Diet Pills: Who Can Benefit, Side Effects of Diet Pills | Health

If millions of people in this world wanted one thing, it would be a weight loss pill, and for decades scientists have been trying to crack the code of obesity, but success has eluded them at every turn. Most people who need to lose weight go through very difficult and demotivating journeys where diet and lifestyle modification alone usually fall short as a treatment option.

Most people do well when they are on the program, but it is not possible to diet forever. At the other end of the spectrum, we have the option of bariatric surgery, but not everyone is eligible for obesity surgery.

As per Obesity and Metabolic Surgery Society of India (OSSI) guidelines, a person with BMI 35 kg/m2 without any co-morbidities or a person with BMI 30 kg/m2 with any two co-morbidities such as diabetes, hypertension, sleep apnea etc. can be considered for operation. There is still a huge treatment gap when it comes to people who fall into the categories of obesity stage 1 or 2.

In an interview with HT Lifestyle, Dr. Aparna Govil Bhasker, bariatric and laparoscopic surgeon at Saifee, Apollo Spectra, Namaha and Currae Hospitals in Mumbai, explained, “Lifestyle and dietary interventions most often fail to meet patient and physician expectations regarding weight. loss targets. Eight out of ten people are said to need some additional intervention for significant weight loss and weight maintenance. Until recently, we had only one drug in India that was approved for weight loss – Orlistat. Years of experience have shown that orlistat has only modest weight loss results and has not been very effective for the Indian population.”

According to Dr Aparna Govil Bhasker, research on weight loss drugs has gained momentum in the last few years. There are many weight loss medications that have been approved by the FDA and several are in the pipeline. Some of the FDA approved drugs are listed below:

● Orlistat

● Phentermine with Topiramate – commonly known as “Qsymia”

● Naltrexone with bupropion – commonly known as “Contrave”

● Liraglutide – commonly known as ‘Victoza’

● Semaglutide – 2.4mg commonly known as “Ozempic or WeGovy”

Dr. Aparna Govil Bhasker pointed out that of these drugs, orlistat and liraglutide are currently approved as weight loss drugs for use in India. Speaking about the results of these weight loss drugs, she revealed: “The current range of weight loss drugs can lead to an overall weight loss of 5-10% when used in combination with diet and lifestyle modification. A 10% loss of total body weight is quite effective for improving metabolic health in terms of better control of diabetes, hypertension, dyslipidemia, etc., which may be associated with obesity. A loss of up to 10% in total body weight is also thought to be beneficial for diabetes-related endpoints and help delay related complications in the future.”

Sharing information about who can benefit from weight loss drugs, the health expert said: “People who are overweight and obese may benefit from weight loss drugs in conjunction with diet and lifestyle modification. However, all weight loss drugs are prescription drugs and self-medication should be avoided. These medications can also be used to help patients regain weight after several years of bariatric surgery. They can be used for patients who are medically ineligible for bariatric surgery.”

She added: “We need to remember that weight loss drugs are not a cure for obesity, but help to keep it under control. Every patient reacts to medication differently and there is a high probability of weight gain again after stopping the medication. That’s why it’s extremely important to adopt a healthy lifestyle that can help maintain weight after stopping the medication.”

According to Dr Aparna Govil Bhasker, the side effects of weight loss drugs are as follows:

● Orlistat – It leads to weight loss by causing malabsorption of fat. It can lead to bothersome gastrointestinal side effects such as gas and loose stools.

● Bupropion-naltrexone – This drug carries a warning about the risk of suicide. It can also lead to high blood pressure, nausea, headache and constipation. It is not currently approved for weight loss in India.

● liraglutide/semaglutide – In the first days, it can lead to nausea, vomiting and other gastrointestinal side effects.

● Phentermine-Topiramate – Phentermine has the potential to be abused because it acts like an amphetamine. It can lead to increased heart rate and blood pressure, insomnia, constipation and nervousness. Topiramate may increase the risk of birth defects.

As the incidence of obesity continues to rise worldwide, Dr Aparna Govil Bhasker said, “Research efforts to defeat obesity have also increased manifold. Some promising drugs are currently being developed. Tirzepatid and Cagri-sema are a couple of weight loss drugs in the pipeline that will be more effective than the current line and hopefully provide some relief from the scourge of obesity. However, only time will tell if these drugs will stand the test of time.”

She concluded: “Obesity is a complex and chronic disease. A multimodal approach is needed for treatment to be effective. Treatment must be tailored to the individual patient, and various variations and combinations of diet, lifestyle modification, pharmacotherapy, and bariatric/metabolic surgery may be necessary based on the patient’s clinical profile. Newer drugs are promising and will play an important role in the treatment of obesity.

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