Lists of approved and prohibited anti-obesity pills - the whole truth about their effects on the body. Anti-obesity drugs - comparison of modern drugs. Obesity of the 3rd degree, treatment with medications.

Antiobesity drugs are divided into drugs that affect the central nervous system and drugs that act peripherally. They are prescribed based on the level of excess fat mass and the degree of the disease. A nutritionist or endocrinologist refers the patient to a diet, prescribes pills, selects a diet and a set of physical exercises. Despite the fact that the list of possible drugs for weight loss is large, in no case should you self-medicate. Consultation with a doctor is required!

To follow the principle “do no harm!” you need to know what contributed to the appearance of obesity, then you can easily select the right drugs that will force the body to fight this disease.

There are three factors for obesity:

1. A large volume is already present in childhood. The constitution of an obese person is inherited genetically.
2. Extra pounds appear as a result of poor nutrition in everyday life. Representatives of such professions as cooks, bakers, confectioners, beer sellers, etc. are at risk.
3. Obesity is associated with changes in the endocrine system - these are hormonal disorders of the maturation of the reproductive system, menopause, and other endocrine diseases.

You can find out if you have a problem with excess weight by determining your BMI. To do this, divide your weight by your height squared. The norm is 18.5-25. Medicines are prescribed to those whose index exceeds the norm.

There are 3, but in any case, to prescribe treatment, the specialist will first ask you to take a blood biochemistry test for sugar levels, a blood test for thyroid and pituitary hormones. Based on the results of the analysis and the collected data, it will be clear which medicine is indicated for the patient.

• If your mass index ranges from 25 to 30, experts call this the pre-obesity stage. Here you can get by with physical activity and a properly selected diet. Perhaps the doctor will prescribe herbs and vitamins to improve metabolic processes.
• If you have the first degree of obesity, then you observe a BMI in the region of 30-35. Here the doctor prescribes pills that act peripherally, those that act directly on substances entering the body.
• In the second stage of the disease, where the BMI is 35-40, drugs that affect the central nervous system are prescribed.
• The third stage of the disease is usually accompanied by endocrine and hormonal disorders. BMI 40 or higher. Complex therapy is prescribed and concomitant diseases are identified.

It must be remembered that all existing weight loss drugs do not have a prolonged action and are active only while the person is undergoing treatment. If after treatment you return to your old lifestyle - where there was no diet or exercise, then excess body weight will return!

How do weight loss medications work?

Conventionally, drugs are divided into groups, there are three of them:

• Remedies that help reduce food consumption and hunger. Substance – Mazindol, name – Prozac – Fluoxetine, Teronac, Minifage – substance Fenfluramine, Phentermine, etc.

The principle of action is appetite suppression. Simply put, taking pills acts on the hypothalamus (part of the brain), where an impulse is produced that is responsible for appetite and suppresses it. I took a pill and my brain doesn’t think about food! These medications are indicated for people with obesity factors 1 and 2. Before taking it, be sure to consult your doctor; the drugs have contraindications and side effects.

• Medicines that help efficiently expend energy: reduxin, ephedrine, caffeine.

In addition to affecting the centers of the brain where appetite is suppressed, these tablets activate heat exchange in the body, due to which energy is consumed faster. Due to the action of such drugs, fat deposits are actively broken down. In addition, when taking these drugs, serotonin is produced in the brain - the hormone of happiness and dieting is much easier psychologically. The drugs are possible for those from the second factor of obesity. They are issued in pharmacies with a doctor's prescription and have many contraindications and side effects on the body from the central nervous system and the cardiovascular system.

• Tablets that reduce the absorption of substances, such as - substance. It blocks the enzyme lipase, so only one third of the food is absorbed.

The body does not know how to absorb undigested fats, and fewer calories are received. Orlistat causes side effects only from the intestines. But even this safe substance contains a number of contraindications and requires consultation with a doctor! The treatment is suitable for the first group of factors, and the second.

For people from the third group of factors, treatment is prescribed only by a doctor! If this obesity is associated with a disruption of the endocrine system, then the doctor will prescribe tablets that act on the principle of accelerating the processing of sugar in the blood and reducing the deposits and storage of glucose in the liver. When taking Glucophage, the patient is advised not to consume carbohydrates in the diet; physical exercise and insulin therapy are required. This drug is prescribed to patients with diabetes.

Diet pills are contraindicated for children under 16-18 years of age, so for teenagers under this age, as a rule, the doctor will prescribe a balanced diet and exercise. Exceptions will be children and adolescents with diseases of the endocrine system and hormonal imbalance. In these cases, special therapy is indicated with the prescription of other medications.

In pharmacies, the cost of medications for extra pounds reaches three thousand rubles. Which can only confirm your seriousness when purchasing these drugs. Therefore, you should not spend money on medicine if you dream that by drinking a “magic pill” you will immediately get rid of excess body fat without using auxiliary treatment methods, such as the right diet and physical activity.

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Excess adipose tissue is formed for various reasons, and an integrated approach is provided to normalize weight. In addition to following a diet and maintaining an active lifestyle, doctors prescribe certain medications that help reduce weight and help maintain it at a normal level. By taking anti-obesity medication, the patient gradually gets rid of extra pounds due to its effect on appetite, metabolic processes and calorie absorption. To avoid adverse reactions, you should refrain from self-medication.

With excessive body weight, it is often impossible to cope without the help of specialists, especially when it comes to the use of medications for obesity. Their selection should be done by an endocrinologist, since any means that promote weight loss, if used incorrectly, can cause undesirable effects.

If you need to normalize your weight, the following medications will help:

• central action (anorectics and adrenergic agonists);
• peripheral action;
• hormonal agents.

It is also possible to prescribe psychotropic medications, diuretics and laxatives, the use of which must be monitored by the attending physician.

How do diet pills work?

Tablets help to cope with excess weight, but without a complete correction of the nutritional diet and lifestyle changes that caused the extra pounds to appear, you should not count on long-term results. The recommendation is especially relevant after the end of the treatment course.

The use of anti-obesity pills leads to:

• suppressing appetite by affecting the satiety center in the brain;
• accelerating metabolism and increasing energy consumption;
• blocking the processes of fat breakdown and absorption in the intestines.

If the pathology is caused by a hormonal imbalance, you will need to take appropriate medications. Laxatives are needed to relieve constipation, which is often found in obesity, and diuretics remove excess fluid.

Medicines

Since the problem of excessive obesity does not lose its relevance, scientists do not stop working on creating new, more effective drugs. Many anti-obesity drugs can cause serious side effects if used incorrectly. In addition, one should not discount the presence of contraindications.

Pharmacology offers a choice of various groups of drugs with which body weight can be reduced to normal levels.

The drugs can be both cheap and effective. The only thing is that therapy cannot be carried out without the knowledge of the doctor. To avoid consequences, obesity must be treated under the supervision of a specialist.

For weight loss

A representative of this group can be called any drug that reduces body weight. The difference between drugs for the treatment of obesity lies in how exactly they affect the processes occurring in the body. For example, some remedies help suppress hunger, while others prevent fats from being absorbed as much as before.

Also, do not forget about dietary supplements, which are not drugs, but when used correctly, accelerate weight loss. Despite the fact that anti-obesity pills, called dietary supplements, are available without prescriptions, you should refrain from thoughtlessly using the drugs.

To reduce appetite

Anorexigenic drugs (anorectics) suppress/reduce appetite. In another way, they are called centrally acting drugs. Thanks to them, fat accumulation decreases.

They are often prescribed to patients with nutritional obesity, which develops against the background of various diseases and provokes disruptions in the cardiovascular system. Also, with the help of anorectics, obesity caused by hormonal disorders is eliminated.

The hypothalamus is responsible for appetite, since the satiety center is located in its medial zone, and the hunger center is located in the medial zone.

Anorexics block the desire to eat food, so even a small portion can make a person feel full without gaining extra pounds.

Depending on the mechanism of action, anorectics are:

• adrenaline-like (promote activation of adrenaline-sensitive receptors and the emergence of a state of euphoria);
• serotonin-like (increase the amount of serotonin).

However, caution must be exercised with these drugs, as they provoke many adverse reactions and seriously harm the body.

Medicines are dispensed in pharmacies by prescription. The list of anorectics is quite large, and among them there are well-known names: Mazindol, Fluoxetine, Fluvoxamine, Reduxin.

Metabolism accelerators

There is a direct relationship between metabolism and weight gain. And in order to reduce the amount of body fat, first of all, it is necessary to properly organize a nutritious diet and increase physical activity.

Also, for weight loss in obesity, drugs that have a positive effect on metabolism are prescribed. They are prescribed in cases where diet therapy and physical education are ineffective.

The list of anti-obesity pills that eliminate the problem of slow metabolism includes Glucophage, Liraglutide, Lindaxa.

Fat and carbohydrate blockers

We are talking about medications that suppress the action of gastrointestinal lipases that break down fats and carbohydrates. This reduces the absorption of substances by at least 30%, which prevents the formation of adipose tissue. For those suffering from obesity, Xenical and Orlistat are most often prescribed.

However, the use of tablets often results in stool disorders, deterioration of the liver and pancreas.

Which medicine is the most effective?

Obese patients always have questions about which drugs should be preferred. Therefore, it is worth naming the best remedies that are usually used against excess weight.

Orlistat

A good remedy with a peripheral mechanism of action. The tablets prevent the digestion and absorption of fats, and also reduce cholesterol levels.

Mode of application:

• 1 tablet three times a day;
• before or after meals, a maximum of one hour.

While using the drug, fecal incontinence may occur.

Sibutramine

Treated as anorexigenic drugs. It is usually prescribed when the body mass index is 27-30, while obesity is accompanied by the development of other diseases.

Taking Sibutramine is prohibited for patients with:

• brain tumors;
• mental disorders;
• liver/renal disorders;
• disruptions in heart function;
• endocrine pathologies;
• anorexia/bulimia.

Sibutramine should not be combined with other anti-obesity medications.

Rimonabant

Helps suppress appetite. It is recommended to take 1 tablet per day one hour before meals or 3 hours after meals. The duration of the course is one month.

In the list of contraindications:

• severe form of renal or hepatic pathologies;
• pregnancy;
• children under 18 years of age;
• glucose-galactose malabsorption syndrome.

Rimonabant is suitable for the treatment of advanced obesity.

Metformin

Taking the medicine leads to normalization of glucose levels, stabilization of fat metabolism and reduction of cholesterol levels. If you are obese, during the first 10 days Metformin should be taken 1-2 tablets per day. In the future, the maximum dosage may be 6 tablets per day.

Metformin is appropriate for type 2 diabetes mellitus, accompanied by excess weight gain, if diet therapy has been ineffective.

Exenatide

This is a new drug for the treatment of patients with type 2 diabetes and obesity. Its benefit is to slow down the evacuation of food from the stomach and reduce appetite. Available in the form of a solution for injection. Injections are given in the forearm, stomach or thigh area.

Dosages:

• initially – 5 mcg twice a day before meals;
• after a month - 10 mcg 2 times a day.

Injections are contraindicated for patients with type 1 diabetes, renal failure, and severe gastrointestinal diseases. Exenatide is also prohibited for pregnant, lactating and patients under 18 years of age.

Senade

Laxative tablets that help relieve constipation. If bowel movements are normal, it is not advisable to use Senade. The medicine is taken before dinner, 1 tablet. If there is no effect, the dosage can be increased.

To avoid health problems, you should not take the medicine for more than 1 week.

Pramlintide

It is used to suppress the feeling of hunger, as a result of which it is possible to reduce weight. Release form: injection. May cause nausea, vomiting, headaches, hypoglycemia.

Glucobay

Blocks carbohydrates and prevents complex sugars from being absorbed in the intestines. The daily dosage, which is 300 mg, is divided into 3 doses. If the desired results are not observed within 2-3 months, the dose of the drug is increased to 600 mg per day.

Glucobay is prohibited for chronic kidney diseases and gastrointestinal disorders.

Isolipane

By reducing appetite, it helps to get rid of excess fat accumulation, without the risk of developing mental disorders and addiction to the medicine. The drug is taken twice a day, one capsule at a time, for 3 months.

Use of dietary supplements

This group is represented, in particular, by supplements containing L-carnitine (amino acid), which are mainly produced in tablet form.

The benefits of the substance for obesity are:

• improving metabolic processes;
• burning excess fat reserves with subsequent release of energy;
• lowering cholesterol;
• reducing the feeling of fatigue;
• increasing endurance - physical and mental.

Effective fat burners are great for those who set aside time for active training. For weight loss, the dietary supplement Turboslim is recommended, which not only helps reduce body weight, but also has a positive effect on the immune and nervous systems, and also normalizes the functioning of the gastrointestinal tract.

Most dietary supplements contain natural ingredients and can be purchased without a prescription. Among them there are quite inexpensive options. However, you should be careful, since dietary supplements do not have medicinal properties, but are only an addition to the main course.

Homeopathy also comes to the aid of obese people. More than 200 drugs are known that can affect excess weight.

For extra pounds they usually take:

• Curdlipid granules (a homeopathic medicine that regulates lipid metabolism);
• Fucus Plus (anorectic, with the help of which it is possible to regulate weight in cases of obesity of 1-3 degrees).

Zlata gel is popular among women, the action of which is aimed at breaking down fat deposits and eliminating the manifestations of cellulite.

Side effects

Even the most effective drugs, when used incorrectly, can provoke many adverse reactions. The consequences depend on the use of a particular drug, since each drug affects the body differently.

In general, patients experience rapid heartbeat, increased blood pressure, stool disorders, excessive anxiety, abdominal pain, severe allergic manifestations, nausea and vomiting, and tremors of the extremities.

When dietary restrictions and physical activity do not produce the desired weight loss, the doctor prescribes medications that can suppress hunger, slow down the absorption of fats and carbohydrates, and also speed up metabolic processes. Self-use of the above-mentioned remedies increases the risk of deterioration in well-being.

Before you start reading this article, it’s worth clarifying one little-known nuance (or few people want to believe in it). To date, there are simply no effective drugs to treat obesity. It is impossible to take a few pills and lose weight today. You didn’t accumulate the fat deposits that you now have on your waist, hips and other places in one day? Therefore, when using anti-obesity medications, you need to understand that you will not lose a large amount of weight.

Also, it is worth noting that you should not think that anti-obesity medications purchased on Internet sites and from unverified sellers can cause serious harm to human health.

Important!

You should not believe that anti-obesity medications will relieve you of excess weight in a day, week or even month. Fat deposits on your body have accumulated for more than one day, therefore, if it were so easy to get rid of them, then everyone around you would have been thin and slender for a long time.

Anti-obesity medications purchased from unverified manufacturers can cause irreparable harm to a person.

Obesity is curable!

If we talk about the means of official medicine, then the treatment methods are:

• A diet based on healthy and proper nutrition;
• Constant physical activity taking into account initial body weight;
• In especially severe cases, surgical intervention is the only option.

Traditional medicine recognizes the use of anti-obesity medications solely as a complement to the above methods.

Is there a magic pill for obesity?

There is no magic pill for obesity. Of course, scientists all over the world are still researching and searching for products that can burn fat in a matter of minutes. But modern technology has not reached this point.

Dinitrophenol

If you are offered the use of dinitrophenol as a means of losing weight, then immediately say a categorical “no”, despite the fact that this drug is indeed very effective.

In the case of constant intake of dinitrophenol, a person experiences disruption of cellular respiration. Irreversible disorders occur in the human body, ranging from increased temperature, pressure, and shortness of breath. In fact, the effect of the drug is based on poisoning the body, due to which, in fact, rapid decomposition of fatty deposits occurs.

Effectively suppress appetite

Despite the fact that most anti-obesity drugs have a large number of side effects, the demand for them does not subside. People suffering from excess body weight are ready to go to any lengths just to get rid of these hated kilograms.

Now the most popular are anorectics - drugs that block a person’s appetite and completely suppress energy expenditure. We list the common remedies that promise to reduce a person’s appetite from the first tablet:

• Sibutramine Meridia is a drug that interacts with active substances in the brain. As a result, a signal of saturation is sent from the brain to the stomach and the person naturally does not want to eat.
• Xenical– a remedy that reduces or even suppresses the absorption of fat (as well as nutrients) from food consumed by a person.
• Hormonal agents, stopping or significantly slowing down metabolism in internal organs and tissues. As a rule, these are hormones, somatotropin and thyroid gland.

Note!

The only more or less harmless drugs from the list above are Xenical and Meridia. All others have a number of severe side effects.

To get rid of obesity, you need to completely reconsider your previous diet and, at a minimum, resort to diet and exercise. Thus, you are guaranteed to be able to lose excess weight and not cause harm to your internal organs.

Medicines for weight loss affect the feeling of hunger, stimulate metabolism (especially the breakdown of fat), and inhibit the absorption of calories from food. They are prescribed if traditional methods - diet and physical activity - have not yielded results, and obesity is dangerous for the state of the cardiovascular, endocrine system, and reproductive function.

Since most drugs either have low effectiveness (weight loss up to 3 - 5%), or are toxic to the body, treatment with medications is recommended only in severe cases.

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History of the fight against obesity with drugs

The treatment of obesity was started by the Greek healer Soranus of Ephesus. In the second century AD, he used heat, massage and gymnastics for this. This is exactly how therapy was carried out until the 30s of the last century.

New, at that time, methods of weight loss were associated with the use of drugs based on thyroid hormone. Their popularity quickly became high, but at the same time sleep was disturbed, blood pressure increased, and symptoms of thyrotoxicosis appeared.

The next stage was the use of drugs from the amphetamine group. They kept you alert throughout the day and suppressed your appetite. Together with them, to enhance the effect and reduce undesirable results, the following were used:

• thyroid-stimulating hormones,
• , laxatives,
• cardiac glycosides,
• barbiturates (to make it easier to fall asleep).

Naturally, such a set could not be harmless. The large percentage of deaths after “complex” therapy led to the ban on the use of amphetamine in 1979.

Fenfluramine became the next hope for obese patients; it guaranteed a loss of 10% of body weight. Its derivative Redux has been registered, but clinical experience has proven that a third of patients developed deformities of the heart valves. Therefore, it was withdrawn from sale. Due to increased blood pressure and a high risk of strokes, Ephedra (ephedrine) was banned in 2004.

Today, not all countries agree to use drugs containing sibutramine (Meridia,) for treatment. And the food supplements Lida, Zhuidemen and others contained tens of times more of it than in the drug. Therefore, their circulation has been stopped.

When are medications prescribed for treatment?

Due to the risk of complications, medications for weight loss are used strictly for the following indications:

• BMI - body mass index (weight divided by the square of height in meters) more than 30 kg/m2;

• BMI exceeds 27 kg/m2, but there is a predisposition to type 2 diabetes, increased blood cholesterol, blood pressure above 140/90 mm Hg. Art.

Intensive treatment with medications, diet, and physical activity may be prescribed in preparation for cardiac surgery to reduce the workload on the heart after surgery.

Pregnant women and children should not take weight loss pills. In the presence of diseases of the cardiovascular system and disorders of the central nervous system, sibutramine is prescribed with caution. It is contraindicated in cases of impaired liver and kidney function, hypertension, thyrotoxicosis, prostate adenoma, glaucoma, pheochromocytoma.

Medicines can only be taken if, following the diet and recommended physical activity, the weight loss has been less than 5 kg in three months. It is strictly forbidden to independently treat obesity; the course of treatment must include non-drug methods.

Mechanism of action

The main points of application of drugs for weight loss are:

• inhibition of the activity of the hunger center in the brain,
• fat burning,
• an obstacle to the absorption of fats and carbohydrates from the intestines.

Appetite suppression is carried out by blocking the reuptake of the neurotransmitter (signal conductor) of the nervous system - serotonin. Antidepressants (Prozac) and phenylfluramine (Minifage) act on this principle.

The second method is associated with activation of the sympathetic system, the release of the hormone adrenaline by the adrenal glands. Drugs with a purely adrenaline effect are prohibited due to the large number of side effects.

The breakdown of fat with the help of medications involves its use for energy production. This type of drug is popular among athletes to give muscles relief. With a sedentary lifestyle, the effect is lost. Fat burners speed up metabolic processes and heat production by the body. These include: caffeine and omega-3 acids.

One of the ways to reduce the intake of carbohydrates, as the main source of calories, is to inhibit their breakdown in the intestines and excretion from the body. Glucobay has these properties. Its negative characteristic is increased gas formation and diarrhea. Xenical has exactly the same mechanism of action and side effects, but only in relation to fats.

Selection of medications

Obesity is not always based on banal overeating, therefore, to determine its cause and the correct prescription of treatment, an examination by an endocrinologist is required.

Hormonal for obesity in women and men

The reasons for weight gain in women may be hormonal imbalances. Low estrogen levels (menopause) and high androgen levels (ovarian or adrenal gland diseases) lead to obesity. For treatment, replacement therapy with drugs is used - Yarina, Diane, Jess, Median. They belong to contraceptives and losing weight can only be a side (desirable) effect of normalizing the balance of sex hormones.

In men, excess weight occurs when male sex hormones decrease. Low levels of testosterone in the blood stimulate fat deposition.

In this condition, Testosterone propionate itself and its derivatives – Omnadren, Androgel – can be prescribed.

Regardless of gender, weight gain can be affected by:

• decreased thyroid function. L-Thyroxine is prescribed for treatment.
• excess insulin in the blood. Characteristic of type 2 diabetes. An effective tool is ().
• increased cortisol levels. Occurs with long-term treatment with hormones (prednisolone) or chronic nervous tension. For therapy, growth hormone is used, as well as ascorbic acid and amino acids.

It should be borne in mind that without a complete determination of the hormone levels in the blood, treatment with these drugs will not only be ineffective, but, on the contrary, may contribute to weight gain.

Drugs for the treatment of 1st, 2nd, 3rd degree obesity

Among the drugs registered in Russia for weight loss, sibutramine can be noted. It is represented by such drugs as Lindaxa, Goldline, Slimia. Sibutramine inhibits the reuptake of nerve impulse transmitters.

Dopamine, serotonin and norepinephrine, remaining in nerve synapses, reduce the need for food intake and activate the body's heat production. An important feature is that with a decrease in body weight, fat metabolism is normalized and the ratio between lipoproteins is restored.

The second drug prescribed for therapy is orlistat. It binds to an enzyme that breaks down fats in the intestines. Lipase loses its activity and triglycerides cannot enter the blood. This significantly reduces the calorie content of food. The original drug containing orlistat is Xenical; in addition to it, Alli, Xenalten, Orlimax have a similar composition.

New achievements

The result of the latest scientific developments are the drugs Acomplia, Bayeta, Symlin.

Sports and a beautiful figure

To get results from sports, you need to know the rules of successful training for weight loss:

• Your heart rate should be between 60 and 80 percent of your maximum (220 minus your age).
• The onset of noticeable fat burning begins at 30-40 minutes.
• For the first lessons, walking at an average pace is best.
• The effect of running or walking increases if you change the pace throughout the session.
• The number of classes per week cannot be less than 4 times.
• The load should be constantly increased to a comfortable state.

Drug weight loss is used only if there is no result from diet and physical activity. The drugs are indicated for BMI exceeding 30 kg/m2, or lower, but with associated risk factors.

Centrally acting drugs reduce hunger and improve the metabolism of fats and carbohydrates. Their side effect is excessive stimulation of the nervous system and heart. There are no contraindications for use of fat binding blockers. An unpleasant consequence may be intestinal discomfort.

Useful video

Watch this video about weight loss medications:

Excessive accumulation of fat cells disrupts metabolic processes in the human body. Changes in vital signs first lead to overweight and then to the development of obesity. Most overweight people are advised to eat a low-calorie diet and exercise. But sometimes this is not enough to achieve weight loss and maintain the achieved results. In most cases, people who have lost weight on a diet realize with bitterness that after several weeks or months of their usual diet, they have gained extra pounds again. To truly cope with obesity, you need to understand when extra pounds became a disease, and what to do to regain your figure.

Why does obesity develop?

We will not discuss the reasons for gaining excess weight, there are a lot of them. But everyone who really wants to get rid of the hated kilograms must admit to themselves the following:

• It is completely pointless to justify your excess weight with a “wide” bone, and to explain nightly raids into the kitchen as stress or depression.
• Overweight and obesity are diagnosed using body mass index (BMI). The indicator can be calculated using an online calculator and checked against the norm table (there are tables by age and gender).
• Obesity is a chronic disease that additionally provokes a host of other ailments (stomach and heart diseases, atherosclerosis, diabetes, etc.).
• Diet, even long-term, and physical activity, at best, provide only a temporary reduction in body weight. To maintain the achieved weight levels, nutritional adjustments and physical activity should become a principle of life, and not a temporary attitude.
• The goal of treatment is not only to reduce weight, but also to at least stop the progression of diseases that have already appeared due to excess weight.
• You shouldn’t assume that a “magic” anti-obesity pill will give you back your beautiful figure in an instant. Most of the newest medications for treating obesity usually lead to a loss of only 5-10% of the initial weight. In this case, drug treatment continues for several months, and sometimes years.
• No one canceled diet and physical activity. Only 3 rules will help you get rid of obesity and maintain weight at the achieved “heights”: a low-calorie diet and no breakdowns, daily exercise and only then taking special medications.
• Anti-obesity medications, like any other medications for obesity, have contraindications and side effects. The use of anti-obesity pills should be approved by a qualified physician.

Important! Drug therapy for overweight and obesity is advisable if the patient strictly adhered to the regimen (diet and physical activity) for 6 months and was unable to reduce his weight, initially BMI > 30 kg/m 2 or BMI > 27 kg/m 2 , but concomitant diseases were diagnosed.

Why do the hated kilograms come back so quickly? It's simple. During exhausting diets or training to the point of complete powerlessness, the body feels a “threat” and experiences stress. In such a situation, survival processes are launched, the body accumulates energy in the form of fat cells. Of course, breakdowns are not excluded: someone who has lost weight again begins to eat to their fill, and the sofa becomes their favorite place. Do you feel like you are boiling with resentment or somewhere deep in your soul do you admit to yourself that all of the above is the pure truth? If, after all, the recognition of reality has taken place, then you are ready to familiarize yourself with very serious information regarding the effectiveness of modern drugs for obesity.

Anti-obesity drugs: research, effectiveness, side effects

In recent years, serious changes have occurred in the treatment of obesity, and this is not counting all kinds of dietary supplements, which in our country are not recognized as drugs and often contain very harmful compounds. So, there are 5 main medications used in the world that are approved by the FDA (American Food and Drug Administration). These are orlistat, lorcaserin, liraglutide, combinations of buproprion - naltrexone and phentermine - topiramate. All of these drugs affect different processes that regulate appetite, energy expenditure and fat absorption. All of them, of course, have side effects. And most importantly, they have different levels of effectiveness, proven by many studies. These medications have one thing in common: they are suitable for long-term and, if necessary, permanent use. For short-term use, phentermine and diethylpropion may be prescribed.

Orlistat

Orlistat (Xenical) has been used to treat obesity since 1999 and has been fairly well studied. By slowing down the synthesis of the lipase enzyme in the gastrointestinal tract, it reduces the absorption of fat from the intestines and thereby promotes weight loss. A regimen of orlistat 120 mg three times a day reduces the absorption of fat from the intestine by 30%, but this treatment must be prescribed by a doctor. It is safe to take 60 mg of orlistat (Alli) on your own. This dose can maintain weight at the level achieved through diet and exercise.

To evaluate the effectiveness of Xenical, including in patients with diabetes, a large 4-year study, XENDOS, was conducted.

* In this and subsequent studies, patients in the placebo groups strictly followed a low-calorie diet, jogged daily, did gymnastic exercises, or worked out in gyms.

Important! In obese patients, orlistat reduces the risk of developing diabetes by 37.3%.

Phentermine - topiramate

The combination drug Knexa is used for long-term treatment of obesity (BMI ≥ 30 kg/m 2 ) or overweight (BMI ≥ 27 kg/m 2 ) with concomitant pathology, one or more. The psychostimulant phentermine excites the sympathetic nervous system: the pupils and bronchi dilate, the a/d and heart rate increase, and breathing quickens. This releases the “stress” hormone norepinephrine and the “happiness and weight loss” hormone dopamine. On a norepinephrine-dopamine background, the patient begins to eat significantly less, and the amount of energy required for the functioning of internal organs when the body is at rest increases noticeably.

Topiramate is familiar to people suffering from epilepsy and migraine attacks. In the treatment of obesity, the property of topiramate is used to significantly reduce appetite, thereby achieving a reduction in calorie intake. The effect of the combination of phentermine and topiramate at different dosages was evaluated in the large-scale CONQUER study, which lasted 52 weeks. The trial involved 2,487 people suffering from stage II obesity with concomitant pathologies (hyperlipidemia, diabetes and prediabetes, hypertension).

Lorcaserin

Lorcaserin is a relatively new drug; it was approved for use in the United States in 2012. The drug belongs to the group of selective serotonergic agonists (specific antidepressants). Lorcaserin blocks the feeling of hunger and allows you to feel full with less food eaten. However, the drug is fundamentally different from related medications fenfluramine and dexfenfluramine. The latter, along with weight loss, sharply increase the risk of heart valve pathology, while lorcaserin does not have such a side effect. For long-term treatment of excess weight, lorcaserin is taken 10 mg twice a day.

The effectiveness of lorcaserin was studied in the BLOOM study (3182 people). Over the 1st year, subjects in the placebo group decreased their weight by an average of 3.6%. In the group taking lorcaserin, 47% of people experienced a weight loss of more than 5%; in the placebo group, only 20.5% of participants achieved this result. The subjects who managed to lose more than 5% of the initial weight continued to take the drug at the same dose for another 1 year. Their result in comparison with the placebo group: better and more stable weight indicators, positive dynamics in heart rate, blood pressure, glycosylated hemoglobin HbAlc, triglycerides and total cholesterol. The expanded BLOOM-DM study (participants with obesity and type 2 diabetes took lorcaserin at a dose of 10 mg 2 times / day) recorded that in 37.5% of subjects after 52 weeks. weight decreased by more than 5%, and HbAlc by 0.9%. At the same time, in the placebo group, the rates of weight loss and reduction in glycosylated hemoglobin were half as much.

Bupropion - naltrexone (Contrav)

Another new anti-obesity drug, Contrav, includes the atypical antidepressant bupropion and naltrexone, used for alcohol/drug addiction. In case of obesity, Contrav inhibits the process of obtaining “reward” (pleasure) after eating, for example, sweets.

Contrave was tested in four large studies with different baseline parameters (obese participants only, + diabetes, + other comorbidities). To achieve maximum accuracy of the studies, patients, a total of 4536 people, were randomly assigned to treatment and placebo groups.

Liraglutide

The drug liraglutide has been approved for sale since 2014. The study of its effectiveness involved obese patients with and without type 2 diabetes. Loraglutide confidently relieved participants of false feelings of hunger and the desire to eat huge portions of food. Slowing the digestion of food in the stomach led to a longer feeling of fullness. Surprisingly, with a decrease in energy expenditure, patients still lost weight, on average 6-8% of the initial values, while in the placebo group the rate of weight loss was approximately 5% less. During the study period, 63.5% of participants in the drug group and 26.6% of those in the placebo group lost more than 5% of their body weight. At the same time, a decrease in blood pressure, triglycerides, and cholesterol was noted in the treatment group.

Phentermine and diethylpropion

Phentermine is a psychostimulant that has been used for a very long time to treat obesity. A large-scale and quite comprehensive study in terms of the information obtained was conducted in 1968. The nature of the effect on the body and the side effects of this drug are similar to amphetamine: increased blood pressure, dry mouth, rapid pulse, insomnia and constipation. Diethylpropion also works. Its distinctive feature is a sharp decrease in appetite. The disadvantage of treatment with phentermine and diethylpropion is that these medications are designed exclusively for a short-term course. With long-term use, these medications cause serious side effects: euphoria, impotence, episodes of psychosis (strange behavior, detachment from reality, non-existent voices, etc.).

conclusions

What medications should I take for obesity? So, medicine offers 5 medications for permanent or long-term treatment of obesity and 2 medications for short courses. The conducted research allows us to draw the following conclusions:

• The most important study results may not be completely accurate - patients who lost more than 5-10% of their initial weight throughout the study may fall into the category of participants who lost their weight by 5% every 3 months.
• The combination of phentermine - topiramate, in comparison with other drugs, showed the highest percentage of weight loss relative to total body weight. However, its use is limited by many contraindications; the drug produces serious side effects.
• The combination of bupropion-naltrexone and the drug lorcaserin causes less negative side effects than other anti-obesity drugs. However, their lower effectiveness and the likelihood of unwanted interactions with other medications used in psychiatry limit the range of use of these drugs.
• The choice of therapeutic drug is determined by the nature and severity of the concomitant pathology, the danger of negative consequences for a particular person.
• Taking into account the fact that treatment is usually quite lengthy, and some medications are expensive, when choosing a treatment, you need to calculate your financial capabilities.