Medications, both over-the-counter and by prescriptionIt is very important that you discuss any and all medications you are taking with your physician.
Medications for treatment of obesity are classified as catecholaminergic or serotonergic. The categories refer to the presumed mechanism of action (via catecholamine or serotonin receptors).
Catecholaminergic medications include amphetamines (with high abuse potential), the nonamphetamine appetite suppressants (phentermine, diethylpropion, and mazindol), and the over-the-counter medication phenylpropanolamine.
Two serotonergic appetite medications, fenfluramine and dexfenfluramine, were withdrawn from the market in September 1997 over concern about side effects. Individuals who have taken either should be evaluated by a physician for possible cardiac side effects.
Although SSRI (serotonin-specific reuptake inhibitors) antidepressants (e.g., sertraline and fluoxetine) have been discussed, studies have not confirmed their effectiveness for weight loss, and they are not approved by the FDA (Food and Drug Administration) for weight loss.
Phentermine remains available, but is approved only for short-term use. Combining SSRIs and phentermine is not approved by the FDA and has been discouraged to date due to ongoing concerns about potential cardiac side effects.
A new medication, sibutramine (Meridia), blocks the uptake of both serotonin and norepinephrine.
Dangers Of Phenypropanolamine
Phenylpropanolamine (PPA), an "amphetamine-like" substance, is one of two ingredients (the other is benzocaine) in the popular-selling over-the-counter diet pills. This has become the focal point of the $300 million diet-pill market dominated by two heavily-promoted brands, Dexatrim and Acutrim.
The FDA requires warning labels, stating that people with hypertension, heart disease, diabetes or thyroid disease, should avoid the drug.
There are conflicting opinions about the risks of PPA in healthy people, with some studies indicating that it can cause those with "normal" blood pressure to experience hypertensive effects.
PPA, both in diet and cold medications, can interact with certain drugs used to treat high blood pressure and depression and cause a potentially life-threatening hypertensive crisis. There are reports of amphetamine-like central nervous system reactions to PPA, including tremor, restlessness, dizziness, anxiety, agitation, hallucinations, and seizures.
Although surgery is the last resort for the treatment of obesity, more than 100,000 patients have chosen to do so. Consensus recommendations are to limit surgical therapies to patients with a Body Mass Index (BMI) greater than 40. (BMI is calculated by dividing the measured body weight in kilograms by the height in meters squared. The normal BMI is 20-25 kilograms per meters squared.)
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What Questions to ask Your Doctor About Weight Management Drugs?
What are the components of a successful weight loss program?What are reasonable goals for weight loss for me?
What is behavior modification?
What medications for weight loss are available?
What are the side effects?
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