenical. When incorporated into a weight-loss program that includes exercise and diet modification, the results are often rapid and dramatic, says Raines. These Are "Risky Drugs" Caroline M. Apovian, MD, is the director of the Nutrition and Weight Management Center at Boston University Medical Center. "Prescription diet medications are risky drugs," says Apovian. "Some can worsen high blood pressure or interact with antidepressants. They should only be prescribed for those with a body mass index over 30, or over 27 for those with arthritis, high blood pressure, or heart disease." (To calculate your body mass index, or BMI, which is a height/weight ratio, log on to www.KnowYourBMI.com.) "In addition, weight-loss agents should only be prescribed in conjunction with diet and exercise in a weight-loss program," says Apovian. Ideally, the program should be long-term and should include the use of support groups, which can help provide emotional support. "Prescription diet aids such as Xenical, when used as a part of a comprehensive weight-loss program, have been found to help to a degree," says Apovian. In trial studies those on a placebo lost approximately 4 percent of their body weight, while those on Xenical lost 6-10 percent. "While it's not a tremendous difference, it is important to remember that a 5-10 percent weight loss can significantly reduce the risks of high blood pressure and heart disease. And the side effects shouldn't be bad if the patient is following a low-calorie, low-fat diet," adds Apovian. You Be the Judge Charvel Simon has had remarkable success with Xenical. At 5'2" and 254 lbs., Simon was desperate. She made an appointment at a weight-loss clinic near her home outside Dallas. Simon was given Xenical. "There were some unpleasant side effects for the first couple of weeks, but I noticed that the side effects were much worse after I had eaten a high-fat meal, so I used the side effects as a gauge to determine what I could eat and what I should avoid. Those unpleasant side effects ended up teaching me how to eat low-fat foods." Simon was gradually able to modify her lifestyle. "I learned how to cook healthy foods, and I began to exercise. Slowly I made changes in my life, and I began to lose the weight." But not everyone is happy with Xenical. Donna Gould is a publicist from New Jersey. "I had about 25 pounds to lose and was having trouble getting started, so I went to a doctor and was given a prescription for Xenical. The side effects were just horrible," says Gould. "The oily bowel movements were just disgusting, and it was a very unnatural feeling. I had gas, cramps, and bloating. I was on it for three weeks, and I lost about 7 pounds, but it was the worst weight-loss experience I've ever had." "They Gave Me Back My Life" The bottom line, says Raines, is that help is available to those who need or want to lose weight. Some self-discipline will be required, though not as much as you may previously have thought. Some, like Simon, have a lot of weight to lose and a lot of living to gain if they are successful. "My weight loss was dramatic," says Simon. She has lost over 100 pounds, and has gone from a size 22 to size 6. "I credit a good doctor who was willing to work with me, a program that taught me how to make some lifestyle changes, and medication that helped me have some self-control. Together, they gave me back my life." Excerpt "Obesity is now an epidemic," says Arthur Raines, M.D., a physician in Dallas who specializes in weight management. "Studies show that overweight people are less likely get into college, get hired, or get married. They are also more likely to have serious health problems." "People need to understand is that there is no magic pill that can make them lose weight," says Raines. "What prescription diet aids do is make it easier for people to make changes in their lifestyle." |
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