“Taking “diet pills” can really be beneficial for patient who struggle to control their appetites, however, not all diet pills work the same in everyone and can be dangerous if not prescribed by a physician who has an expertise in medical weight loss“-Dr. Hayley DeGraaff, M.D.
Medically supervened weight loss programs can be life changing for patients who struggle with their weight and have appetite control issues. Up until very recently, we only had two generic appetite suppressants that were FDA approved. Over the last couple of years, there have been 4 new FDA approved weight loss medications come to that market and it has really given a tremendous variety of medications to chose from. There is has been a reluctance to approve any new medications for weight loss due to some adverse reactions from some weight loss mediactions approved in the past. These new medications has so far proved to be safe and well tolerated for most patients. Even though they are safe ALL medications for weight loss should be prescribed under very strict guidelines and by a physician well trained in obesity. So what are the most important things to know before taking a weight loss medication?
1. There still is NO magic pill!- Even though we have several NEW FDA approved weight loss medications available, there are still no magic weight loss pills that exist. Diet pills will only work if you put in your part and follow the diet and exercise program. Appetite control medications should be looked at as an aid or tool to a comprehensive overall diet plan and not just medication to give to an obese patient with no guidance on what to eat etc. In other words, doctors can’t just give a patient these medications and say “Good Luck” and expect them to succeed. You will still have to make significant changes to your lifestyle. We provide a program that actaully tells you what to eat while taking a weigh loss medications, what forms of exercise work best for weight loss, AND give you access to weekly nutritional counseling to ensure your success.
2. Remember the “30-30-30” rule! As a general rule, most medications follow what Dr. DeGraaff calls the “30-30-30” rule. This means that 30% of patients will respond very well to a medication and lose weight easily. 30% of patients will just do “OK” and lose some weight and 30% of patient usually find a certain medication doesn’t work at all. It is almost impossible to tell by looking at a patient which medication will give you the best result. It really depends on the patient. If the medication doesn’t seem to be helping, the good news is is that we have a whole new group of medications to chose from until we find the right medication for each patient. Patients should be prepared and open to the idea that several different medications my have to be tried until their goal weight is obtained.
3, Understand that there are differences in the medications and how they work and that they all have limitations. Until recently, the only FDA approved weight loss medications were in the “stimulant” class of medications. This included medications like Bontril and Adipex (phentermine). Patients will eventually build up a tolerance to these medications after several months of use and then patients find that they are struggling with hunger again. Most patients will have a 3-6 month window of opportunity before the medications stop working Some patients my not tolerate stimulant type of medications due to high blood pressure, heart or thyroid problems. The good news is is that a couple of the newer FDA approves medications are NOT in the stimulant class of medications and can be taken by patients with these health condition. The other limitation to weight loss medication in the past was that one a goal weight was reached, the medications had to be stopped. Now, we have medication that are FDA approved for long term use and for weight MAINTENANCE and not just weight loss! This was a great advancement becuase it has cut down on patients regaining the weigh they lost.
4. No method of weight loss is permanent! Yo-yo dieting and weight re-gain are two well know problems in the management of obesity. Even gastric bypass surgery patient can and DO regain weight in some cases. In fact, Dr. DeGraaff has had many gastric bypass patient need to go back on a medically supervised weight loss program because they were steadily gaining weight again. Patient need to be aware that they will more than likely be going on and off weight loss medications for the rest of their lives. Fortunately, there is no lifetime limit to how many times these medications can be taken. Patient should weigh themselves frequently after reaching their goal weight and consider restarting a weight loss medication after 6-8 pounds have been regained. So instead of losing 40-50 pounds over 6 months, the patient hopefully will only have to take a short round of the medication to lose the smaller amount of regained weight. Once again, the FDA has approved a couple of medications that can be used long term to prevent weight regain.
5. Don’t do anything dumb! Weight loss medications, MUST be taken exactly as prescribed. The old saying that if “one is good two is better” is definitely not a good idea then it comes to taking weight loss medications. Diet pills can have serious side effects if over used and should never be combined with other weight loss medications or over-the-counter weight loss supplements. It also, NEVER a good idea to take a friends or relatives left-over medications to see if they will work for you. These medications could interact with a health condition you have or other medications you may be taking. Also, these medications should be monitored closely and the law requires that a patient be seen monthly to get refilsl on the stimulant type medications. Make sure the doctor you are seeing has experience in prescribing these medication. Dr. DeGraaff has been prescribing these medications and treating obesity for almost 20 years and has treated hundreds of over weight patient safely and effectively!
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