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Weight loss remedy: is it worth it?

Most people already know that, to lose weight in a healthy way, the best way is to combine a balanced diet with the practice of physical activities. But there is no denying it: many people would like to be able to count on the help of a “magic formula”, which would make weight loss occur faster and without great suffering!

And it is usually with this in mind that some people end up resorting to weight loss remedies. But do they, in fact, provide safe weight loss? What are the risks of relying on the help of this type of medication? Anyway, is it worth betting on them?

Below you can find the main information about weight loss remedies and the opinion of an endocrinologist on the subject.

What are the drugs that promote weight loss?

When talking about weight loss drugs, sibutramine is probably the first name that comes to people’s minds. For a period, its sale was prohibited, but now it can, again, be bought in pharmacies, as long as it has a doctor’s prescription.

Fernando Moreno Sebastianes, endocrinologist and metabologist, with a PhD from USP-São Paulo, explains that, in addition to sibutramine, there is only orlistat (better known as Xenical) approved for weight loss in Brazil.

The endocrinologist points out that some medications, widely used in the past, such as fenproporex, amfepramone and mazindol, were suspended from the market a few years ago and are no longer sold in Brazil.

Also according to Sebastianes, there are also many herbal medicines that promise to help with weight loss, although, in most cases, they have not been subjected to adequate studies to confirm their supposed benefit.

“In other countries, there are two more options for treating obesity: lorcaserin and also a combination of topiramate and phentermine in the same pill. However, these drugs are not yet released for sale in Brazil”, adds Fernando Sebastianes.

How do weight-loss drugs work?

Fernando Sebastianes explains that sibutramine is a drug with action on the central nervous system, acting mainly in the control of satiety. “Most drugs do this, albeit at different points in the complex pathways that regulate hunger and satiety,” he says.

The endocrinologist adds that most drugs have a minimal effect of “accelerating metabolism”, which is not the main mechanism by which they act.

“Orlistat has a slightly different mode of action, where about 30% of ingested fat is eliminated in the faeces. This medication does not increase satiety (‘does not reduce appetite’)”, explains the professional.

Medicines that have weight loss as a side effect

It is worth mentioning that there are medicines that can have weight loss as a side effect. “However, they are not approved exclusively for weight loss, but rather for the treatment of other conditions”, says Sebastianes, who cites some examples:

  • Overweight and frequent migraine sufferers may benefit from treatment with topiramate as it helps prevent migraine attacks and can aid weight loss.
  • People who are very anxious or depressed and overweight can benefit, for example, from bupropion.
  • People with diabetes mellitus and weight loss may benefit from metformin, liraglutide, or even a new drug called dapaglifozin.

The endocrinologist emphasizes that an eventual prescription of any of these drugs for the treatment of obesity only characterizes the off-label use of the medication (practice of prescribing registered drugs for an indication not included in the product’s package insert), allowed by the CFM, but which must be well explained to the patient by the doctor.

“These are just some of the options we have. But it is worth noting that it is essential to always consult an endocrinologist before starting the use of any medication for weight loss”, adds Sebastianes.

Side effects of weight loss drugs

According to Sebastianes, most drugs are relatively safe as long as they are prescribed after a good medical evaluation. “However, like any medication, side effects can occur,” she says. He cites some examples below:

  • headache
  • Change in bowel habits (constipation or diarrhea)
  • Palpitations
  • Increase in blood pressure
  • Insomnia
  • Dry mouth
  • Irritability
  • mood swing
  • Depression
  • Anxiety
  • Tingles
  • Spots on the skin
  • memory change

The endocrinologist adds that, in very rare cases, even seizures are possible side effects of one or more of these drugs. “That’s why it’s important to have a medical evaluation before using them”, he highlights.

How can I buy weight loss pills?

Most weight loss drugs are sold under controlled conditions, that is, they are only sold with medical prescriptions. This is the case with sibutramine and orlistat.

Herbal medicines do not require a prescription. “However, we know that they can also have side effects. For example, those who have arrhythmias should avoid green tea, as it can worsen the condition. Therefore, I do not encourage the use of any of these drugs without first consulting a doctor”, highlights endocrinologist Sebastianes.

In which cases are weight loss remedies indicated?

Fernando Sebastianes explains, in general, in which cases weight loss drugs are indicated.

Obesity: this is a disease, like diabetes mellitus, whose treatment is based on the elaboration of a food plan, physical activity and, in some cases, medications and even bariatric surgery.

BMI (body mass index) > 30 kg/m2: the endocrinologist explains that, usually, the drugs are indicated in cases of patients with a BMI (body mass index) > 30 kg/m2, with difficulty in losing weight, only with improved diet and exercise.

Diseases associated with obesity: the presence of diseases associated with obesity (diabetes, hypertension, sleep apnea, etc.)

Anyway, is it worth adhering to weight loss drugs?

Many people comment that they have difficulties in losing weight, so they want to adhere to the remedies that promise faster weight loss. But is this really the way?

Unless the person falls into one of the cases mentioned above (whether obese, has a BMI greater than 30kg/m2, suffers from a disease associated with obesity), the recommendation is generally to follow a balanced diet and practice physical activities to lose weight. That is, without the help of medication, but with the guidance of a nutritionist and, preferably, a physical educator.

Often, the desire to lose weight is due only to an aesthetic issue. That is, the person wants to lose a few (few) pounds because they are not feeling well with their body. However, in these cases, drugs are hardly recommended. The best way, without a doubt, is to look for a nutritionist and start following healthy lifestyle habits.

It is also worth mentioning that weight loss drugs do not always offer lasting results, especially when the person does not understand that – in parallel with the use of the drug – they need to change their eating habits to achieve good results.

There are not a few reports of people who took a certain drug for this purpose for a while and, soon after, regained weight or even gained more pounds than they had lost during the regimen.

Therefore, it is worth mentioning, a person should never adhere to a weight loss medication without consulting a doctor first. This should only be an alternative when presented by a professional.

“My advice to people who have difficulties in losing weight, and who are thinking about adhering to the drugs, is to look for an endocrinologist who will be able to evaluate better on a case-by-case basis”, guides Sebastianes.

The endocrinologist adds that currently there are even more accurate means of analyzing how much weight a particular person needs to lose. “Through, for example, the bioimpedance exam it is possible to measure the amount of fat, water and body musculature. Achieving a good weight means achieving good body composition, with adequate levels of fat and muscle. In this way, it is possible to carry out a more personalized treatment for the needs of each patient and, depending on the current medical history, medications may or may not be indicated”, concludes Fernando Sebastianes.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.

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