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Weight loss help from the pharmacy?

By Jason Poquette, BPharm, R.Ph

So how are those New Year’s Resolutions coming along?  If you are like millions of other Americans you have included some sort of weight loss goal on your list.  This isn’t surprising.  According to statistics from the National Institute of Health, nearly two-thirds of adults are overweight and one-third qualify as obese based on BMI (body mass index). This results in numerous health-related concerns like type 2 diabetes, heart disease and high blood pressure.

Could a trip to the local pharmacy offer any help? 

Currently there are no shortage of options for patients and physicians to consider when it comes to losing weight.  For example, there is Xenical® (orlistat) which works by blocking some of the fat from your food, preventing it from being absorbed.  There is Qsymia® (phentermine/topiramate) which works by making you feel more full and curbing the appetite.  Other prescription products include names such as Belviq® (lorcaserin), Contrave® (naltrexone/bupropion) and Lomaira® (phentermine). 

But nearly all these options have some drawbacks and limits.  Most are only appropriate for patients who are truly obese, meaning they have a BMI over 30. They all have potential side effects which must be considered.  Finally, none of them produce miraculous results.  When compared to placebo, studies indicate they may improve weight loss by anywhere from 8-20 pounds over the course of a year, depending on the product.

The typical pharmacy also contains dozens of shelves of OTC products and supplements which claim to help you lose weight and look great. Reading through the ingredient list will reveal names like guar gum, green tea extract, CLA (conjugated linoleic acid), chromium, chitosan, bitter orange and others.  Then there are the drinks and powders and meal replacement bars.  If all that seems overwhelming, it should, because it is.  But while you can find a stray study to support the benefit of virtually any ingredient, there are usually just as many that show these ingredients have only modest, if any, real benefits.

So what is a patient supposed to do?

First, I remind patients that weight gain and being overweight is a highly individualized problem. The reason you weigh too much may be very different from the reason someone else does.  There can be medical causes, medication-related reason and even genetic issues involved.  This is why trying to find a single solution that works for every patient is impossible.

Second, since our causes for weight gain are different, we also should expect different results. Studies have shown that similar patients may respond very differently to the very same diets.  Therefore, don’t be discouraged if it takes you longer to lose weight than others.  And try not to be that “expert” that tells all your friends about the trick you have found that works for everyone.  It doesn’t.

Third, most of us could stand to get some more regular exercise and limit the amount of sugar, carbs and processed foods that we eat. The fact is that some sensible form of calorie reduction and increase in exercise would help.  Choose a form of exercise you will enjoy, and make your dietary changes realistic (i.e. don’t commit to never eating a piece of cake again).

Fourth, talk to your doctor or pharmacist about medication and supplement options. While we don’t turn to them as a magic bullet, and some are definitely inappropriate for certain patients, nevertheless “to everything there is a season” and there are times when they may be useful.

I’m a big fan of resolutions, and I hope you stick to yours.  So in the words of Benjamin Franklin, “be at war with your vices, at peace with your neighbors, and let every new year find you a better man.”